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de Jong Y, Boon AE, Mulder CL, van der Gaag M. Do help-seeking adolescents report more psychotic-like experiences than young adults on the 16-item version of the prodromal questionnaire (PQ-16)? Early Interv Psychiatry 2025; 19:e13597. [PMID: 39092558 PMCID: PMC11730084 DOI: 10.1111/eip.13597] [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: 09/25/2023] [Revised: 06/29/2024] [Accepted: 07/10/2024] [Indexed: 08/04/2024]
Abstract
AIM To compare psychotic-like experiences (PLEs) in adolescents and young adults referred to the Mental Health Services (MHSs). METHODS Participants scored the 16-item Prodromal Questionnaire (PQ-16) as part of the intake procedure. Data on the Diagnostic and Statistical Manual of Mental Disorders (DSM) classification and demographic data were collected. RESULTS The PQ-16 was completed by 13 783 respondents (mean age 24.63 years, SD = 6.09; 62.6% female). Overall, the scores on the PQ-16 were not higher for adolescents (11-17 years; m = 4.84, SD = 3.62) than for young adults (18-35 years; m = 5.47, SD = 3.85). On PQ-16 item level, adolescents reported seeing and hearing things more than adults did. Across all age groups, males scored lower on the PQ-16 than females. Specifically, adolescent males scored lower than other participants. For adolescents and young adults alike, PQ-16 scores were higher for participants with borderline personality disorder, PTSD, and mood disorder than for those with other DSM classifications. CONCLUSIONS Although help-seeking adolescents did not score higher on the PQ-16 than help-seeking young adults, more of them reported perceptual anomalies. Irrespective of age, participants with borderline personality disorder, PTSD and mood disorder scored higher on the PQ-16 than those with other DSM classifications.
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Affiliation(s)
- Yvonne de Jong
- Youz Child and Adolescent PsychiatryParnassia Psychiatric InstituteRotterdam and The HagueThe Netherlands
- Department of Psychiatry, Epidemiological and Psychiatric Research instituteErasmus MCRotterdamThe Netherlands
| | - Albert E. Boon
- Youz Child and Adolescent PsychiatryParnassia Psychiatric InstituteRotterdam and The HagueThe Netherlands
- LUMC Curium—Child and Adolescent PsychiatryLeiden University Medical CenterLeidenThe Netherlands
| | - Cornelis L. Mulder
- Youz Child and Adolescent PsychiatryParnassia Psychiatric InstituteRotterdam and The HagueThe Netherlands
- Department of Psychiatry, Epidemiological and Psychiatric Research instituteErasmus MCRotterdamThe Netherlands
| | - Mark van der Gaag
- Department of Clinical PsychologyVrije UniversiteitAmsterdamThe Netherlands
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Alotaibi AM, Alosaimi MH, Alshammari NS, Orfali RS, Alwatban AZ, Alsharif RA, Meyer GF, Bentall RP. Exploring the relationship between hallucination proneness and brain morphology. Neuroimage 2024; 304:120942. [PMID: 39586342 DOI: 10.1016/j.neuroimage.2024.120942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2024] [Revised: 11/15/2024] [Accepted: 11/18/2024] [Indexed: 11/27/2024] Open
Abstract
BACKGROUND Hallucinations, including both auditory and visual forms, are often associated with alterations in brain structure, particularly in specific language-related cortical areas. Existing models propose different frameworks for understanding the relationship between brain volume and hallucination proneness, but practical evidence supporting these models is limited. METHODS This study investigated the relationship between hallucination proneness and brain volume in language-related cortical regions, specifically the superior temporal gyrus and Broca's area. A total of 68 participants, primarily university students, completed the Launay-Slade Hallucination Scale (LSHS) to assess hallucination proneness for both auditory and visual experiences. Structural MRI scans were used to measure brain volume in the targeted regions. RESULTS The results indicated significant positive correlations between LSHS scores and brain volume in the superior temporal gyrus and Broca's area regions previously linked to volume reductions in patients with clinically diagnosed hallucinations. Participants reporting high hallucination proneness for both auditory and visual hallucinations exhibited higher brain volumes in these language areas compared to those experiencing hallucinations rarely or never. CONCLUSIONS These findings challenge existing models by suggesting that higher brain volumes in language-related cortical areas may be associated with increased proneness to both auditory and visual hallucinations in non-clinical populations. This contrasts with the volume reductions seen in patients with clinical hallucinations and highlights the need for further research into the complex interplay between brain structure and hallucinatory experiences.
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Affiliation(s)
- Abdullah M Alotaibi
- Research Centre, King Fahad Medical City, Riyadh, 12231, Saudi Arabia; Clinical and Cognitive Neuroscience Group, Department of Experimental Psychology, Liverpool University, L69 7ZA, Liverpool, L69 7ZX, UK.
| | - Manal H Alosaimi
- Radiological Science Department, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia
| | | | - Razan S Orfali
- Research Centre, King Fahad Medical City, Riyadh, 12231, Saudi Arabia
| | - Adnan Z Alwatban
- Research Centre, King Fahad Medical City, Riyadh, 12231, Saudi Arabia
| | - Roaa A Alsharif
- Research Centre, King Fahad Medical City, Riyadh, 12231, Saudi Arabia
| | - Georg F Meyer
- Clinical and Cognitive Neuroscience Group, Department of Experimental Psychology, Liverpool University, L69 7ZA, Liverpool, L69 7ZX, UK.
| | - Richard P Bentall
- Department of Psychology, University of Sheffield, Cathedral Court, 1 Vicar Lane, Sheffield, S1 2LT, UK.
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Burton IJ, Tibbo PG, Ponto N, Crocker CE. Heterogeneity in assessing the risk of developing a psychotic disorder given a previous subclinical psychotic-like experience in children and adolescents: A systematic review and meta-analysis. Psychiatry Res 2024; 342:116207. [PMID: 39378536 DOI: 10.1016/j.psychres.2024.116207] [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: 04/02/2024] [Revised: 09/14/2024] [Accepted: 09/17/2024] [Indexed: 10/10/2024]
Abstract
Psychotic-like experiences (PLEs) are common in the general population. Child and adolescent PLEs are the most prevalent and linked with future psychotic disorders. Significant heterogeneity in PLE assessment has obscured its clinical utility to identify psychosis-prone trajectories and improve clinical outcomes. This meta-analysis aimed to assess i) PLE prevalence in children and adolescents and ii) their relationship with subsequent psychotic disorder while exploring sources of heterogeneity. PubMed, Embase, PsycINFO, and CINAHL databases were searched in August 2023 for population-based longitudinal studies that assessed child or adolescent PLEs and early adulthood psychotic outcomes. Six studies were included (n = 16,560), showing a pooled PLE prevalence of 17.3 %. Child and adolescent PLEs were associated with an increased risk of psychotic disorder in early adulthood (unadjusted OR = 3.80, 95 % CI: 2.31-6.26), with a population attributable fraction of 32.6 %. Significant heterogeneity in the strength of this relationship (I2 = 70 %, p = .01) was related to assessment type (self-report vs. interview). This review contends that interview-based PLE assessments could more accurately identify children or adolescents on a path towards psychosis and are better suited for psychotic risk identification. Further research is needed to elucidate interactions between PLEs and other psychotic risk factors.
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Affiliation(s)
- Isaiah J Burton
- Department of Psychiatry, Dalhousie University, 5909 Veterans' Memorial Lane, 8th Floor, Abbie J Lane Building, QEII Health Sciences Centre, Halifax, NS, B3H 2E2, Canada.
| | - Philip G Tibbo
- Department of Psychiatry, Dalhousie University, 5909 Veterans' Memorial Lane, 8th Floor, Abbie J Lane Building, QEII Health Sciences Centre, Halifax, NS, B3H 2E2, Canada; Early Psychosis Intervention Nova Scotia (EPINS), Nova Scotia Health Authority, 5909 Veterans' Memorial Lane, Halifax, NS, B3H 2E2, Canada; Department of Psychology and Neuroscience, Dalhousie University, 6287 Alumni Crescent, 3rd Floor Life Sciences Centre, Halifax, NS, B3H 4R2, Canada
| | - Nicole Ponto
- Department of Medical Neuroscience, Dalhousie University, Sir Charles Tupper Medical Building, 5850 College Street, Halifax, NS, B3H 4R2, Canada
| | - Candice E Crocker
- Department of Psychiatry, Dalhousie University, 5909 Veterans' Memorial Lane, 8th Floor, Abbie J Lane Building, QEII Health Sciences Centre, Halifax, NS, B3H 2E2, Canada; Department of Diagnostic Radiology, Dalhousie University, Victoria Building, 1276 South Park Street, Halifax, NS, B3H 2Y9, Canada
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McCluskey A, Watson C, Nugent L, O'Connor T, Moore Z, Molloy L, Patton D. 'Sometimes You Have No Choice but to Give Them Medication': Experiences of Nurses Caring for People With Auditory Hallucinations in an Acute Unit. Int J Ment Health Nurs 2024; 33:2193-2202. [PMID: 38965712 DOI: 10.1111/inm.13380] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2024] [Revised: 06/01/2024] [Accepted: 06/04/2024] [Indexed: 07/06/2024]
Abstract
The aim of this study was to explore psychiatric nurse's experiences of caring for people with auditory hallucinations in an acute unit. A qualitative study was conducted using thematic analysis. The study involved semi-structured interviews with 18 acute unit nurses all of whom provided interventions to patients with auditory hallucinations. Overall, participants identified their role in the management of risk within an acute unit, the importance of their therapeutic role and a perceived over-reliance on medication administration as a primary nursing intervention. These findings thus demonstrate the personal and professional conflict that nurses face when working in an acute unit with patients who experience auditory hallucinations. Nurses are in a prime position to provide effective interventions and assistance for people with auditory hallucinations in an acute unit. The findings of this study indicate that mental health nurses may require additional support and education to provide care in a truly recovery-based manner, with training in specific interventions and engagement skills for people who hear voices. Due to an unpredictable environment and sometimes high-risk workplace, nurses may also benefit from organisational assistance in this area.
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Affiliation(s)
- Anita McCluskey
- School of Nursing and Midwifery, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Chanel Watson
- School of Nursing and Midwifery, RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Linda Nugent
- School of Nursing and Midwifery, RCSI University of Medicine and Health Sciences, Dublin, Ireland
- Department of Nursing, Fakeeh College of Health Sciences, Jeddah, Saudi Arabia
| | - Tom O'Connor
- Department of Nursing, Fakeeh College of Health Sciences, Jeddah, Saudi Arabia
- School of Nursing and Midwifery and Lead Researcher, Skin Wounds and Trauma Research Centre, RCSI University of Medicine and Health Sciences, Dublin, Ireland
- Department of Nursing, Lida Institute, Shanghai, China
- School of Nursing and Midwifery, Griffith University, Brisbane, Queensland, Australia
| | - Zena Moore
- Department of Nursing, Fakeeh College of Health Sciences, Jeddah, Saudi Arabia
- School of Nursing and Midwifery and Lead Researcher, Skin Wounds and Trauma Research Centre, RCSI University of Medicine and Health Sciences, Dublin, Ireland
- Department of Nursing, Lida Institute, Shanghai, China
- School of Nursing and Midwifery, Griffith University, Brisbane, Queensland, Australia
- Faculty of Medicine, Nursing and Health Sciences, Monash University, Melbourbe, Victoria, Australia
- Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
- University of Wales, Cardiff, UK
| | - Luke Molloy
- Department of Medicine and Health, School of Nursing, Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
| | - Declan Patton
- Department of Nursing, Fakeeh College of Health Sciences, Jeddah, Saudi Arabia
- School of Nursing and Midwifery, Griffith University, Brisbane, Queensland, Australia
- Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
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Zold AL, Jourdain MK. Empathy Amplified: Exploring the Transformative Potential of Understanding Auditory Hallucinations Through Staff Training. J Am Psychiatr Nurses Assoc 2024; 30:989-997. [PMID: 38767121 DOI: 10.1177/10783903241252162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/22/2024]
Abstract
BACKGROUND Stigmatization of individuals diagnosed with psychosis, especially those who experience auditory hallucinations, is a well-documented issue with negative outcomes on provision of care. Existing research has predominantly concentrated on experiential training for students, leaving a significant gap in knowledge regarding the training's impact on practicing psychiatric nurses and technicians. AIMS This study aims to address this gap by investigating the efficacy of a concise, 1-hour educational activity designed to improve empathy, confidence, competence, and knowledge in psychiatric professionals. METHODS Participants engaged in a 1-hour training session that included simulated activities while listening to distressing voices and completed pretraining and posttraining assessments. RESULTS Results demonstrated a notable increase in empathy toward individuals who hear voices, suggesting that the training had a positive effect. Furthermore, significant differences were observed in the participants' perceptions of the level of difficulty as well as increased levels of confidence and perceived competence in their ability to provide care. CONCLUSIONS The results underscore the practicality and effectiveness of brief hearing voices simulations as a means to enhance the skills of existing health care providers. This approach allows professionals to better express empathy and gain a deeper understanding of the experiences of voice hearers.
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Affiliation(s)
- Amanda Lynn Zold
- Amanda Lynn Zold, PhD, Hartford Hospital, Hartford, CT, USA; The University of Texas Health Science Center, Houston, TX, USA
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Nishiura S, Miyawaki D, Hirai K, Sukigara A, Kakishita Y, Inoue K. Association between hallucinations and sensory processing difficulties in children and adolescents. Front Psychiatry 2024; 15:1472328. [PMID: 39435125 PMCID: PMC11491950 DOI: 10.3389/fpsyt.2024.1472328] [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: 07/29/2024] [Accepted: 09/16/2024] [Indexed: 10/23/2024] Open
Abstract
Introduction Hallucinations are serious symptoms that can lead to high levels of distress, functional impairment, and increased risk of suicide in both adults and children. However, their etiology and treatment remain unclear. Hallucinations and sensory processing difficulties (SPDs) are associated with various psychiatric disorders, including mood, anxiety, and post-traumatic stress disorder. This study aimed to investigate the potential association between hallucinations and SPDs in a pediatric population. Methods We conducted a cross-sectional study with 335 children aged 6-18 years who visited the child psychiatry outpatient clinic at Osaka Metropolitan University Hospital between April 2020 and March 2023 and continued treatment for at least three months. After excluding those with intellectual disabilities or uncontrolled epilepsy, 304 participants were included in the analyses. The presence of hallucinations was assessed through interviews with the children and their parents. SPDs were evaluated using the Short Sensory Profile. Binomial logistic regression analysis was conducted to assess the association between hallucinations and SPDs, adjusting for age, sex, autism spectrum disorder, socioeconomic difficulties (low-income, single-parent households), and the presence of mood and anxiety disorders. Results Hallucinations were present in 64 children (21%). Logistic regression analysis showed a significant positive association between SPDs and hallucinations, even after adjusting for age, sex, autism spectrum disorder, socioeconomic difficulties, and the presence of mood and anxiety disorders (odds ratio, 1.02; 95% CI, 1.008-1.036; p = 0.002). Conclusion The results of this study suggest a potential association between hallucinations and SPDs in pediatric patients. Further prospective studies are needed to explore the causal relationship between these factors and determine whether interventions for SPDs can alleviate hallucinations in children.
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Affiliation(s)
- Sayaka Nishiura
- Department of Neuropsychiatry, Osaka City University Graduate School of Medicine, Osaka, Japan
- Department of Neuropsychiatry, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Dai Miyawaki
- Department of Neuropsychiatry, Osaka City University Graduate School of Medicine, Osaka, Japan
- Department of Child and Adolescent Psychiatry, Osaka City General Hospital, Osaka, Japan
| | - Kaoru Hirai
- Department of Neuropsychiatry, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Ayaka Sukigara
- Department of Neuropsychiatry, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Yui Kakishita
- Department of Pediatrics, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
| | - Koki Inoue
- Department of Neuropsychiatry, Osaka Metropolitan University Graduate School of Medicine, Osaka, Japan
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Marschall TM, Brederoo SG, Koops S, Ćurčić-Blake B, Sommer IEC. Content-based clustering of hallucinations across sensory modalities in a large online survey. Sci Rep 2024; 14:23108. [PMID: 39367045 PMCID: PMC11452635 DOI: 10.1038/s41598-024-69798-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Accepted: 08/08/2024] [Indexed: 10/06/2024] Open
Abstract
Hallucinations can have rather heterogeneous aetiology and presentation. This inspired the concept of different subtypes based on symptom profiles, especially in the field of auditory hallucinations. As many people experience hallucinations in more than one sensory modality, it seems important to investigate potential hallucination subtypes across different sensory modalities. We assessed the content of hallucinations as part of a large survey among the general Dutch population (n = 10,448) using the Questionnaire for Psychotic Experiences. Based on their descriptions, thematic categories were created in a data-driven cluster analysis. 2594 participants who experienced hallucinations over the past week that contained at least 2 different thematic categories were selected. Clustering of their hallucination content was performed with the HDBSCAN method. We identified 4 clusters, i.e., subtypes, which can be typified as 1. hallucinations of foul odors, 2. complex visual scenes, 3. a vast variety of rather common hallucinations possibly related to heightened alertness, and 4. possibly bereavement hallucinations. The bereavement subtype showed an increase in emotional loneliness and the presence of delusions. Our findings suggest that the content of hallucinations can be informative, especially when investigated across sensory modalities. Such subtypes may help to better understand their underlying mechanisms.
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Affiliation(s)
- Theresa M Marschall
- Department of Psychiatry, University of Groningen, University Medical Center Groningen, Antonius Deusinglaan 2, 9713 AW, Groningen, The Netherlands.
| | - Sanne G Brederoo
- Department of Psychiatry, University of Groningen, University Medical Center Groningen, Antonius Deusinglaan 2, 9713 AW, Groningen, The Netherlands
| | - Sanne Koops
- Department of Psychiatry, University of Groningen, University Medical Center Groningen, Antonius Deusinglaan 2, 9713 AW, Groningen, The Netherlands
| | - Branislava Ćurčić-Blake
- Department of Psychiatry, University of Groningen, University Medical Center Groningen, Antonius Deusinglaan 2, 9713 AW, Groningen, The Netherlands
| | - Iris E C Sommer
- Department of Psychiatry, University of Groningen, University Medical Center Groningen, Antonius Deusinglaan 2, 9713 AW, Groningen, The Netherlands
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Pinheiro AP, Aucouturier JJ, Kotz SA. Neural adaptation to changes in self-voice during puberty. Trends Neurosci 2024; 47:777-787. [PMID: 39214825 DOI: 10.1016/j.tins.2024.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2024] [Revised: 07/18/2024] [Accepted: 08/01/2024] [Indexed: 09/04/2024]
Abstract
The human voice is a potent social signal and a distinctive marker of individual identity. As individuals go through puberty, their voices undergo acoustic changes, setting them apart from others. In this article, we propose that hormonal fluctuations in conjunction with morphological vocal tract changes during puberty establish a sensitive developmental phase that affects the monitoring of the adolescent voice and, specifically, self-other distinction. Furthermore, the protracted maturation of brain regions responsible for voice processing, coupled with the dynamically evolving social environment of adolescents, likely disrupts a clear differentiation of the self-voice from others' voices. This socioneuroendocrine framework offers a holistic understanding of voice monitoring during adolescence.
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Affiliation(s)
- Ana P Pinheiro
- Faculdade de Psicologia, Universidade de Lisboa, Alameda da Universidade, 1649-013 Lisboa, Portugal.
| | | | - Sonja A Kotz
- Maastricht University, Maastricht, The Netherlands; Max Planck Institute for Human Cognitive and Brain Sciences, Leipzig, Germany
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Dumas LE, Fernandez A, Auby P, Askenazy F. Relationship between social cognition and emotional markers and acoustic-verbal hallucination in youth with post-traumatic stress disorder: Protocol for a prospective, 2-year, longitudinal case-control study. PLoS One 2024; 19:e0306338. [PMID: 38954699 PMCID: PMC11218996 DOI: 10.1371/journal.pone.0306338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 06/11/2024] [Indexed: 07/04/2024] Open
Abstract
INTRODUCTION Auditory-verbal hallucinatory experiences (AVH) have a 12% prevalence in the general pediatric population. Literature reports a higher risk of developing AVH in post-traumatic stress disorder (PTSD). The persistence of AVHs during adolescence represents a risk of evolution into psychotic disorders. Social cognition and emotional markers could be considered prodromes markers of this evolution. The objectives of this prospective observational study are to observe social cognition and emotional markers correlation with the presence and persistence of AVH over two years and with the evolution of PTSD and psychotic diagnosis. METHODS AND ANALYSIS This prospective case-control study, longitudinal over two years (with an interim reassessment at six months and one year), will include 40 participants aged 8 to 16 years old with a diagnosis of PTSD and without a diagnosis of psychosis according to the criteria of DSM-5 (K-SADS-PL). Subjects included are divided into two groups with AVH and without AVH matched by gender, age and diagnosis. The primary outcome measure will be the correlation between social cognition and emotional makers and the presence of AVH in the PTSD pediatric population without psychotic disorders. The social cognition marker is assessed with the NEPSY II test. The emotional marker is assessed with the Differential Emotion Scale IV and the Revised Beliefs About Voices Questionnaire. The secondary outcome measures are the correlation of these markers with the persistence of AVH and the evolution of the patient's initial diagnosis two years later. DISCUSSION The originality of our protocol is to explore the potential progression to psychosis from PTSD by cognitive biases. This study supports the hypothesis of connections between PTSD and AVH through sensory, emotional and cognitive biases. It proposes a continuum model from PTSD to psychotic disorder due to impaired perception like AVH. TRIAL REGISTRATION Clinical trial registration: ClinicalTrials.gov Identifier: NCT03356028.
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Affiliation(s)
- Louise-Emilie Dumas
- University Department of Child and Adolescent Psychiatry, Pediatric Hospitals of Nice CHU-Lenval, Nice, France
- Université Côte d’Azur, CoBTek, FRIS, Nice, France
| | - Arnaud Fernandez
- University Department of Child and Adolescent Psychiatry, Pediatric Hospitals of Nice CHU-Lenval, Nice, France
- Université Côte d’Azur, CoBTek, FRIS, Nice, France
- Expert Center for Psychotrauma Paca Corse, Nice, France
| | - Philippe Auby
- University Department of Child and Adolescent Psychiatry, Pediatric Hospitals of Nice CHU-Lenval, Nice, France
- Université Côte d’Azur, CoBTek, FRIS, Nice, France
| | - Florence Askenazy
- University Department of Child and Adolescent Psychiatry, Pediatric Hospitals of Nice CHU-Lenval, Nice, France
- Université Côte d’Azur, CoBTek, FRIS, Nice, France
- Expert Center for Psychotrauma Paca Corse, Nice, France
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Rodell S, Parry S. Family members' experiences of seeking help for a young person with symptoms associated with the psychosis spectrum: A narrative review and synthesis. Clin Child Psychol Psychiatry 2024; 29:897-912. [PMID: 37188330 PMCID: PMC11188561 DOI: 10.1177/13591045231176701] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
Young people often rely on family carers to access support for their mental health. However, stigma can be a barrier to help seeking for young people and families. Little research has been undertaken with young people who experience highly stigmatised symptoms, such as psychosis spectrum symptoms, and even less research has been conducted with parents and carers, meaning barriers to help go unchallenged. Therefore, this narrative review aimed to explore stories of family experiences of seeking help for young people with symptoms associated with the psychosis spectrum. Sources searched were PsycINFO and PubMed. Reference lists of the selected papers were also cross-checked to ensure the search had not missed potential papers for inclusion. Searches returned 139 results, of which 12 were identified for inclusion. A narrative analytic approach was adopted to synthesise qualitative findings to provide a nuanced interpretation of help-seeking experiences. The narrative synthesis provided an opportunity to identify differences, similarities, and patterns across the studies to tell a cumulative emancipatory narrative of family experiences of seeking help for psychosis spectrum symptoms. Help-seeking experiences had a relational impact on families, with stress adding to conflict and anxieties inhibiting hopefulness, although families could emerge stronger and assertively with compassionate support.
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Affiliation(s)
- Sadie Rodell
- Doctorate of Clinical Psychology, Lancaster University, Lancaster, United Kingdom
| | - Sarah Parry
- Division of Health Research, Lancaster University, Lancaster, LA1 4YW, United Kingdom
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D'Andrea G, Quattrone D, Malone K, Tripoli G, Trotta G, Spinazzola E, Gayer-Anderson C, Jongsma HE, Sideli L, Stilo SA, La Cascia C, Ferraro L, Lasalvia A, Tosato S, Tortelli A, Velthorst E, de Haan L, Llorca PM, Rossi Menezes P, Santos JL, Arrojo M, Bobes J, Sanjuán J, Bernardo M, Arango C, Kirkbride JB, Jones PB, Rutten BP, Van Os J, Selten JP, Vassos E, Schürhoff F, Szöke A, Pignon B, O'Donovan M, Richards A, Morgan C, Di Forti M, Tarricone I, Murray RM. Variation of subclinical psychosis across 16 sites in Europe and Brazil: findings from the multi-national EU-GEI study. Psychol Med 2024; 54:1810-1823. [PMID: 38288603 DOI: 10.1017/s0033291723003781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/22/2024]
Abstract
BACKGROUND Incidence of first-episode psychosis (FEP) varies substantially across geographic regions. Phenotypes of subclinical psychosis (SP), such as psychotic-like experiences (PLEs) and schizotypy, present several similarities with psychosis. We aimed to examine whether SP measures varied across different sites and whether this variation was comparable with FEP incidence within the same areas. We further examined contribution of environmental and genetic factors to SP. METHODS We used data from 1497 controls recruited in 16 different sites across 6 countries. Factor scores for several psychopathological dimensions of schizotypy and PLEs were obtained using multidimensional item response theory models. Variation of these scores was assessed using multi-level regression analysis to estimate individual and between-sites variance adjusting for age, sex, education, migrant, employment and relational status, childhood adversity, and cannabis use. In the final model we added local FEP incidence as a second-level variable. Association with genetic liability was examined separately. RESULTS Schizotypy showed a large between-sites variation with up to 15% of variance attributable to site-level characteristics. Adding local FEP incidence to the model considerably reduced the between-sites unexplained schizotypy variance. PLEs did not show as much variation. Overall, SP was associated with younger age, migrant, unmarried, unemployed and less educated individuals, cannabis use, and childhood adversity. Both phenotypes were associated with genetic liability to schizophrenia. CONCLUSIONS Schizotypy showed substantial between-sites variation, being more represented in areas where FEP incidence is higher. This supports the hypothesis that shared contextual factors shape the between-sites variation of psychosis across the spectrum.
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Affiliation(s)
- Giuseppe D'Andrea
- University of Montreal Hospital Reseach Centre (CRCHUM), Montréal, Québec, Canada
- Douglas Mental Health University Institute, Prevention and Early Intervention Program for Psychosis (PEPP-Montréal), Montréal, Québec, Canada
- Community Mental Health Center of Sassuolo, Department of Mental Health and Drug Abuse, AUSL Modena, Modena, Italy
| | - Diego Quattrone
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Kathryn Malone
- Central and North West London NHS Foundation Trust, London, UK
| | - Giada Tripoli
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), Psychiatry Section, University of Palermo, Palermo, Italy
- Department of Health Promotion, Mother and Child Care, Internal Medicine and Medical Specialties, University of Palermo, Piazza delle Cliniche, Palermo, Italy
| | - Giulia Trotta
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Edoardo Spinazzola
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Charlotte Gayer-Anderson
- ESRC Center for Society and Mental Health, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Hannah E Jongsma
- Centre for Transcultural Psychiatry 'Veldzicht', Balkbrug, The Netherlands
- University Centre for Psychiatry, University Medical Centre Groningen, Groningen, The Netherlands
| | - Lucia Sideli
- Department of Human Science, LUMSA University, Rome, Italy
| | - Simona A Stilo
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Department of Mental Health and Addiction Services, ASP Crotone, Crotone, Italy
| | - Caterina La Cascia
- Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), Psychiatry Section, University of Palermo, Palermo, Italy
| | - Laura Ferraro
- Department of Biomedicine, Neuroscience and Advanced Diagnostics (BiND), Psychiatry Section, University of Palermo, Palermo, Italy
| | - Antonio Lasalvia
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement, University of Verona, Piazzale L.A. Scuro 10, Verona, Italy
| | - Sarah Tosato
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement, University of Verona, Piazzale L.A. Scuro 10, Verona, Italy
| | | | - Eva Velthorst
- Department of Research, Community Mental Health Service, GGZ Noord-Holland-Noord, The Netherlands
| | - Lieuwe de Haan
- Department of Psychiatry, Amsterdam UMC, Amsterdam, The Netherlands
| | | | - Paulo Rossi Menezes
- University Hospital, Section of Epidemiology, University of São Paulo, São Paulo, Brazil
| | - Jose Luis Santos
- Department of Psychiatry, Servicio de Psiquiatría Hospital "Virgen de la Luz", Cuenca, Spain
| | - Manuel Arrojo
- Department of Psychiatry, Psychiatric Genetic Group, Instituto de Investigación Sanitaria de Santiago de Compostela, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago, Spain
| | - Julio Bobes
- Department of Medicine, Psychiatry Area, School of Medicine, Universidad de Oviedo, ISPA, Ineuropa, CIBERSAM, Oviedo, Spain
| | - Julio Sanjuán
- Department of Psychiatry, School of Medicine, Universidad de Valencia, Centro de Investigación Biomédica en Red de Salud Mental, Valencia, Spain
| | - Miguel Bernardo
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic, Departament de Medicina, Institut de Neurociències (UBNeuro), Universitat de Barcelona (UB), Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), CIBERSAM, ISCIII, Barcelona, Spain
| | - Celso Arango
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, School of Medicine, Universidad Complutense, CIBERSAM, Centro de Investigación Biomédica en Red de Salud Mental, Madrid, Spain
| | | | - Peter B Jones
- Department of Psychiatry, University of Cambridge, Cambridge, England, UK
| | - Bart P Rutten
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Jim Van Os
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- School for Mental Health and Neuroscience, University of Maastricht, Maastricht, The Netherlands
| | - Jean-Paul Selten
- School for Mental Health and Neuroscience, University of Maastricht, Maastricht, The Netherlands
| | - Evangelos Vassos
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Franck Schürhoff
- Univ Paris Est Creteil, INSERM, IMRB, AP-HP, Hôpitaux Universitaires « H. Mondor », DMU IMPACT, Fondation Fondamental, Creteil, France
| | - Andrei Szöke
- Univ Paris Est Creteil, INSERM, IMRB, AP-HP, Hôpitaux Universitaires « H. Mondor », DMU IMPACT, Fondation Fondamental, Creteil, France
| | - Baptiste Pignon
- Univ Paris Est Creteil, INSERM, IMRB, AP-HP, Hôpitaux Universitaires « H. Mondor », DMU IMPACT, Fondation Fondamental, Creteil, France
| | - Michael O'Donovan
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - Alexander Richards
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - Craig Morgan
- ESRC Center for Society and Mental Health, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Marta Di Forti
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Ilaria Tarricone
- Department of Medical and Surgical Sciences, Bologna Transcultural Psychosomatic Team (BoTPT), University of Bologna, Bologna, Italy
- Department of Mental Health and Pathological Addiction, AUSL Bologna, Bologna, Italy
| | - Robin M Murray
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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12
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Wang D, Chen XY, Scherffius A, Yu Z, Wang X, Sun M, Fan F. Perceived school bullying and psychotic-like experiences in sexual minority adolescents: the mediating and moderating roles of resilience. Child Adolesc Psychiatry Ment Health 2024; 18:55. [PMID: 38755658 PMCID: PMC11100180 DOI: 10.1186/s13034-024-00747-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Accepted: 05/06/2024] [Indexed: 05/18/2024] Open
Abstract
AIMS This two-wave, longitudinal study aimed to examine the potential moderating and mediating effects of resilience on the association between perceived school bullying and psychotic-like experiences among Chinese sexual minority adolescents. METHODS A total of 4192 senior high students were included and 984 (23.5%) of them were identified as a sexual minority (mean age = 16.68 years, SD = 0.71). Participants completed two online surveys during April 21 to May 12, 2021 and December 17 to 26, 2021, respectively, as well as completed self-report measures of sample characteristics, perceived school bullying, resilience, and psychotic-like experiences (including two dimensions: delusional experiences and hallucinatory experiences). RESULTS Perceived school bullying and resilience were associated with psychotic-like experiences in sexual minority adolescents. Resilience mediated the relationship between perceived school bullying and subsequent psychotic-like experiences (b = 0.03, 95% CI = 0.01 ~ 0.04)/ delusional experiences (b = 0.03, 95% CI = 0.01 ~ 0.04)/ hallucinatory experiences (b = 0.02, 95% CI = 0.01 ~ 0.03). Additionally, resilience only moderated the associations of perceived school bullying with hallucinatory experiences (b = -0.06, 95% CI = -0.12 ~ -0.01). CONCLUSIONS These findings indicated that resilience plays a crucial role in mediating or moderating the relationship between perceived school bullying and psychotic-like experiences. Assessing and reducing school bullying, as well as promoting resilience, may have important clinical implications for reducing the risk of psychotic-like experiences in sexual minority adolescents.
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Affiliation(s)
- Dongfang Wang
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, Guangdong Emergency Response Technology Research Center for Psychological Assistance in Emergencies, South China Normal University, Guangzhou, China
| | - Xiao-Yan Chen
- School of Psychology, Fujian Normal University, Fuzhou, China
| | - Andrew Scherffius
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Zhijun Yu
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, Guangdong Emergency Response Technology Research Center for Psychological Assistance in Emergencies, South China Normal University, Guangzhou, China
| | - Xuan Wang
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, Guangdong Emergency Response Technology Research Center for Psychological Assistance in Emergencies, South China Normal University, Guangzhou, China
| | - Meng Sun
- Department of Social Psychiatry, The Affiliated Brain Hospital of Guangzhou Medical University (Guangzhou Huiai Hospital), Guangzhou, China
| | - Fang Fan
- School of Psychology, Centre for Studies of Psychological Applications, Guangdong Key Laboratory of Mental Health and Cognitive Science, Ministry of Education Key Laboratory of Brain Cognition and Educational Science, Guangdong Emergency Response Technology Research Center for Psychological Assistance in Emergencies, South China Normal University, Guangzhou, China.
- School of Psychology, South China Normal University, Shipai Road, Guangzhou, China.
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13
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Aldhafeeri FM. Altered brain responses to emotional auditory stimuli in AVH subjects: an fMRI study. Int J Neurosci 2024; 134:333-340. [PMID: 35849653 DOI: 10.1080/00207454.2022.2102977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Revised: 03/07/2022] [Accepted: 06/30/2022] [Indexed: 10/17/2022]
Abstract
Purpose: Auditory verbal hallucinations (AVH) are a frequently occurring phenomenon in which subjects hear verbal sounds in the absence of any external stimuli. The prevalence of auditory hallucinations in schizophrenia has been revealed in many studies. Healthy subjects may also experience auditory hallucinations without accompanying psychological or neurological disorders, and in rare cases they seek clinical assistance for this emotionally disturbing condition. The aim of this study was to investigate the neural basis of emotional disturbance in auditory hallucinating subjects who do not suffer from any psychological or neurological disorder. Materials and Methods: Fourteen subjects suffering from auditory hallucinations and 15 age- and sex-matched healthy controls were recruited in this study. All participants underwent fMRI in two experimental sessions. In the first experimental session, all participants from both groups listened to pleasant auditory stimuli. In the second session, both groups listened to unpleasant auditory stimuli. The auditory stimuli were obtained from the International Affective Digitized Sounds (IADS). Results: Compared with the healthy control group, AVH subjects exhibited significantly increased activation in limbic, auditory, and frontal regions. Conclusion: Current results suggest that AVH may induce functional reorganization in emotion-related brain regions.
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Affiliation(s)
- Faten Mane Aldhafeeri
- Department of Radiology, College of Applied Medical Sciences, University of Hafr Albatin, Hafr Albatin, Saudi Arabia
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14
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Anagnostopoulou N, Papachristou E, Galitzer H, Alba A, Gaete J, Dima D, Rogdaki M, Salazar de Pablo G, Kyriakopoulos M. Psychotic symptoms with and without a primary psychotic disorder in children requiring inpatient mental health admission. Eur Psychiatry 2024; 67:e25. [PMID: 38439671 PMCID: PMC10988161 DOI: 10.1192/j.eurpsy.2024.23] [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: 12/19/2023] [Revised: 02/14/2024] [Accepted: 02/15/2024] [Indexed: 03/06/2024] Open
Abstract
Psychotic symptoms are relatively common in children and adolescents attending mental health services. On most occasions, their presence is not associated with a primary psychotic disorder, and their clinical significance remains understudied. No studies to date have evaluated the prevalence and clinical correlates of psychotic symptoms in children requiring inpatient mental health treatment. All children aged 6 to 12 years admitted to an inpatient children's unit over a 9-year period were included in this naturalistic study. Diagnosis at discharge, length of admission, functional impairment, and medication use were recorded. Children with psychotic symptoms without a childhood-onset schizophrenia spectrum disorder (COSS) were compared with children with COSS and children without psychotic symptoms using Chi-square and linear regressions. A total of 211 children were admitted during this period with 62.4% experiencing psychotic symptoms. The most common diagnosis in the sample was autism spectrum disorder (53.1%). Psychotic symptoms were not more prevalent in any diagnosis except for COSS (100%) and intellectual disability (81.8%). Psychotic symptoms were associated with longer admissions and antipsychotic medication use. The mean length of admission of children with psychotic symptoms without COSS seems to lie in between that of children without psychotic symptoms and that of children with COSS. We concluded that psychotic symptoms in children admitted to the hospital may be a marker of severity. Screening for such symptoms may have implications for treatment and could potentially contribute to identifying more effective targeted interventions and reducing overall morbidity.
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Affiliation(s)
| | | | - Hayley Galitzer
- South London and Maudsley NHS Foundation Trust, London, UK
- Division of Internal Medicine, Stanford University School of Medicine, Stanford, CA, USA
| | - Anca Alba
- South London and Maudsley NHS Foundation Trust, London, UK
- Counselling London and Mental Health Support Service, King’s College London, London, UK
| | - Jorge Gaete
- South London and Maudsley NHS Foundation Trust, London, UK
- Faculty of Education, Universidad de los Andes, Santiago, Chile
- Millennium Nucleus to Improve the Mental Health of Adolescents and Youths (Imhay), Santiago, Chile
| | - Danai Dima
- Department of Psychology, School of Health and Psychological Sciences, City, University of London, London, UK
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Maria Rogdaki
- South London and Maudsley NHS Foundation Trust, London, UK
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
| | - Gonzalo Salazar de Pablo
- South London and Maudsley NHS Foundation Trust, London, UK
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
- Institute of Psychiatry and Mental Health, Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón School of Medicine, Universidad Complutense, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), CIBERSAM, Madrid, Spain
| | - Marinos Kyriakopoulos
- South London and Maudsley NHS Foundation Trust, London, UK
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK
- 1st Department of Psychiatry, National and Kapodistrian University of Athens, Athens, Greece
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15
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Toh WL, Yolland CO, Li Y, Sommer IE, Rossell S. Multisensory Hallucinatory Experiences in Migraine: A Preliminary Basis for Olfactory, Somatic-Tactile, and Gustatory Auras. Neurol Clin Pract 2024; 14:e200217. [PMID: 38045728 PMCID: PMC10691754 DOI: 10.1212/cpj.0000000000200217] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 10/27/2023] [Indexed: 12/05/2023]
Abstract
Background and Objectives Visual auras in migraine have been extensively studied, but less is known about unusual experiences in other sensory domains, including whether they should be diagnostically considered as part of aura symptoms. This study aimed to examine the prevalence of multisensory aura experiences in migraine and their phenomenologic and clinical correlates. Methods Respondents were 729 participants with probable migraine, who completed an online study examining unusual sensory experiences. These comprised aura experiences in the auditory, visual, olfactory, somatic-tactile, and gustatory domains. Basic demographic and clinical information and migraine symptomatology were also collected. To facilitate groupwise comparisons, participants with probable migraine were divided into those with and without (visual) aura experiences. Results Endorsement of visual aura experiences was the highest (42.1%), whether in a single modality (44.2%) or multiple (55.8%) modalities, followed by somatic-tactile (32.0%), gustatory (21.9%), olfactory (18.6%), and auditory (11.0%) domains. Phenomenologic similarities, for instance, in frequency, personification, and controllability, existed across sensory domains. Somatic-tactile and gustatory auras conversely exhibited greater duration and negative emotional valence. Participants with probable migraine with visual aura tended to report significantly more severe migraine symptoms relative to those with nonvisual or no aura. Discussion Our findings provide preliminary indication that unusual olfactory, somatic-tactile, and gustatory experiences in migraine are common and could be clinically significant as aura symptoms. Increased clinician and patient awareness and effective management of these symptoms are essential for a holistic therapeutic approach to migraine.
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Affiliation(s)
- Wei Lin Toh
- Centre for Mental Health & Brain Sciences (WLT, COY, YL, SR), Swinburne University of Technology, Melbourne, Victoria, Australia; and University Medical Center Groningen (IES), University of Groningen, The Netherlands
| | - Caitlin O Yolland
- Centre for Mental Health & Brain Sciences (WLT, COY, YL, SR), Swinburne University of Technology, Melbourne, Victoria, Australia; and University Medical Center Groningen (IES), University of Groningen, The Netherlands
| | - Yixuan Li
- Centre for Mental Health & Brain Sciences (WLT, COY, YL, SR), Swinburne University of Technology, Melbourne, Victoria, Australia; and University Medical Center Groningen (IES), University of Groningen, The Netherlands
| | - Iris E Sommer
- Centre for Mental Health & Brain Sciences (WLT, COY, YL, SR), Swinburne University of Technology, Melbourne, Victoria, Australia; and University Medical Center Groningen (IES), University of Groningen, The Netherlands
| | - Susan Rossell
- Centre for Mental Health & Brain Sciences (WLT, COY, YL, SR), Swinburne University of Technology, Melbourne, Victoria, Australia; and University Medical Center Groningen (IES), University of Groningen, The Netherlands
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16
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Strachan LP, Paulik G, Preece DA, McEvoy PM. Pathways from trauma to unusual perceptual experiences: Modelling the roles of insecure attachment, negative affect, emotion regulation and dissociation. Psychol Psychother 2023; 96:934-951. [PMID: 37493351 DOI: 10.1111/papt.12486] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2022] [Accepted: 07/11/2023] [Indexed: 07/27/2023]
Abstract
BACKGROUND A range of traumas have been linked to voices (auditory verbal hallucinations) and unusual perceptual experiences (UPEs) in other perceptual-sensory domains. Models of PTSD and positive symptoms of psychosis are insufficient in explaining the relationship between trauma and voices. The trauma-related voices (TRV) model was developed to generate novel research in this area. AIMS This study aimed to investigate pathways from trauma to the frequency of UPEs based on a subset of hypothesised relationships in the TRV model. MATERIALS The PTSD Diagnostic Scale for DSM-5, State Adult Attachment Measure, Depression Anxiety and Stress Scales-21, Perth Emotion and Regulation Competency Inventory, Dissociative Experiences Measure Oxford, and Multi-modality Unusual Perceptual Experiences Questionnaire. METHODS We used path analysis in a non-clinical sample (N = 528) to model indirect effects from diverse trauma experiences to the frequency of multi-sensory UPEs via a subset of mediators within the TRV model: insecure attachment, emotion regulation deficits, negative affect and dissociation. RESULTS Our model was an excellent fit to the data and accounted for 37.1% of variance in UPE frequency, and all direct (βs = .14-.61) and indirect pathways (βs = .01-.08) were significant (ps < .001). DISCUSSION Our findings suggest that insecure attachment may link diverse trauma experiences to emotion regulation deficits and negative affect, which are linked to UPE frequency via dissociation. CONCLUSION Our findings provide preliminary evidence for a subset of relationships within the TRV model. Future studies are needed to gather stronger evidence of temporality and causation between these factors, and to test broader pathways within the TRV model.
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Affiliation(s)
- Laura P Strachan
- Discipline of Psychology, Curtin School of Population Health & enAble Institute, Curtin University, Perth, Western Australia, Australia
| | - Georgie Paulik
- School of Psychology, Murdoch University, Perth, Western Australia, Australia
- Perth Voices Clinic, Perth, Western Australia, Australia
- School of Psychological Science, University of Western Australia, Perth, Western Australia, Australia
| | - David A Preece
- Discipline of Psychology, Curtin School of Population Health & enAble Institute, Curtin University, Perth, Western Australia, Australia
- School of Psychological Science, University of Western Australia, Perth, Western Australia, Australia
| | - Peter M McEvoy
- Discipline of Psychology, Curtin School of Population Health & enAble Institute, Curtin University, Perth, Western Australia, Australia
- Centre for Clinical Interventions, Perth, Western Australia, Australia
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17
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Kimhy D, Ospina LH, Beck-Felts K, Lister A, Omene C, Bodenhausen G, Mittal V. Psychiatric and affective predictors of negative racial attitudes. Psychiatry Res 2023; 327:115376. [PMID: 37531817 DOI: 10.1016/j.psychres.2023.115376] [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: 04/03/2023] [Revised: 07/24/2023] [Accepted: 07/25/2023] [Indexed: 08/04/2023]
Abstract
Negative Racial Attitudes (NRA) have been identified as major contributors to discrimination and inequalities. Previous studies of predictors of NRA have focused largely on socioeconomic, socialization, social attitudes, and personality characteristics. Yet, the potential links of psychiatric and affective indicators to NRA have received little scientific inquiry. Three-hundred-and-two participants completed measures of explicit, covert, and implicit NRA, along with indices of psychotic-like experiences (PLEs), mood symptoms, affective processing, social attitudes, and personality characteristics. Explicit and covert NRA were significantly correlated with difficulty identifying and describing feelings, use of suppression to regulate emotion, and the PLEs domains of perceptual abnormalities, bizarre experiences, and persecutory ideation, along with social attitudes and personality characteristics. Implicit NRA was not associated with any indicators. Next, employing hierarchical multiple linear regression analyses, the affective and psychiatric indicators accounted 5.2% and 10.4% of the explicit and covert NRA variance, respectively, controlling for previously identified predictors including demographics, social attitudes, and personality characteristics. Our results point to newly identified predictors of NRA including difficulties identifying and describing emotions, use of suppression to regulate emotions, as well as PLEs, specifically perceptual abnormalities. We discuss the implications of the findings to the development and adaptation of anti-racism interventions.
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Affiliation(s)
- David Kimhy
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States; MIRECC, The James J. Peters VA Medical Center, Bronx, NY, United States.
| | - Luz H Ospina
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Katie Beck-Felts
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Amanda Lister
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - Coral Omene
- Rutgers Cancer Institute of New Jersey, Rutgers - The State University of New Jersey, New Brunswick, NJ, United States
| | - Galen Bodenhausen
- Department of Psychology, Northwestern University, Evanston, IL, United States
| | - Vijay Mittal
- Department of Psychology, Northwestern University, Evanston, IL, United States
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18
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Dhondt N, Staines L, Healy C, Cannon M. Childhood adversity and recurrence of psychotic experiences during adolescence: the role of mediation in an analysis of a population-based longitudinal cohort study. Psychol Med 2023; 53:4046-4054. [PMID: 35311635 PMCID: PMC10317802 DOI: 10.1017/s003329172200071x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 01/15/2022] [Accepted: 02/22/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND Psychotic experiences (PEs) are relatively common in childhood and adolescence and are associated with increased risk of functional issues and psychiatric illness in young adulthood, and PEs that recur are associated with increased risk of poorer psychiatric and functional outcomes. Childhood adversity is a well-established risk factor for PEs. The aim of this study was to investigate (1) the relationship between childhood adversity and recurring PEs in adolescence and (2) candidate mediators of that relationship. METHODS We used data from Cohort '98 of the Growing Up in Ireland study (n = 6039) at three time points (ages 9, 13 and 17) to investigate the relationship between childhood adversity (parent-reported at age 9), recurring PEs (measured using a subset of the Adolescent Psychotic-like Symptoms Screener at ages 13 and 17). The mediating roles of parent-child relationship, internalising and externalising difficulties, self-concept, physical activity, dietary quality, perceived neighbourhood safety and friendship quantity were investigated using the KHB path decomposition method. RESULTS Childhood adversity was associated with an increased risk of recurring PEs with a population attributable fraction of 23%. Internalising difficulties and self-concept explained 13% of the relationship between childhood adversity and PEs suggesting a partial mediation. A significant direct effect remained between childhood adversity and recurring PEs. CONCLUSIONS The established relationship between childhood adversity and PEs may be mainly driven by the relationship between childhood adversity and recurring PEs. Internalising difficulties and self-concept together mediate part of the relationship between childhood adversity and recurring PEs.
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Affiliation(s)
- N. Dhondt
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin 2, Dublin, Ireland
- St James's Hospital, Dublin 8, Dublin, Ireland
| | - L. Staines
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin 2, Dublin, Ireland
| | - C. Healy
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin 2, Dublin, Ireland
| | - M. Cannon
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin 2, Dublin, Ireland
- Department of Psychiatry, Beaumont Hospital, Dublin 9, Dublin, Ireland
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19
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Steenkamp LR, de Neve-Enthoven NGM, João AM, Bouter DC, Hillegers MHJ, Hoogendijk WJG, Blanken LME, Kushner SA, Tiemeier H, Grootendorst-van Mil NH, Bolhuis K. Psychotic experiences, suicidality and non-suicidal self-injury in adolescents: Independent findings from two cohorts. Schizophr Res 2023; 257:50-57. [PMID: 37285715 DOI: 10.1016/j.schres.2023.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2022] [Revised: 01/10/2023] [Accepted: 05/06/2023] [Indexed: 06/09/2023]
Abstract
BACKGROUND Prior studies have shown that psychotic experiences are prospectively associated with an increased risk of suicidality. However, it is unclear whether this association is causal or arises from shared risk factors. Furthermore, little is known about the association between psychotic experiences and non-suicidal self-injury (NSSI). METHODS We used data from two independent samples of young adolescents, which we analyzed separately. In a population-based cohort, data on hallucinatory experiences and suicidality were collected at ages 10 and 14 years (N = 3435). In a cross-sectional study of a population oversampled for elevated psychopathology levels, psychotic experiences, suicidality, and NSSI were assessed at age 15 years (N = 910). Analyses were adjusted for sociodemographic covariates, maternal psychopathology, intelligence, childhood adversity, and mental health problems. RESULTS Psychotic experiences were prospectively associated with an increased risk of suicidality, even when considering self-harm ideation at baseline. Furthermore, persistent and incident, but not remittent, patterns of psychotic experiences were related to an increased burden of suicidality. Self-harm ideation was also prospectively associated with the risk for psychotic experiences, although of smaller magnitude and only by self-report. Among at-risk adolescents, psychotic experiences were cross-sectionally associated with a greater burden of suicidality and a higher frequency of NSSI events, with more extensive tissue damage. CONCLUSION Psychotic experiences are longitudinally associated with suicidality beyond the effects of shared risk factors. We also found modest support for reverse temporality, which warrants further investigation. Overall, our findings highlight the importance of assessing psychotic experiences as an index of risk for suicidality and NSSI.
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Affiliation(s)
- Lisa R Steenkamp
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC Sophia Children's Hospital, Rotterdam, the Netherlands; Generation R Study Group, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | | | - Amanda Moreira João
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC Sophia Children's Hospital, Rotterdam, the Netherlands
| | - Diandra C Bouter
- Department of Psychiatry, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | - Manon H J Hillegers
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC Sophia Children's Hospital, Rotterdam, the Netherlands
| | - Witte J G Hoogendijk
- Department of Psychiatry, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | - Laura M E Blanken
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC Sophia Children's Hospital, Rotterdam, the Netherlands; Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands
| | - Steven A Kushner
- Department of Psychiatry, Erasmus MC, University Medical Center, Rotterdam, the Netherlands
| | - Henning Tiemeier
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC Sophia Children's Hospital, Rotterdam, the Netherlands; Department of Social and Behavioral Science, Harvard TH Chan School of Public Health, Boston, USA
| | | | - Koen Bolhuis
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus MC Sophia Children's Hospital, Rotterdam, the Netherlands.
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20
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Corentin C, Fitzgerald C, Goodwin J. Benefits of Hearing Voices Groups & Other Self-Help Groups for Voice Hearers: A Systematic Review. Issues Ment Health Nurs 2023; 44:228-244. [PMID: 37075309 DOI: 10.1080/01612840.2023.2189953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/21/2023]
Abstract
People who hear voices that others do not often rely on mainstream mental health services. Several alternatives to treatment have grown in popularity including "Hearing Voices Groups" and other self-help groups for voice hearers. The aim of this systematic review is to evaluate the current evidence relating to the use of Hearing Voices Groups (HVGs) and other self-help groups for voice hearers, and identify the benefits felt by those attending such groups. The following databases were searched for relevant academic articles: CINAHL; APA PsycArticles; APA PsycInfo; Social Sciences; SocINDEX; UK & Ireland Reference Centre and Medline, with 13 papers identified for inclusion. Participants reported several benefits of attending a HVG/self-help group, which reduced isolation, improved social and coping skills, and gave them a better understanding of the meaning and context of their voices. The groups also provide hope for the future and act as a catalyst for recovery. These study findings suggest that voice hearers find some benefits from attending HVGs/self-help groups. Evidence indicates that voice hearers can live meaningful lives and continue to hear voices once context and meaning to their voices become clear. HVGs/self-help groups provide a vital service to voice hearers, which they felt was not available within mainstream mental health services. If mental health providers gained a better understanding of the HVN, they may be able to integrate the values and ethos of the HVN into groups for voice hearers within mainstream mental health services or signpost voice hearers to these groups.
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21
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Stephan-Otto C, Núñez C, Lombardini F, Cambra-Martí MR, Ochoa S, Senior C, Brébion G. Neurocognitive bases of self-monitoring of inner speech in hallucination prone individuals. Sci Rep 2023; 13:6251. [PMID: 37069194 PMCID: PMC10110610 DOI: 10.1038/s41598-023-32042-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2022] [Accepted: 03/20/2023] [Indexed: 04/19/2023] Open
Abstract
Verbal hallucinations in schizophrenia patients might be seen as internal verbal productions mistaken for perceptions as a result of over-salient inner speech and/or defective self-monitoring processes. Similar cognitive mechanisms might underpin verbal hallucination proneness in the general population. We investigated, in a non-clinical sample, the cerebral activity associated with verbal hallucinatory predisposition during false recognition of familiar words -assumed to stem from poor monitoring of inner speech-vs. uncommon words. Thirty-seven healthy participants underwent a verbal recognition task. High- and low-frequency words were presented outside the scanner. In the scanner, the participants were then required to recognize the target words among equivalent distractors. Results showed that verbal hallucination proneness was associated with higher rates of false recognition of high-frequency words. It was further associated with activation of language and decisional brain areas during false recognitions of low-, but not high-, frequency words, and with activation of a recollective brain area during correct recognitions of low-, but not high-, frequency words. The increased tendency to report familiar words as targets, along with a lack of activation of the language, recollective, and decisional brain areas necessary for their judgement, suggests failure in the self-monitoring of inner speech in verbal hallucination-prone individuals.
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Affiliation(s)
- Christian Stephan-Otto
- Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Christian Núñez
- Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
| | | | | | - Susana Ochoa
- Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Carl Senior
- School of Life & Health Sciences, Aston University, Birmingham, UK.
- University of Gibraltar, Gibraltar, UK.
| | - Gildas Brébion
- Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain.
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain.
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.
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22
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Carey E, Healy C, Perry Y, Gillan D, Whitehouse AJO, Cannon M, Lin A. Evidence that infant and early childhood developmental impairments are associated with hallucinatory experiences: results from a large, population-based cohort study. Psychol Med 2023; 53:2116-2124. [PMID: 34583789 PMCID: PMC10106299 DOI: 10.1017/s0033291721003883] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/28/2021] [Revised: 09/03/2021] [Accepted: 09/03/2021] [Indexed: 12/19/2022]
Abstract
BACKGROUND Cognitive and motor dysfunction are hallmark features of the psychosis continuum, and have been detected during late childhood and adolescence in youth who report psychotic experiences (PE). However, previous investigations have not explored infancy and early childhood development. It remains unclear whether such deficits emerge much earlier in life, and whether they are associated with psychotic, specifically hallucinatory, experiences (HE). METHODS This study included data from Gen2 participants of The Raine Study (n = 1101), a population-based longitudinal cohort study in Western Australia. Five areas of childhood development comprising: communication; fine motor; gross motor; adaptive (problem-solving); and personal-social skills, were assessed serially at ages 1, 2 and 3 years. Information on HE, depression and anxiety at ages 10, 14 and 17 years was obtained. HE were further subdivided into those with transient or recurrent experiences. Mixed effects logistic regression models and cumulative risk analyses based on multiple domain delays were performed. RESULTS Early poorer development in multiple areas was noted from ages 1, 2 and 3 years among youth who reported HE. Early developmental delays significantly increased the risk for later HE. This association was particularly marked in the recurrent HE group, with over 40% having early developmental delays in multiple domains. There was no significant association between early childhood development and later anxiety/depression apart from lower gross motor scores at age 3. CONCLUSIONS The findings suggest that early pan-developmental deficits are associated with later HE, with the effect strongest for young people who report recurrent HE throughout childhood and adolescence.
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Affiliation(s)
- Eleanor Carey
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
- Trinity College Institute of Neuroscience, Dublin, Ireland
| | - Colm Healy
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Yael Perry
- Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia
| | - Diane Gillan
- Department of Psychology, Beaumont Hospital, Dublin, Ireland
| | | | - Mary Cannon
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
- Trinity College Institute of Neuroscience, Dublin, Ireland
- Department of Psychiatry, Beaumont Hospital, Dublin, Ireland
| | - Ashleigh Lin
- Telethon Kids Institute, The University of Western Australia, Perth, WA, Australia
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23
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Ngo HVV, Oster H, Andreou C, Obleser J. Circadian rhythms in auditory hallucinations and psychosis. Acta Physiol (Oxf) 2023; 237:e13944. [PMID: 36744985 DOI: 10.1111/apha.13944] [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: 09/23/2022] [Revised: 01/31/2023] [Accepted: 02/01/2023] [Indexed: 02/07/2023]
Abstract
Circadian rhythms are imprinted in all organisms and influence virtually all aspects of physiology and behavior in adaptation to the 24-h day-night cycle. This recognition of a circadian timekeeping system permeating essentially all healthy functioning of body and mind quickly leads to the realization that, in turn, human ailments should be probed for the degree to which they are rooted in or marked by disruptions and dysregulations of circadian clock functions in the human body. In this review, we will focus on psychosis as a key mental illness and foremost one of its cardinal symptoms: auditory hallucinations. We will discuss recent empirical evidence and conceptual advances probing the potential role of circadian disruption in auditory hallucinations. Moreover, a dysbalance in excitation and inhibition within cortical networks, which in turn drive a disinhibition of dopaminergic signaling, will be highlighted as central physiological mechanism. Finally, we will propose two avenues for experimentally intervening on the circadian influences to potentially alleviate hallucinations in psychotic disorders.
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Affiliation(s)
- Hong-Viet V Ngo
- Department of Psychology, University of Lübeck, Lübeck, Germany
- Center of Brain, Behavior and Metabolism, University of Lübeck, Lübeck, Germany
| | - Henrik Oster
- Center of Brain, Behavior and Metabolism, University of Lübeck, Lübeck, Germany
- Institute of Neurobiology, University of Lübeck, Lübeck, Germany
| | - Christina Andreou
- Center of Brain, Behavior and Metabolism, University of Lübeck, Lübeck, Germany
- Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany
| | - Jonas Obleser
- Department of Psychology, University of Lübeck, Lübeck, Germany
- Center of Brain, Behavior and Metabolism, University of Lübeck, Lübeck, Germany
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24
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Stanyon D, DeVylder J, Yamasaki S, Yamaguchi S, Ando S, Usami S, Endo K, Miyashita M, Kanata S, Morimoto Y, Hosozawa M, Baba K, Nakajima N, Niimura J, Nakanishi M, Hiraiwa-Hasegawa M, Kasai K, Nishida A. Auditory Hallucinations and Self-Injurious Behavior in General Population Adolescents: Modeling Within-Person Effects in the Tokyo Teen Cohort. Schizophr Bull 2023; 49:329-338. [PMID: 36333883 PMCID: PMC10016404 DOI: 10.1093/schbul/sbac155] [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: 11/06/2022]
Abstract
BACKGROUND AND HYPOTHESES A wealth of evidence suggests that adolescent psychotic experiences (PEs), and especially auditory hallucinations (AHs), are associated with an increased risk for self-injurious behavior (SIB). However, the directionality and specificity of this association are not well understood, and there are no published studies investigating within-person effects over time. The present study aimed to test whether AHs and SIB prospectively increase reciprocal risk at the individual level during early-to-middle adolescence. STUDY DESIGN Three waves (12y, 14y, and 16y) of self-reported AHs and SIB data from a large Tokyo-based adolescent birth cohort (N = 2825) were used. Random Intercept Cross-Lagged Panel Model (RI-CLPM) analysis was conducted to test the within-person prospective associations between AHs and SIB. STUDY RESULTS At the within-person level, AHs were associated with subsequent SIB over the observation period (12y-14y: β = .118, P < .001; 14-16y: β = .086, P = .012). The reverse SIB->AHs relationship was non-significant at 12-14y (β = .047, P = .112) but emerged from 14y to 16y as the primary direction of influence (β = .243, P < .001). Incorporating depression as a time-varying covariate did not meaningfully alter model estimates. CONCLUSIONS A complex bi-directional pattern of relationships was observed between AHs and SIB over the measurement period, and these relationships were independent of depressive symptoms. Adolescent AHs may be both a predictor of later SIB and also a manifestation of SIB-induced psychological distress.
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Affiliation(s)
- Daniel Stanyon
- Research Center for Social Science & Medicine, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Jordan DeVylder
- Research Center for Social Science & Medicine, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan.,Graduate School of Social Service, Fordham University, New York, NY, USA
| | - Syudo Yamasaki
- Research Center for Social Science & Medicine, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Satoshi Yamaguchi
- Research Center for Social Science & Medicine, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Shuntaro Ando
- Research Center for Social Science & Medicine, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan.,Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Satoshi Usami
- Graduate School of Education, The University of Tokyo, Tokyo, Japan
| | - Kaori Endo
- Research Center for Social Science & Medicine, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Mitsuhiro Miyashita
- Research Center for Social Science & Medicine, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Sho Kanata
- Department of Psychiatry, Teikyo University School of Medicine, Tokyo, Japan
| | - Yuko Morimoto
- Department of Psychology, Ube Frontier University, Yamaguchi, Japan
| | - Mariko Hosozawa
- Institute for Global Health Policy Research, Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan
| | - Kaori Baba
- Research Center for Social Science & Medicine, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Naomi Nakajima
- Research Center for Social Science & Medicine, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Junko Niimura
- Research Center for Social Science & Medicine, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Miharu Nakanishi
- Research Center for Social Science & Medicine, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan.,Department of Psychiatric Nursing, Tohoku University Graduate School of Medicine, Sendai-shi, Miyagi, Japan
| | - Mariko Hiraiwa-Hasegawa
- School of Advanced Science, SOKENDAI (Graduate University for Advanced Studies), Kanagawa, Japan
| | - Kiyoto Kasai
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,The International Research Center for Neurointelligence (WPI-IRCN), The University of Tokyo Institutes for Advanced Study (UTIAS), The University of Tokyo, Tokyo, Japan
| | - Atsushi Nishida
- Research Center for Social Science & Medicine, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
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25
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Yehya A, Khaled SM, Sommer IEC, Elhag SF, Hassan MHMO, Woodruff P, Alabdalla M. The Arabic Questionnaire for Psychotic Experiences in patients with psychotic disorders: a clinical validation. BMC Psychiatry 2023; 23:141. [PMID: 36882727 PMCID: PMC9990290 DOI: 10.1186/s12888-023-04649-4] [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: 12/06/2022] [Accepted: 03/02/2023] [Indexed: 03/09/2023] Open
Abstract
BACKGROUND Psychotic experiences are reported in the general population. The Questionnaire for Psychotic Experiences (QPE) was created to test the phenomenological features of these experiences and compare them with those reported in patients with psychiatric and other medical conditions. The aim of this study was to test the psychometric properties of the Arabic version of the QPE. METHODS We recruited 50 patients with psychotic disorders from the Hamad Medical Hospital in Doha, Qatar. Patients underwent assessment over three sessions with trained interviewees using the Arabic versions of QPE, Positive and Negative Syndrome Scale (PANSS), Beck Depression Inventory (BDI), and the Global Assessment of Functioning Scale (GAF). Patients were also reassessed using the QPE and GAF after 14-days from the initial assessment in order to test for the stability of the scale. In this respect, this is the first study that assesses the test-retest reliability of the QPE. The psychometric properties including convergent validity, stability, and internal consistency met the benchmarked criteria. RESULTS Results confirmed that the Arabic version of QPE accurately measured the experiences of patients that were also reported using the PANSS, an internationally accepted, well-established scale for measuring psychotic symptom severity. CONCLUSION We propose the use of the QPE to describe the phenomenology of PEs across modalities in Arabic speaking communities.
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Affiliation(s)
- Arij Yehya
- Core Curriculum Program, Deanship of General Studies, Qatar University, P.O. Box 2713, Doha, Qatar.
| | - Salma M Khaled
- Social & Economic Survey Research Institute (SESRI), Qatar University, Doha, Qatar
| | - Iris E C Sommer
- Department of Neuroscience and Department of Psychiatry, University Medical Center Groningen, Groningen, The Netherlands
| | - Saba F Elhag
- Social & Economic Survey Research Institute (SESRI), Qatar University, Doha, Qatar
| | | | - Peter Woodruff
- Psychiatry Department, Hamad Medical Corporation, Doha, Qatar.,Department of Neuroscience, School of Medicine, University of Sheffield, Sheffield, UK
| | - Majid Alabdalla
- Psychiatry Department, Hamad Medical Corporation, Doha, Qatar.,College of Medicine, Qatar University, Doha, Qatar
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26
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Quidé Y. Dissociation, trauma and the experience of visual hallucinations in post-traumatic stress disorder and schizophrenia. BJPsych Open 2023; 9:e23. [PMID: 36700248 PMCID: PMC9885325 DOI: 10.1192/bjo.2023.3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Abstract
Dissociative behaviours and hallucinations are often reported in trauma-exposed people with schizophrenia spectrum disorders and post-traumatic stress disorder (PTSD). Auditory hallucinations are the most commonly reported type of hallucination, but often co-occur with experiences in other sensory modalities. The phenomenology and the neurobiological systems involved in visual experiences are not well characterised. Are these experiences similar in nature, content or severity among people with schizophrenia and/or PTSD? What are the neurobiological bases of these visual experiences and what is the role of dissociative behaviours in the formation of these experiences? A study by Wearne and colleagues in BJPsych Open aimed to characterise these phenomenological systems in groups of people with PTSD, schizophrenia or both (schizophrenia + PTSD).
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Affiliation(s)
- Yann Quidé
- NeuroRecovery Research Hub, School of Psychology, UNSW Sydney, Sydney, NSW, Australia; and Centre for Pain IMPACT, Neuroscience Research Australia, Randwick, NSW, Australia
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27
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Reed P. Impact of previous reinforcement on false perceptions for individuals lower and higher in schizotypy traits. PERSONALITY AND INDIVIDUAL DIFFERENCES 2023. [DOI: 10.1016/j.paid.2022.111898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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28
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Allen S, Goodall T, Jones C, James R, Surtees A. What Is the Prevalence of Visual Hallucinations in a First-Episode Psychosis Population? A Systematic Review and Meta-analysis of the Literature. SCHIZOPHRENIA BULLETIN OPEN 2023; 4:sgad002. [PMID: 39145351 PMCID: PMC11207659 DOI: 10.1093/schizbullopen/sgad002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 08/16/2024]
Abstract
Background and Hypothesis This systematic review and meta-analysis review the literature regarding the prevalence of visual hallucinations in patients with first-episode psychosis. Previous reviews have focused on the prevalence of visual hallucinations in a general psychosis population, highlighting a weighted prevalence of 27%. However, no reviews have focused specifically on the experiences of those with a first episode of psychosis. Understanding "first-episode" experiences is crucial, as intervention during this "critical period" is thought to define long-term outcome. Therefore, it is important that the prevalence of different symptoms during this period is accurately represented. Study Design Systematic searches yielded 15 studies to be meta-analyzed. Information to calculate event rates was extracted. Studies were rated for their methodological quality using a risk of bias tool. The quality of included studies varied; generalizability bias was the domain with the most risk of bias. Study Results Prevalence rates were synthesized from the 15 papers included in the final analysis, which generated a weighted prevalence estimate of 33% of people with first-episode psychosis experiencing visual hallucinations. Subgroup analyses were carried out and did not demonstrate significant associations. Conclusions This meta-analysis provides a robust estimate of 33% for the prevalence of visual hallucinations in first-episode psychosis; highlighting that visual hallucinations are relatively common experiences.
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Affiliation(s)
- Sophie Allen
- School of Psychology, University of Birmingham, Birmingham, UK
- Birmingham & Solihull Mental Health Foundation Trust, Birmingham, UK
| | | | - Chris Jones
- School of Psychology, University of Birmingham, Birmingham, UK
| | - Rachel James
- School of Psychology, University of Birmingham, Birmingham, UK
- Birmingham & Solihull Mental Health Foundation Trust, Birmingham, UK
| | - Andrew Surtees
- School of Psychology, University of Birmingham, Birmingham, UK
- Birmingham Women’s and Children’s NHS Foundation Trust, Birmingham, UK
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29
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Linszen MMJ, de Boer JN, Schutte MJL, Begemann MJH, de Vries J, Koops S, Blom RE, Bohlken MM, Heringa SM, Blom JD, Sommer IEC. Occurrence and phenomenology of hallucinations in the general population: A large online survey. SCHIZOPHRENIA 2022; 8:41. [PMID: 35853871 PMCID: PMC9261095 DOI: 10.1038/s41537-022-00229-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/27/2020] [Accepted: 11/23/2021] [Indexed: 11/18/2022]
Abstract
Although epidemiological studies report that hallucinations occur in 6–15% of the general population, little is known about their phenomenology. To overcome this paucity, this study investigates the phenomenological characteristics of hallucinations in the general population, by using a nationally promoted online survey to assess hallucination phenomenology in four sensory modalities, through a self-report version of the Questionnaire for Psychotic Experiences (QPE), in 10,448 participants (aged 14–88 years). The phenomenology of hallucinations was assessed if hallucinations reportedly occurred in the past month. In the past month, auditory hallucinations were reported most frequently (29.5%), followed by visual (21.5%), tactile (19.9%), and olfactory hallucinations (17.3%); hallucinations in two or more modalities were reported by 47.6%. Substantial numbers of participants rated their hallucinations as severe, due to negative content (16.0–31.6%), previous bothersome experiences (14.8–20.2%), ensuing distress (10.5–16.8%), and/or ensuing disfunctioning (12.7–17.3%). Decreased insight was found in 10.2–11.4%. Hypnagogia was reported by 9.0–10.6%, and bereavement hallucinations by 2.8%. Despite a low prevalence of delusions (7.0%), these phenomena were significantly associated with recent hallucinations, observed in up to 13.4% of the participants with hallucinations during the past week (p < 0.001). Our results indicate a wide variety of the phenomenology of hallucinations in the general population and support the existence of a phenomenological continuum.
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30
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Buck B, Munson J, Chander A, Wang W, Brenner CJ, Campbell AT, Ben-Zeev D. The relationship between appraisals of auditory verbal hallucinations and real-time affect and social functioning. Schizophr Res 2022; 250:112-119. [PMID: 36399900 PMCID: PMC9750498 DOI: 10.1016/j.schres.2022.10.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 09/03/2022] [Accepted: 10/30/2022] [Indexed: 11/18/2022]
Abstract
In addition to being a hallmark symptom of schizophrenia-spectrum disorders, auditory verbal hallucinations (AVH) are present in a range of psychiatric disorders as well as among individuals who are otherwise healthy. People who experience AVH are heterogeneous, and research has aimed to better understand what characteristics distinguish, among those who experience AVH, those who experience significant disruption and distress from those who do not. The cognitive model of AVH suggests that appraisals of voices determine the extent to which voices cause distress and social dysfunction. Previous work has relied largely on comparisons of "clinical" and "non-clinical" voice hearers, and few studies have been able to provide insight into the moment-to-moment relationships between appraisals and outcomes. The current study examines longitudinal data provided through ecological momentary assessment and passive sensors of 465 individuals who experience cross-diagnostic AVH. Results demonstrated associations of AVH appraisals to negative affect and social functioning. Above and beyond within-individual averages, when a participant reported increased appraisals of their voices as powerful and difficult to control, they were more likely to feel increased negative affect and reduced feelings of safety. AVH power appraisals were also associated with next-day number and duration of phone calls placed, and AVH controllability appraisals were associated with increased time near speech and reduced next-day time away from primary location. These results suggest that appraisals are state-like characteristics linked with day-to-day and moment-to-moment changes in impactful affective and behavioral outcomes; intervention approaches should aim to address these domains in real-time.
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Affiliation(s)
- Benjamin Buck
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States of America.
| | - Jeffrey Munson
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States of America
| | - Ayesha Chander
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States of America
| | - Weichen Wang
- Department of Computer Science, Dartmouth College, Hanover, NH, United States of America
| | - Carolyn J Brenner
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States of America
| | - Andrew T Campbell
- Department of Computer Science, Dartmouth College, Hanover, NH, United States of America
| | - Dror Ben-Zeev
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, United States of America
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31
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Peters EM, Yates K, DeVylder J, Lodhi RJ, Kelleher I. Understanding the inverse relationship between age and psychotic symptoms: The role of borderline personality traits. Acta Psychiatr Scand 2022; 146:484-491. [PMID: 35821578 DOI: 10.1111/acps.13475] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2022] [Revised: 05/31/2022] [Accepted: 07/09/2022] [Indexed: 01/29/2023]
Abstract
OBJECTIVE There is a well-established inverse relationship between age and positive psychotic symptoms, both in patients with psychotic disorders and in general population samples with psychotic experiences. The reason for this inverse relationship is unclear. We hypothesized that life-course developmental changes in borderline personality traits, which also typically decline with age, might explain the inverse relationship between age and positive psychotic symptoms. METHODS We tested this hypothesis with data from 19,980 adults who completed 2000, 2007, and 2014 UK Adult Psychiatric Morbidity Survey studies. Hallucinations and delusions were assessed with the Psychosis Screening Questionnaire. Borderline features were assessed with the Structured Clinical Interview for DSM-IV Axis II Personality Disorders Screening Questionnaire. Logistic regression models with effect decompositions were used to conduct the analyses. RESULTS As expected, age was negatively associated with hallucinations and delusions. These effects were wholly or mostly reduced after controlling for borderline features. Similar results were found in a subgroup of participants with a probable psychotic disorder. Repeating the analysis with a broad index of psychopathology severity instead of borderline features did not produce comparable results. Borderline factor scores reflecting identity/relationship disturbance, mood instability/anger, and self-harm/suicidality were created, all of which appeared to explain part of the inverse relationship between age and psychotic experiences. CONCLUSION Declining borderline traits throughout adulthood may account for the reduced prevalence of positive psychotic symptoms in both clinical and non-clinical populations. Future research might evaluate the impact of treatments that target borderline traits on positive psychotic symptoms.
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Affiliation(s)
- Evyn M Peters
- Department of Psychiatry, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Kathryn Yates
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Jordan DeVylder
- Graduate School of Social Service, Fordham University, New York, New York, USA
| | - Rohit J Lodhi
- Department of Psychiatry, Schulich School of Medicine & Dentistry, Western University, Ottawa, Ontario, Canada
| | - Ian Kelleher
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland.,School of Medicine, University College Dublin, Dublin, Ireland.,Lucena Clinic, St John of God Hospitaller Services, Dublin, Ireland
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32
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Positiv psychotische Symptome in Kindheit und Jugend. Prax Kinderpsychol Kinderpsychiatr 2022; 71:640-657. [DOI: 10.13109/prkk.2022.71.7.640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Toh WL, Phillipou A, Neill E, Rossell SL. Intersections of paranoia and the body in the general population. J Health Psychol 2022; 28:633-647. [DOI: 10.1177/13591053221133890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Negative body image may be associated with heightened feelings of paranoia. The current study aimed to conduct multidimensional assessments of body image and psychosis facets in the general population. Respondents were 407 individuals, who provided basic sociodemographic information, and completed online questionnaires evaluating dysmorphic concerns, body consciousness, paranoia, persecutory and magical ideation and perceptual aberration. Correlation analysis and a series of regressions onto various body image facets (i.e. dysmorphic concerns, private body consciousness, public body consciousness and body competence) were conducted. Distinct patterns of significant associations were uncovered across the range of body image and psychosis facets examined. Paranoia significantly contributed to the severity of dysmorphic concerns, and magical ideation significantly contributed to private and public body consciousness, though effect sizes were modest. Our findings corroborate the relationship between paranoia and dysmorphic concerns, and tentatively suggest that challenging paranoid beliefs could be a useful strategy for managing negative body image.
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Affiliation(s)
- Wei Lin Toh
- Swinburne University of Technology, Australia
| | - Andrea Phillipou
- Swinburne University of Technology, Australia
- St Vincent’s Hospital, Australia
- University of Melbourne, Australia
- Austin Hospital, Australia
| | - Erica Neill
- Swinburne University of Technology, Australia
- St Vincent’s Hospital, Australia
- University of Melbourne, Australia
| | - Susan L Rossell
- Swinburne University of Technology, Australia
- St Vincent’s Hospital, Australia
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Cavelti M, Kaeser JM, Lerch S, Bauer S, Moessner M, Berger T, Hayward M, Kaess M. Smartphone-assisted guided self-help cognitive behavioral therapy for young people with distressing voices (SmartVoices): study protocol for a randomized controlled trial. Trials 2022; 23:902. [PMID: 36274185 PMCID: PMC9590132 DOI: 10.1186/s13063-022-06846-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Accepted: 10/14/2022] [Indexed: 11/25/2022] Open
Abstract
Background The long-standing view that auditory verbal hallucinations (AVH) or hearing voices is a sign of schizophrenia has been challenged by research demonstrating that they lie on a continuum ranging from normal to pathological experience related to distress and need for care. Hearing voices is more prevalent in adolescence than in later life, and hearing voices during adolescence indicates a risk for severe psychopathology, functional impairments, and suicide later in life. While there is increasing evidence for the efficacy of cognitive behavioral therapy for voices (CBTv) in adults with schizophrenia, research on psychological treatments for youth with distressing voices has been scarce. The aim of the current study is to examine the efficacy of CBTv, delivered using smartphone-based Ecological Momentary Assessment Intervention (EMI) in a transdiagnostic sample of youth. Methods This is a superiority randomized controlled trial comparing 8 weeks of CBTv-based EMI in addition to treatment as usual (TAU) versus TAU only. TAU covers both no treatment and any form of psychiatric/psychological treatment. In the EMI condition, participants will be prompted twice a day to complete an EMA survey, and receive one intervention proposal per assessment. One-hundred fifty-four youth aged 14–25 years with distressing voices will be recruited from psychiatric clinics, local private practices, internet forums, and advertisements in print and social media. Before and after the intervention phase, participants will undergo a 9-day EMA. Single-blinded assessments will be conducted at baseline (T0) and at 3-month (T1) and 6-month (T2) follow-up. The primary outcome is the distress dimension of the Auditory Hallucinations subscale of the Psychotic Symptom Rating Scales at T1. Secondary outcomes include perceived hostile intention, power, and dominance of voices, passive, aggressive, and assertive relating to voices, and negative core beliefs about the self. Discussion Adolescence provides a crucial window of opportunity for early intervention for hearing voices. However, youth are notoriously reluctant help-seekers. This study offers a low-intensity psychological intervention for youth with distressing voices beyond diagnostic boundaries that, using a mobile technology approach, may match the treatment preferences of the generation of “digital natives.” Trial registration German Clinical Trials Register DRKS00026243. Registered on 2 September 2021 Supplementary Information The online version contains supplementary material available at 10.1186/s13063-022-06846-0.
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Momentary effects of Temstem, an app for voice-hearing individuals: Results from naturalistic data from 1048 users. Internet Interv 2022; 30:100580. [PMID: 36277314 PMCID: PMC9582699 DOI: 10.1016/j.invent.2022.100580] [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: 03/02/2022] [Revised: 09/13/2022] [Accepted: 10/04/2022] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Temstem is a mobile application developed in cooperation with voice-hearing persons to help them cope with distressing voices. After psychoeducation about voice hearing, Temstem offers two functions: Silencing is a mode designed to inhibit voice activity through the processing of incompatible language; the Challenging mode introduces dual tasking (as used in eye movement desensitisation and reprocessing) designed to reduce the emotionality and vividness of a voice memory. Two different language games, Lingo Tapper and Word Link, are provided, containing both functions. This study aimed to explore the momentary effects of Temstem on voice-hearing distress, emotionality and vividness in a naturalistic sample of voice-hearing app users. METHOD Temstem is freely available in the Netherlands. We collected data through the app from 1048 individual users who had given informed consent for the study. We assessed changes in pre- and post-session scores on distress, emotionality and vividness, and we evaluated differences in outcomes between the games and whether effects remained stable over multiple sessions. RESULTS Users had been hearing voices for an average of 4.95 years; 79 % had been informed about Temstem by a mental health therapist or coach. After a Silencing session, voice-hearing distress was reduced, t(958) = 27.12, p < .001, d = 0.49; the degree of reduction remained stable after repeated use, F(1, 7905.57) = 1.91, p = .167. After a Challenging session, emotionality, t(651) = 23.16, p < .001, d = 0.74, and the vividness of voice memories were reduced, t(651) = 22.20, p < .001, d = 0.71; both diminished slightly with frequent use, F(1, 2222.86) = 7.21, p < .05; F(1, 2289.92) = 4.25, p < .05. In comparison with Lingo Tapper, larger reductions were seen for a Word Link game: emotionality t(226) = 2.88, p < .005, d = 0.21; vividness t(226) = 2.29, p < .05, d = 0.17. DISCUSSION In this heterogeneous sample of voice-hearing individuals, Temstem appeared to be a promising coping tool; momentary voice-hearing distress and the emotionality and vividness of voice statements were reduced after a Temstem session. Despite important limitations and the need for more research, naturalistic studies of user app data may yield interesting and generalisable findings.
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Hosseini SR, Tabbassi SS, Mosaferi S, Mousavinezad SH, Nooripour R, Firoozabadi A, Ghanbari N. The Persian version of the Psychotic‐Like Experiences Questionnaire for Children (PLEQ‐C): Psychometric properties in Iranian school students. PSYCHOLOGY IN THE SCHOOLS 2022. [DOI: 10.1002/pits.22797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Seyed Ruhollah Hosseini
- Department of Psychology, Faculty of Education Sciences and Psychology Ferdowsi University of Mashhad Mashhad Iran
| | - Saeideh Saffar Tabbassi
- Department of Psychology, Faculty of Education Sciences and Psychology Ferdowsi University of Mashhad Mashhad Iran
| | - Simin Mosaferi
- Department of Psychology, Faculty of Education Sciences and Psychology Ferdowsi University of Mashhad Mashhad Iran
| | - Seyyed Hossein Mousavinezad
- Department of Psychology, Faculty of Education Sciences and Psychology Ferdowsi University of Mashhad Mashhad Iran
| | - Roghieh Nooripour
- Department of Counseling, Faculty of Education and Psychology Alzahra University Tehran Iran
| | - Abbas Firoozabadi
- Department of Psychology, Faculty of Education Sciences and Psychology Ferdowsi University of Mashhad Mashhad Iran
| | - Nikzad Ghanbari
- Department of Clinical Psychology, Faculty of Psychology and Educational Sciences Shahid Beheshti University Tehran Iran
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Staines L, Healy C, Coughlan H, Clarke M, Kelleher I, Cotter D, Cannon M. Psychotic experiences in the general population, a review; definition, risk factors, outcomes and interventions. Psychol Med 2022; 52:1-12. [PMID: 36004805 PMCID: PMC9772919 DOI: 10.1017/s0033291722002550] [Citation(s) in RCA: 50] [Impact Index Per Article: 16.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 07/19/2022] [Accepted: 07/21/2022] [Indexed: 12/31/2022]
Abstract
Psychotic experiences (PE) are common in the general population, in particular in childhood, adolescence and young adulthood. PE have been shown to be associated with an increased risk for later psychotic disorders, mental disorders, and poorer functioning. Recent findings have highlighted the relevance of PE to many fields of healthcare, including treatment response in clinical services for anxiety & depression treatment, healthcare costs and service use. Despite PE relevance to many areas of mental health, and healthcare research, there remains a gap of information between PE researchers and experts in other fields. With this review, we aim to bridge this gap by providing a broad overview of the current state of PE research, and future directions. This narrative review aims to provide an broad overview of the literature on psychotic experiences, under the following headings: (1) Definition and Measurement of PE; (2) Risk Factors for PE; (3) PE and Health; (4) PE and Psychosocial Functioning; (5) Interventions for PE, (6) Future Directions.
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Affiliation(s)
- Lorna Staines
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin 2, Ireland
| | - Colm Healy
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin 2, Ireland
| | - Helen Coughlan
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin 2, Ireland
| | - Mary Clarke
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin 2, Ireland
- Department Psychology, Royal College of Surgeons in Ireland, Dublin 2, Ireland
- Department Psychiatry Beaumont Hospital, Dublin 9, Ireland
| | - Ian Kelleher
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin 2, Ireland
- School of Medicine, University College, Dublin 4, Ireland
- Lucena Clinic Child and Adolescent Mental Health Service, Rathgar, Dublin 6, Ireland
| | - David Cotter
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin 2, Ireland
- Department Psychiatry Beaumont Hospital, Dublin 9, Ireland
| | - Mary Cannon
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin 2, Ireland
- Department Psychiatry Beaumont Hospital, Dublin 9, Ireland
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Mayer C, Dodgson G, Woods A, Alderson‐Day B. "Figuring out how to be normal": Exploring how young people and parents make sense of voice-hearing in the family context. Psychol Psychother 2022; 95:600-614. [PMID: 35049128 PMCID: PMC9303802 DOI: 10.1111/papt.12381] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 12/17/2021] [Accepted: 01/04/2022] [Indexed: 01/05/2023]
Abstract
OBJECTIVES Making sense of voice-hearing-exploring the purpose, cause, and relationship with voices-is seen as therapeutically valuable for adults, but there is a paucity of research with adolescents. Family intervention is recommended for young people, yet little is known about families' perspectives on, or role in, a child's voice-hearing. This study therefore aimed to explore how both young people and parents had made sense of voice-hearing in the family context. METHOD Semi-structured interviews were conducted with seven young people who hear voices (six females, one male, age M = 17 years) and six parents of young people who hear voices (five females, one male). Data were analysed using interpretative phenomenological analysis. RESULTS The young people struggled to reconcile their voice-hearing experiences within themselves, wanted control, 'normality', and not to let their mental health hold them back. Parents saw the voices as separate to their child, who they were protective of, and came to an acceptance and hope for the future amidst continued uncertainty. Pragmatism, and shame, ran through parents' and young people's accounts. Tensions between them, such as autonomy versus involvement, were also apparent. CONCLUSIONS Few participants had made sense of their experiences in any concrete form, yet hope, control, and getting on with their lives were not conditional on having done so. Young people valued the family as a safe, non-enquiring space to be 'normal' and not to talk about their experiences. While all had been challenged by their experiences, an energy and strength ran through their accounts.
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Affiliation(s)
- Claire Mayer
- Department of PsychologyNewcastle UniversityNewcastle upon TyneUK,Cumbria, Northumberland, Tyne and Wear NHS Foundation TrustNewcastle upon TyneUK
| | - Guy Dodgson
- Cumbria, Northumberland, Tyne and Wear NHS Foundation TrustNewcastle upon TyneUK
| | - Angela Woods
- Institute for Medical Humanities, Pharmacy and HealthDurham UniversityDurhamUK
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Premorbid characteristics of patients with DSM-IV psychotic disorders. Compr Psychiatry 2022; 115:152310. [PMID: 35385814 DOI: 10.1016/j.comppsych.2022.152310] [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: 09/29/2021] [Accepted: 03/09/2022] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Psychotic disorder not otherwise specified (PNOS) is considered part of the psychosis spectrum, together with schizophrenia spectrum disorders (SSD) and psychotic bipolar spectrum disorders (PBD). The atypical clinical presentations of PNOS conditions may lead to uncertainty regarding treatment choices and expected outcomes. PNOS is understudied, and little is known about patients' premorbid characteristics including premorbid adjustment, prevalence of early cannabis use and childhood trauma. Knowledge about early illness phases can increase our understanding of this diagnostic group. METHODS We included 1099 participants from the Norwegian TOP-study; 688 with narrow SSD diagnoses (schizophrenia, schizoaffective disorder, schizophreniform disorder), 274 with PBD (psychotic bipolar 1 and bipolar NOS) and 137 with PNOS diagnosed with the SCID-I for DSM-IV. Participants were assessed with the Premorbid Adjustment Scale (PAS) divided into the areas of premorbid academic and social functioning. We obtained information on age at first exposure to cannabis and use of cannabis before the age of 16. The participants also provided information regarding early traumatic experiences using the Childhood Trauma Questionnaire (CTQ). RESULTS Participants with PNOS and SSD had poorer premorbid academic functioning than those with PBD (F2, 1029 = 7.81, p < 0.001, pη2 = 0.015). Premorbid social adjustment was significantly worse in the SSD group compared to the PBD group (F2, 1024 = 3.10, p = 0.045, pη2 = 0.006), with PNOS in the middle position. Significantly more of the participants with PNOS (17.5%) and SSD (11.5%) used cannabis before the age of 16 compared with PBD (5.3%, Wald χ2 = 6.86, p = 0.03). There were no significant differences between the three groups regarding mean CTQ scores or in the proportion of participants who had experienced at least one type of childhood adversity. CONCLUSIONS Participants with PNOS appear as more similar to participants with SSD than to those with PBD regarding early premorbid adjustment and early cannabis use. The results indicate that many conditions classified as PNOS have functional impairments and problematic substance use from an early age. The prevalence of childhood adversities are high in all three groups.
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Volpato E, Cavalera C, Castelnuovo G, Molinari E, Pagnini F. The "common" experience of voice-hearing and its relationship with shame and guilt: a systematic review. BMC Psychiatry 2022; 22:281. [PMID: 35443637 PMCID: PMC9022353 DOI: 10.1186/s12888-022-03902-6] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Accepted: 03/24/2022] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Despite Auditory Verbal Hallucinations (AVHs) having been long associated with mental illness, they represent a common experience also in the non-clinical population, yet do not exhibit distress or need for care. Shame and guilt are emotions related to one's perception of oneself and one's responsibility. As such, they direct our attention to aspects of AVHs that are under-researched and elusive, particularly about the status of voices as others, their social implications and the constitution and conceptualisation of the self. OBJECTIVES This paper aims to provide a systematic review of studies that investigated the relationship between auditory hallucinations, shame, and guilt in people without relevant signs of psychiatric issues. METHODS We searched studies reporting information about voices characteristics, the relationship between voices and hearers, hearer's reactions, and beliefs, paying peculiar attention to shame and guilt issues. Included papers were evaluated for risk of bias. RESULTS Eleven studies that explored the relationship between AVHs, shame and guilt, were extracted. Phenomenological, pragmatic, as well as neuropsychological features of hearing voices in non-clinical populations, allowed us to note a dynamic relationship and the constellation of subjective experiences that can occur. The role of guilt was characterized by few studies and mixed results, while shame was mainly common. CONCLUSIONS Due to the high heterogeneity detected and the scarce sources available, further studies should focus on both the aetiology and the bidirectional relationship between hearing voices, shame, and guilt in non-clinical people. This can be helpful in therapies for non-clinical populations who are distressed by their voices (e.g., psychotherapy), and for whom shame, and guilt may contribute to negative consequences such as isolation, anxiety or future depression. Moreover, it might favour the development and implication of different treatments considering emotion regulation, distress tolerance and interpersonal sensitivity on the clinical populations.
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Affiliation(s)
- E Volpato
- Department of Psychology, Università Cattolica del Sacro Cuore, Largo A. Gemelli, 1, 20123, Milan, Italy.
- IRCCS Fondazione Don Carlo Gnocchi, Milan, Italy.
| | - C Cavalera
- Department of Psychology, Università Cattolica del Sacro Cuore, Largo A. Gemelli, 1, 20123, Milan, Italy
| | - G Castelnuovo
- Department of Psychology, Università Cattolica del Sacro Cuore, Largo A. Gemelli, 1, 20123, Milan, Italy
- Istituto Auxologico Italiano IRCCS, Psychology Research Laboratory , Verbania , Italy
| | - E Molinari
- Department of Psychology, Università Cattolica del Sacro Cuore, Largo A. Gemelli, 1, 20123, Milan, Italy
- Laboratory, Istituto Auxologico Italiano IRCCS, Milan, Italy
| | - F Pagnini
- Department of Psychology, Università Cattolica del Sacro Cuore, Largo A. Gemelli, 1, 20123, Milan, Italy
- Department of Psychology, Harvard University, Cambridge, MA, USA
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Giugliano M, Contrada C, Foglia L, Francese F, Romano R, Dello Iacono M, Di Fausto E, Esposito M, Azzara C, Bilotta E, Carcione A, Nicolò G. Metacognitive Abilities as a Protective Factor for the Occurrence of Psychotic-Like Experiences in a Non-clinical Population. Front Psychol 2022; 13:805435. [PMID: 35282208 PMCID: PMC8910609 DOI: 10.3389/fpsyg.2022.805435] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Accepted: 01/17/2022] [Indexed: 11/13/2022] Open
Abstract
Psychotic-like experiences (PLEs) are a phenomenon that occurs in the general population experiencing delusional thoughts and hallucinations without being in a clinical condition. PLEs involve erroneous attributions of inner cognitive events to the external environment and the presence of intrusive thoughts influenced by dysfunctional beliefs; for these reasons, the role played by metacognition has been largely studied. This study investigates PLEs in a non-clinical population and discriminating factors involved in this kind of experience, among which metacognition, as well as psychopathological features, seems to have a crucial role. The aim of this study was to extend the knowledge about the relationship between metacognition, psychopathology, and PLEs, orienting the focus on metacognitive functioning. The sample consisted of 207 Italian participants (men = 32% and women = 68%) voluntarily recruited online, who gave consent to participate in the study. The average age of the sample was 32.69 years (SD: 9.63; range: 18-71). Subjects affected by psychosis, neurological disease, and drug addiction were excluded from the analyses. The following scales were used to investigate PLEs: Peters et al. Delusions Inventory (PDI), Launay-Slade Hallucinations Scale-Extended Revised (LSHSE), Prodromal Questionnaire-Brief (PQ-B), and Revised Hallucination Scale (RHS). To assess general psychopathological features, the Behavior and Symptom Identification Scale (BASIS-32) was administrated. The Metacognition Self-Assessment Scale (MSAS) was chosen to evaluate metacognitive functioning. From hierarchical regression analyses, it emerged that the presence of anxiety, depression, and impulsive/addictive symptoms constitute a remarkable vulnerability factor for PLEs, in line with previous evidence regarding the relationship between general psychopathology and PLEs. Metacognition negatively predicts PLEs, and its presence does not affect the significance of psychopathological variables, suggesting that metacognitive abilities seem to play a protective role for the occurrence of PLEs among non-clinical individuals, and such ability operates as an independent predictor along with other variables. These results are explained by the role of metacognitive functions, which allow individuals to operate many mental processes such as interpreting sensorial events as real or illusory, understanding behaviors, thoughts, and drives of others, and questioning the subjective interpretation of facts.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Carla Azzara
- Società Italiana di Cognitivismo Clinico, Rome, Italy
| | - Elena Bilotta
- Società Italiana di Cognitivismo Clinico, Rome, Italy.,Terzo Centro di Psicoterapia, Rome, Italy
| | - Antonino Carcione
- Società Italiana di Cognitivismo Clinico, Rome, Italy.,Terzo Centro di Psicoterapia, Rome, Italy
| | - Giuseppe Nicolò
- Società Italiana di Cognitivismo Clinico, Rome, Italy.,Terzo Centro di Psicoterapia, Rome, Italy
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de Boer JN, Corona Hernández H, Gerritse F, Brederoo SG, Wijnen FNK, Sommer IE. Negative content in auditory verbal hallucinations: a natural language processing approach. Cogn Neuropsychiatry 2022; 27:139-149. [PMID: 34154512 DOI: 10.1080/13546805.2021.1941831] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
INTRODUCTION Negative content of auditory verbal hallucinations (AVH) is a strong predictor of distress and impairment. This paper quantifies emotional voice-content in order to explore both subjective (i.e. perceived) and objectively (i.e. linguistic sentiment) measured negativity and investigates associations with distress. METHODS Clinical and non-clinical participants with frequent AVH (n = 40) repeated and recorded their AVH verbatim directly upon hearing. The AVH were analyzed for emotional valence using Pattern, a rule-based sentiment analyzer for Dutch. The AVH of the clinical individuals were compared to those of non-clinical voice-hearers on emotional valence and associated with experienced distress. RESULTS The mean objective valence of AVH in patients was significantly more negative than those of non-clinical voice-hearers. In the clinical individuals a larger proportion of the voice-utterances was negative (34.7% versus 18.4%) in objective valence. The linguistic valence of the AVH showed a significant, strong association with the perceived negativity, amount of distress and disruption of life, but not with the intensity of distress. CONCLUSIONS Our results indicate that AVH of patients have a more negative linguistic content than those of non-clinical voice-hearers, which is associated with the experienced distress. Thus, patients not only perceive their voices as more negative, objective analyses confirm this.
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Affiliation(s)
- J N de Boer
- Department of Biomedical Sciences of Cells & Systems, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.,Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, the Netherlands
| | - H Corona Hernández
- Department of Biomedical Sciences of Cells & Systems, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - F Gerritse
- Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, the Netherlands
| | - S G Brederoo
- Department of Biomedical Sciences of Cells & Systems, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands.,Department of Psychiatry, University Medical Center Groningen, Groningen, the Netherlands
| | - F N K Wijnen
- Utrecht Institute of Linguistics OTS, Utrecht University, Utrecht, the Netherlands
| | - I E Sommer
- Department of Biomedical Sciences of Cells & Systems, University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
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Corona-Hernández H, Brederoo SG, de Boer JN, Sommer IEC. A data-driven linguistic characterization of hallucinated voices in clinical and non-clinical voice-hearers. Schizophr Res 2022; 241:210-217. [PMID: 35151122 DOI: 10.1016/j.schres.2022.01.055] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2021] [Revised: 01/11/2022] [Accepted: 01/24/2022] [Indexed: 01/15/2023]
Abstract
BACKGROUND Auditory verbal hallucinations (AVHs) are heterogeneous regarding phenomenology and etiology. This has led to the proposal of AVHs subtypes. Distinguishing AVHs subtypes can inform AVHs neurocognitive models and also have implications for clinical practice. A scarcely studied source of heterogeneity relates to the AVHs linguistic characteristics. Therefore, in this study we investigate whether linguistic features distinguish AVHs subtypes, and whether linguistic AVH-subtypes are associated with phenomenology and voice-hearers' clinical status. METHODS Twenty-one clinical and nineteen non-clinical voice-hearers participated in this study. Participants were instructed to repeat verbatim their AVHs just after experiencing them. AVH-repetitions were audio-recorded and transcribed. AVHs phenomenology was assessed using the Auditory Hallucinations Rating Scale of the Psychotic Symptom Rating Scales. Hierarchical clustering analyses without a priori group dichotomization were performed using quantitative measures of sixteen linguistic features to distinguish sets of AVHs. RESULTS A two-AVHs-cluster solution best partitioned the data. AVHs-clusters significantly differed in linguistic features (p < .001); AVHs phenomenology (p < .001); and distribution of clinical voice-hearers (p < .001). The "expanded-AVHs" cluster was characterized by more determiners, more prepositions, longer utterances (all p < .01), and mainly contained non-clinical voice-hearers. The "compact-AVHs" cluster had fewer determiners and prepositions, shorter utterances (all p < .01), more negative content, higher degree of negativity (both p < .05), and predominantly came from clinical voice-hearers. DISCUSSION Two voice-speech clusters were recognized, differing in syntactic-grammatical complexity and negative phenomenology. Our results suggest clinical voice-hearers often hear negative, "compact-voices", understandable under Broca's right hemisphere homologue and memory-based mechanisms. Conversely, non-clinical voice-hearers experience "expanded-voices", better accounted by inner speech AVHs models.
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Affiliation(s)
- H Corona-Hernández
- Department of Biomedical Sciences of Cells & Systems, University Medical Center Groningen, University of Groningen, the Netherlands.
| | - S G Brederoo
- Department of Biomedical Sciences of Cells & Systems, University Medical Center Groningen, University of Groningen, the Netherlands; Department of Psychiatry, University Medical Center Groningen, University of Groningen, the Netherlands
| | - J N de Boer
- Department of Biomedical Sciences of Cells & Systems, University Medical Center Groningen, University of Groningen, the Netherlands; Department of Psychiatry, University Medical Center Utrecht, Utrecht University & Brain Center Rudolf Magnus, Utrecht, the Netherlands
| | - I E C Sommer
- Department of Biomedical Sciences of Cells & Systems, University Medical Center Groningen, University of Groningen, the Netherlands; Department of Psychiatry, University Medical Center Groningen, University of Groningen, the Netherlands
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Kramer M, Juckel G, Mavrogiorgou P. [Psychopathology and Theory of Perceptual Disturbances]. FORTSCHRITTE DER NEUROLOGIE-PSYCHIATRIE 2022; 90:280-287. [PMID: 35196716 DOI: 10.1055/a-1720-1298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Current classification systems for psychiatric disorders are primarly based on categorial typologies and describe these as distinct nosological entities. A dimensional perspective allows descriptions of a gradual transition between pathologies as well as between normality and pathologies of psychiatric symptoms. Using acoustic hallucinations as most common form of perception disturbances as example, psychiatric-psychopathological and theoretical pros and cons for a dimensional classification of psychiatric symptomatology are sketched in this article. Although doubts concerning the similarity of real perceptions and acoustic hallucinations which underlie such mental events are controversially discussed, many hints could be found for a continuum of hallucinatoric symptoms from the mentally healthy population up to the group of patients with schizophrenia. Studies which investigate the neurophysiological mechanisms of acoustic hallucinations such as hearing voices in healthy persons in comparison to those in patients with schizophrenia could contribute to further differentiation.
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Affiliation(s)
- Marco Kramer
- Ruhr-Universität Bochum, Psychiatrie, Bochum, Germany
| | - Georg Juckel
- Ruhr-Universität Bochum, Psychiatrie, Bochum, Germany
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45
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Bornheimer LA, Martz ME, Suzuki T, Tso IF, Burton CZ, Li Verdugo J, Grove T, Heitzeg MM, Taylor SF. Affective Dysregulation Precedes Emergence of Psychosis-Like Experiences in a Community Sample of Young Adults. Schizophr Bull 2022; 48:664-672. [PMID: 35190837 PMCID: PMC9077429 DOI: 10.1093/schbul/sbac015] [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: 11/13/2022]
Abstract
Affective dysregulation (AD) among persons with schizophrenia spectrum disorders, involving the tendency to exhibit sensitivity to minor stress and negative affective states, is an important diagnostic feature and relates to poorer functional and clinical outcomes. Studies of persons with elevated risk for psychosis demonstrate similar AD to those with schizophrenia, and literature suggest a potential influence of AD in the transition from psychosis-like symptoms (PLEs) to disorder. Cross-sectional investigations to date have supported the link between AD and psychosis, and longitudinal studies have mostly yielded mixed findings without demonstration of potential causal relationships between AD and psychosis. This study examined the concurrent and predictive relationships between AD and PLE in a community sample of youth (n = 630) with attention to distinct facets of AD as a latent construct, including low resiliency, low reactive control, and negative emotionality, using structural equation to estimate a longitudinal cross-lagged and autoregressive model across 3 study waves from 15 to 24 years of age. As hypothesized, AD in the mid-teen years predicted subsequent PLE 3 years later. In addition, we found that increasing PLE in the end of the teen years related to a subsequent increase in AD in the early 20s. A cross-sectional relationship between AD and PLE in the mid-teen years was also supported. Findings overall describe important relationships between AD and PLE that appear to vary with developmental stage, implicating various factors to inform approaches for identifying youth who may be at risk for subsequent PLE or other mental health conditions.
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Affiliation(s)
- Lindsay A Bornheimer
- To whom correspondence should be addressed; 1080 South University Ave, Ann Arbor, MI 48109; tel: (734) 615-2915, fax: 1 (734) 936-1961, e-mail:
| | - Meghan E Martz
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Takakuni Suzuki
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA,Department of Psychology, University of Michigan, Ann Arbor, MI, USA
| | - Ivy F Tso
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA,Department of Psychology, University of Michigan, Ann Arbor, MI, USA
| | - Cynthia Z Burton
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | | | - Tyler Grove
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Mary M Heitzeg
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Stephan F Taylor
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA,Department of Psychology, University of Michigan, Ann Arbor, MI, USA
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46
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Stanyon D, Yamasaki S, Ando S, Endo K, Nakanishi M, Kiyono T, Hosozawa M, Kanata S, Fujikawa S, Morimoto Y, Hiraiwa-Hasegawa M, Kasai K, Nishida A. The role of bullying victimization in the pathway between autistic traits and psychotic experiences in adolescence: Data from the Tokyo Teen Cohort study. Schizophr Res 2022; 239:111-115. [PMID: 34871995 DOI: 10.1016/j.schres.2021.11.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2021] [Revised: 10/13/2021] [Accepted: 11/14/2021] [Indexed: 11/28/2022]
Abstract
Autistic traits are associated with psychotic experiences in adolescence; however, the mechanisms underlying this relationship are not well understood. Prior research indicates that bullying victimization increases the risk of psychotic experiences in general adolescent populations, and autistic youth are at higher risk of being bullied than their non-autistic peers. Using longitudinal data from general population adolescents aged 10-14 in the Tokyo Teen Cohort study, we tested the hypothesis that bullying is responsible for the association between autistic traits and psychotic experiences in adolescence. We identified an indirect effect (estimate = 0.033 [95% CIs: 0.014-0.057], p < 0.001) between autistic traits and psychotic experiences via bullying victimization, even after controlling for known confounders. Prevention of bullying victimization may be one avenue for reducing risk of psychosis among adolescents with high levels of autistic traits.
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Affiliation(s)
- Daniel Stanyon
- Research Center for Social Science & Medicine, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Syudo Yamasaki
- Research Center for Social Science & Medicine, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan.
| | - Shuntaro Ando
- Research Center for Social Science & Medicine, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan; Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Kaori Endo
- Research Center for Social Science & Medicine, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Miharu Nakanishi
- Research Center for Social Science & Medicine, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
| | - Tomoki Kiyono
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Mariko Hosozawa
- Institute for Global Health Policy Research, Bureau of International Health Cooperation, National Center for Global Health and Medicine, Tokyo, Japan
| | - Sho Kanata
- Department of Psychiatry, Teikyo University School of Medicine, Tokyo, Japan
| | - Shinya Fujikawa
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
| | - Yuko Morimoto
- Department of Psychology, Ube Frontier University, Yamaguchi, Japan
| | - Mariko Hiraiwa-Hasegawa
- School of Advanced Science, SOKENDAI (Graduate University for Advanced Studies), Kanagawa, Japan
| | - Kiyoto Kasai
- Department of Neuropsychiatry, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan; The International Research Center for Neurointelligence (WPI-IRCN), The University of Tokyo Institutes for Advanced Study (UTIAS), The University of Tokyo, Tokyo, Japan
| | - Atsushi Nishida
- Research Center for Social Science & Medicine, Tokyo Metropolitan Institute of Medical Science, Tokyo, Japan
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47
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Di Luzio M, Pontillo M, Di Vincenzo C, Bellantoni D, Demaria F, Vicari S. Hallucinations in the Child and Adolescent "Ultra-High Risk" population: A Systematic Review. SCHIZOPHRENIA BULLETIN OPEN 2022; 3:sgac068. [PMID: 39144782 PMCID: PMC11205958 DOI: 10.1093/schizbullopen/sgac068] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 08/16/2024]
Abstract
Background and Hypothesis "Ultra-high risk" for psychosis young adults are assumed to be at higher risk of developing a psychotic spectrum disorder. Predominantly, the ultrahigh-risk population is aged 18-35 years, but it may also include younger children and adolescents. Individuals in this population experience psychosis prodromes in the form of attenuated or brief psychotic symptoms (particularly perceptual abnormalities). Albeit diagnosis is made via structured interviews, such measures fail to sufficiently assess the precise form and content of perceptual abnormalities, especially as they manifest in children and adolescents. Study Design The present study involved a systematic review of the literature on perceptual abnormalities (particularly hallucinations) in ultrahigh-risk children and adolescents. Results The analysis reviewed five studies and drew conclusions about the perceptual abnormalities (ie, hallucinations) experienced by the study samples, focusing on form, content, and associations with other symptoms. Of note, 2 of the investigated studies suggested a relationship between hallucinations and experiences of childhood trauma. Conclusions The transition to psychosis and experiences of childhood trauma could correspond to different types of hallucinations in ultrahigh-risk children and adolescents. This knowledge could improve the identification of prodromal states in the young, ultrahigh-risk population.
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Affiliation(s)
- Michelangelo Di Luzio
- Child and Adolescence Neuropsychiatry Unit, Department of Neuroscience, IRCCS “Bambino Gesù” Children’s Hospital, Rome, Italy
| | - Maria Pontillo
- Child and Adolescence Neuropsychiatry Unit, Department of Neuroscience, IRCCS “Bambino Gesù” Children’s Hospital, Rome, Italy
| | - Cristina Di Vincenzo
- Child and Adolescence Neuropsychiatry Unit, Department of Neuroscience, IRCCS “Bambino Gesù” Children’s Hospital, Rome, Italy
| | - Domenica Bellantoni
- Child and Adolescence Neuropsychiatry Unit, Department of Neuroscience, IRCCS “Bambino Gesù” Children’s Hospital, Rome, Italy
| | - Francesco Demaria
- Child and Adolescence Neuropsychiatry Unit, Department of Neuroscience, IRCCS “Bambino Gesù” Children’s Hospital, Rome, Italy
| | - Stefano Vicari
- Child and Adolescence Neuropsychiatry Unit, Department of Neuroscience, IRCCS “Bambino Gesù” Children’s Hospital, Rome, Italy
- Department of Life Sciences and Public Health, Università Cattolica del Sacro Cuore, 00168 Rome, Italy
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48
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Schultze-Lutter F, Kindler J, Ambarini TK, Michel C. Positive psychotic symptoms in childhood and adolescence. Curr Opin Psychol 2021; 45:101287. [PMID: 35016089 DOI: 10.1016/j.copsyc.2021.11.007] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2021] [Revised: 10/21/2021] [Accepted: 11/24/2021] [Indexed: 11/30/2022]
Abstract
Based on the assumption of a universal neurodevelopmental model of psychosis, especially of the schizophrenia spectrum, the diagnosis (and treatment) of psychosis in minors commonly follows those in adults. Yet, as our review demonstrates, recent years have seen an emergence of studies of minors indicating that developmental aspects may play a crucial role in the prevalence and appraisal of diagnostically relevant positive psychotic symptoms in their full-blown and subthreshold forms, including neurobiogenetic and other risk factors, such as migration. Thus, caution is advised to not overpathologize potentially transient and clinically irrelevant occurrence of (subthreshold) positive psychotic symptoms in the diagnosis and treatment of psychotic disorders and their clinical high-risk states in minors. More studies on developmental aspects are urgently needed.
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Affiliation(s)
- Frauke Schultze-Lutter
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University Düsseldorf, Bergische Landstraße 2, 40470 Düsseldorf, Germany; University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bolligenstr, 111, 3000 Bern 60, Switzerland; Department of Psychology, Faculty of Psychology, Airlangga University, Airlangga 4-6, Surabaya 60286, Indonesia.
| | - Jochen Kindler
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bolligenstr, 111, 3000 Bern 60, Switzerland
| | - Tri Kurniati Ambarini
- Department of Psychology, Faculty of Psychology, Airlangga University, Airlangga 4-6, Surabaya 60286, Indonesia
| | - Chantal Michel
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bolligenstr, 111, 3000 Bern 60, Switzerland
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49
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Shao X, Liao Y, Gu L, Chen W, Tang J. The Etiology of Auditory Hallucinations in Schizophrenia: From Multidimensional Levels. Front Neurosci 2021; 15:755870. [PMID: 34858129 PMCID: PMC8632545 DOI: 10.3389/fnins.2021.755870] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2021] [Accepted: 10/14/2021] [Indexed: 11/25/2022] Open
Abstract
Enormous efforts have been made to unveil the etiology of auditory hallucinations (AHs), and multiple genetic and neural factors have already been shown to have their own roles. Previous studies have shown that AHs in schizophrenia vary from those in other disorders, suggesting that they have unique features and possibly distinguishable mechanisms worthy of further investigation. In this review, we intend to offer a comprehensive summary of current findings related to AHs in schizophrenia from aspects of genetics and transcriptome, neurophysiology (neurometabolic and electroencephalogram studies), and neuroimaging (structural and functional magnetic resonance imaging studies and transcriptome–neuroimaging association study). Main findings include gene polymorphisms, glutamate level change, electroencephalographic alterations, and abnormalities of white matter fasciculi, cortical structure, and cerebral activities, especially in multiple regions, including auditory and language networks. More solid and comparable research is needed to replicate and integrate ongoing findings from multidimensional levels.
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Affiliation(s)
- Xu Shao
- Department of Psychiatry, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Yanhui Liao
- Department of Psychiatry, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Lin Gu
- RIKEN AIP, Tokyo, Japan.,Research Center for Advanced Science and Technology, The University of Tokyo, Tokyo, Japan
| | - Wei Chen
- Department of Psychiatry, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jinsong Tang
- Department of Psychiatry, Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, Hangzhou, China
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50
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Hafeez D, Yung AR. Early persistence of psychotic-like experiences in a community sample of adolescents. Early Interv Psychiatry 2021; 15:1575-1583. [PMID: 33283458 DOI: 10.1111/eip.13096] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 09/22/2020] [Accepted: 11/14/2020] [Indexed: 01/20/2023]
Abstract
AIMS Psychotic-like experiences (PLEs) are common in adolescents. Their persistence may confer increased susceptibility to psychotic disorder. The early evolution of transient to persistent PLEs is not well known. This study aimed to investigate the early persistence of PLEs (over 6-12 months) in a community sample of adolescents and examine baseline and longitudinal associations of early persistent PLEs. METHODS Five hundred and ninety Year 10 students were administered the community assessment of psychic experiences (CAPE) to measure PLEs at baseline and at follow up 6-12 months later. Persistent PLEs were defined as those present at or above the 90th centile at both time points. Independent variables of depression, psychological distress and functioning were all measured at both baseline and follow up. Self-esteem, personality and suicidality were assessed at follow up. RESULTS The study found 5.1% of participants had early persistent PLEs. Persistence was associated positively with depression and distress at both time points, neuroticism and openness at baseline and suicidality at follow up. Persistence was negatively associated with functioning at both time points, agreeableness at baseline and self-esteem at follow-up. Only depression remained significantly associated at both time points when accounting for other variables. Thus, depressive symptoms may account for changes in other domains and be a predictor of early PLEs persistence. CONCLUSIONS These results reinforce the importance of monitoring and assessing PLEs in young people especially when associated with depression. Further research is required to investigate PLE persistence over longer periods with increased measurement intervals.
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Affiliation(s)
- Danish Hafeez
- School of Medical Sciences, The University of Manchester, Manchester, UK
| | - Alison R Yung
- Orygen, The National Centre of Excellence in Youth Mental Health, Parkville, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia.,School of Health Sciences, The University of Manchester, Manchester, UK
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