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Filip TF, Hellemann GS, Ventura J, Subotnik KL, Green MF, Nuechterlein KH, McCleery A. Defeatist performance beliefs in individuals with recent-onset schizophrenia: Relationships with cognition and negative symptoms. Schizophr Res 2024; 270:212-219. [PMID: 38924939 DOI: 10.1016/j.schres.2024.06.021] [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: 12/19/2023] [Revised: 06/01/2024] [Accepted: 06/15/2024] [Indexed: 06/28/2024]
Abstract
BACKGROUND The cognitive model of negative symptoms of schizophrenia suggests that defeatist performance beliefs (DPB), or overgeneralized negative beliefs about one's performance, are an intermediary variable along the pathway from impaired neurocognitive performance to negative symptoms and functioning in daily life. Although reliable associations between these variables have been established in chronic schizophrenia, less is known about the nature of these relationships in recent-onset schizophrenia (ROSz). This current study tested the associations between DPB and variables in the cognitive model (neurocognitive performance, negative symptoms, functioning) as well as mediation by DPB of the association between neurocognitive performance and negative symptoms in ROSz. METHODS A total of 52 participants (32 adults with ROSz and 20 non-psychiatric healthy comparators; HC) completed in-lab measures of neurocognitive performance, self-reported defeatist performance beliefs, and clinician administered measures of negative symptoms and functional outcome. Bivariate relationships among these variables were tested with Pearson correlations. Bootstrapped regression analyses were conducted to test the strength of the indirect effect of neurocognitive performance on negative symptoms through DPB. RESULTS Defeatist performance beliefs were significantly elevated in ROSz, and were associated with neurocognitive performance, negative symptoms, and functional outcome as predicted by the cognitive model. There was a significant indirect effect of neurocognition on experiential negative symptoms through DPB, indicating DPB are a partial mediator of the relationship between neurocognitive performance and negative symptoms. CONCLUSION These findings are consistent with the cognitive model of negative symptoms and extend previous findings in both ROSz and established schizophrenia. Specifically, these data demonstrate that DPB are elevated among ROSz and the associations with neurocognition and clinical outcomes (e.g., negative symptoms and functioning) are of similar magnitude to those reported in chronic schizophrenia. DPB may therefore be a viable treatment target in the early course of illness.
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Affiliation(s)
- Tess F Filip
- Department of Psychological and Brain Sciences, The University of Iowa, Iowa City, IA, United States of America
| | - Gerhard S Hellemann
- Department of Public Health, The University of Alabama at Birmingham, Birmingham, AL, United States of America
| | - Joseph Ventura
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, CA, United States of America
| | - Kenneth L Subotnik
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, CA, United States of America
| | - Michael F Green
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, CA, United States of America; Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, United States of America
| | - Keith H Nuechterlein
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, CA, United States of America; Department of Psychology, University of California Los Angeles, Los Angeles, CA, United States of America
| | - Amanda McCleery
- Department of Psychological and Brain Sciences, The University of Iowa, Iowa City, IA, United States of America; Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, CA, United States of America; Department of Psychiatry, Carver College of Medicine, The University of Iowa, Iowa City, IA, United States of America.
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Kammerer MK, Nowak U, Lincoln TM, Krkovic K. Revisiting Cognitive Deficits in Outpatients with Psychotic Disorders: A Transdiagnostic Comparison of Cognitive Performance While Accounting for Putative Confounding Factors. Brain Sci 2024; 14:446. [PMID: 38790425 PMCID: PMC11119287 DOI: 10.3390/brainsci14050446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Revised: 04/26/2024] [Accepted: 04/28/2024] [Indexed: 05/26/2024] Open
Abstract
Recent research suggests that cognitive deficits in individuals with psychotic disorders could be overestimated because poor cognitive test performance is partly attributable to non-cognitive factors. To further test this, we included non-hospitalized individuals with psychotic disorders (PSY, n = 38), individuals with attenuated psychotic symptoms (n = 40), individuals with obsessive-compulsive disorders (n = 39), and healthy controls (n = 38). Relevant cognitive domains were assessed using the MATRICS Consensus Cognitive Battery. Putative confounding non-cognitive factors-heart rate, self-reported stress, negative affect, performance-related beliefs, and actigraphy-derived sleep-were assessed before cognitive testing. A multivariate analysis of covariance was calculated to examine group differences in cognitive performance while controlling for non-cognitive factors. PSY showed decreased test performance in graphomotor speed, attention, and verbal tasks compared to the other groups, whereas non-verbal/visual-spatial tasks were unimpaired. After accounting for non-cognitive factors, group differences diminished in verbal learning, whereas differences in the other domains remained significant. Against our hypotheses, the present findings indicate that some cognitive deficits in PSY cannot be attributed to momentary confounding factors.
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Affiliation(s)
- Mathias Konstantin Kammerer
- Clinical Psychology and Psychotherapy, Institute of Psychology, Faculty of Psychology and Movement Sciences, Universität Hamburg, 20146 Hamburg, Germany; (M.K.K.); (U.N.); (T.M.L.)
| | - Ulrike Nowak
- Clinical Psychology and Psychotherapy, Institute of Psychology, Faculty of Psychology and Movement Sciences, Universität Hamburg, 20146 Hamburg, Germany; (M.K.K.); (U.N.); (T.M.L.)
| | - Tania M. Lincoln
- Clinical Psychology and Psychotherapy, Institute of Psychology, Faculty of Psychology and Movement Sciences, Universität Hamburg, 20146 Hamburg, Germany; (M.K.K.); (U.N.); (T.M.L.)
| | - Katarina Krkovic
- Clinical Psychology and Psychotherapy for Children and Youth, Department of Psychology, Faculty of Human Sciences, University of Potsdam, 14476 Potsdam, Germany
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Øie MB, Haugen I, Stubberud J, Øie MG. Effects of Goal Management Training on self-efficacy, self-esteem, and quality of life for persons with schizophrenia spectrum disorders. Front Psychol 2024; 15:1320986. [PMID: 38515967 PMCID: PMC10955763 DOI: 10.3389/fpsyg.2024.1320986] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2023] [Accepted: 02/26/2024] [Indexed: 03/23/2024] Open
Abstract
Persons with schizophrenia often show executive dysfunction assessed with both subjective (self-report) and objective (neuropsychological tests) measures. In a recent randomized controlled trial (RCT), subjective executive functioning in everyday life was improved following Goal Management Training (GMT). The aim of the current study is to investigate the potential of GMT to improve secondary well-being outcomes from that RCT, including self-esteem, self-efficacy, and quality of life in persons with schizophrenia spectrum disorders. Since well-being is frequently lower in persons with schizophrenia compared to healthy individuals, further knowledge about well-being as an outcome after cognitive remediation may have implications for clinical treatment. Sixty-five participants were randomly assigned to GMT (n = 31) or a waiting list control condition (n = 34). Assessments were conducted at baseline (T1), immediately after the intervention (T2-5 weeks), and at six-month follow-up (T3). Measures included the Rosenberg Self-Esteem Scale, the Perceived Quality of Life Scale, and the General Self-Efficacy Scale. Results were analyzed using a linear mixed model analysis for repeated measures. There were no significant effects of GMT on self-esteem or quality of life. Only the GMT group showed a significant increase in self-efficacy that was most evident at six months follow-up, F(1, 34) = 10.71, p = 0.002, d = 0.71. Improved self-efficacy was found to correlate significantly with a reduction in perceived executive dysfunction in an exploratory post hoc analysis. Our findings demonstrate the potential of GMT in improving self-efficacy in schizophrenia Clinical trial registration:https://clinicaltrials.gov, NCT03048695.
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Affiliation(s)
| | - Ingvild Haugen
- Research Division, Innlandet Hospital Trust, Brumunddal, Norway
| | - Jan Stubberud
- Department of Psychology, University of Oslo, Oslo, Norway
- Department of Research, Lovisenberg Diaconal Hospital, Oslo, Norway
| | - Merete Glenne Øie
- Department of Psychology, University of Oslo, Oslo, Norway
- Research Division, Innlandet Hospital Trust, Brumunddal, Norway
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4
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Tinch-Taylor R, Pickles A, Stringer D, Csipke E, Cella M, McCrone P, Reeder C, Birchwood M, Fowler D, Greenwood K, Johnson S, Perez J, Ritunnano R, Thompson A, Upthegrove R, Wilson J, Kenny A, Isok I, Joyce EM, Wykes T. Understanding the Mechanisms of Cognitive Remediation on Recovery in People With Early Psychosis: A Mediation and Moderation Analysis. Schizophr Bull 2024:sbae021. [PMID: 38428943 DOI: 10.1093/schbul/sbae021] [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] [Indexed: 03/03/2024]
Abstract
BACKGROUND To provide precision cognitive remediation therapy (CR) for schizophrenia, we need to understand whether the mechanism for improved functioning is via cognition improvements. This mechanism has not been rigorously tested for potential moderator effects. STUDY DESIGN We used data (n = 377) from a randomized controlled trial using CIRCuiTS, a therapist-supported CR, with participants from first-episode psychosis services. We applied structured equation modeling to test whether: (1) CR hours explain the goal attainment functional outcome (GAS) at posttreatment, (2) global cognitive improvement mediates GAS, and if (3) total symptoms moderate the CR hours to cognitive improvement pathway, and/or negative symptoms moderate the cognition to functioning pathway, testing moderator effects via the mediator or directly on CR hours to functioning path. STUDY RESULTS CR produced significant functioning benefit for each therapy hour (Coeff = 0.203, 95% CI 0.101-0.304, P < .001). The mediated path from CR hours to cognition and cognition to functioning was small and nonsignificant (Coeff = 0.014, 95% CI = -0.010, 0.037, P = .256). Total symptoms did not moderate the path to cognition (P = .211) or the direct path to outcome (P = .896). However, negative symptoms significantly moderated the effect of cognitive improvements on functioning (P = .015) with high negative symptoms reducing the functional gains of improved cognition. CONCLUSIONS Although cognitive improvements were correlated with functioning benefit, they did not fully explain the positive effect of increased therapy hours on functioning, suggesting additional CR factors also contribute to therapy benefit. Negative symptoms interfere with the translation of cognitive improvements into functional gains so need consideration.
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Affiliation(s)
- Rose Tinch-Taylor
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Andrew Pickles
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Dominic Stringer
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Emese Csipke
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Matteo Cella
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
| | - Paul McCrone
- School of Health Sciences, University of Greenwich, London, UK
| | - Clare Reeder
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Max Birchwood
- Warwick Medical School, University of Warwick, Coventry, UK
| | - David Fowler
- School of Psychology, University of Sussex, Brighton, UK
| | | | - Sonia Johnson
- Faculty of Brain Sciences, University College London, London, UK
| | - Jesus Perez
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | - Rosa Ritunnano
- Warwick Medical School, University of Warwick, Coventry, UK
| | | | | | - Jon Wilson
- Norfolk and Suffolk NHS Foundation Trust, Norwich, UK
| | - Alex Kenny
- Patient Advisory Board, King's College London, London, UK
| | - Iris Isok
- Patient Advisory Board, King's College London, London, UK
| | - Eileen M Joyce
- UCL Queen Square Institute of Neurology, University College London, London, UK
| | - Til Wykes
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- South London and Maudsley NHS Foundation Trust, London, UK
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D'Anna G, Zarbo C, Cardamone G, Zamparini M, Calza S, Rota M, Correll CU, Rocchetti M, Starace F, de Girolamo G. Interplay between negative symptoms, time spent doing nothing, and negative emotions in patients with schizophrenia spectrum disorders: results from a 37-site study. SCHIZOPHRENIA (HEIDELBERG, GERMANY) 2023; 9:63. [PMID: 37735175 PMCID: PMC10514038 DOI: 10.1038/s41537-023-00372-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 06/26/2023] [Indexed: 09/23/2023]
Abstract
This study evaluated the relationship between negative symptoms, daily time use (productive/non-productive activities, PA/NPA), and negative emotions in schizophrenia-spectrum disorders (SSDs): 618 individuals with SSDs (311 residential care patients [RCPs], 307 outpatients) were surveyed about socio-demographic, clinical (BPRS, BNSS) and daily time use (paper-and-pencil Time Use Survey completed twice/week) characteristics. Among them 57 RCPs and 46 outpatients, matched to 112 healthy controls, also underwent ecological monitoring of emotions (8 times/day for a week) through Experience Sampling Method (ESM). RCPs spent significantly less time in PA than outpatients. Patients with more negative symptomatology spent more time in NPA and less in PA compared to patients with milder symptoms. Higher time spent in NPA was associated with negative emotions (p < 0.001 during workdays) even when correcting for BNSS total and antipsychotic polypharmacy (p = 0.002 for workdays, p = 0.006 for Sundays). Future studies are needed to explore in more detail the relationship between negative emotions, negative symptoms, time use, and functioning in individuals with SSDs, providing opportunities for more informed and personalised clinical treatment planning and research into interactions between different motivational, saliency and behavioural aspects in individuals with SSDs.
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Grants
- RF-2018-12365514 Ministero della Salute (Ministry of Health, Italy)
- RF-2018-12365514 Ministero della Salute (Ministry of Health, Italy)
- RF-2018-12365514 Ministero della Salute (Ministry of Health, Italy)
- RF-2018-12365514 Ministero della Salute (Ministry of Health, Italy)
- RF-2018-12365514 Ministero della Salute (Ministry of Health, Italy)
- RF-2018-12365514 Ministero della Salute (Ministry of Health, Italy)
- RF-2018-12365514 Ministero della Salute (Ministry of Health, Italy)
- RF-2018-12365514 Ministero della Salute (Ministry of Health, Italy)
- RF-2018-12365514 Ministero della Salute (Ministry of Health, Italy)
- RF-2018-12365514 Ministero della Salute (Ministry of Health, Italy)
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Affiliation(s)
- Giulio D'Anna
- Department of Mental Health, AUSL Toscana Centro, Prato, Italy
| | - Cristina Zarbo
- Department of Psychology, University of Milano Bicocca, Milan, Italy
| | | | - Manuel Zamparini
- Unit of Epidemiological and Evaluation Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Stefano Calza
- Unit of Biostatistics and Bioinformatics, Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy.
| | - Matteo Rota
- Unit of Biostatistics and Bioinformatics, Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Christoph U Correll
- Department of Psychiatry, The Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA
- Department of Psychiatry and Molecular Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
- Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin Berlin, Berlin, Germany
| | - Matteo Rocchetti
- Department of Mental Health and Dependence, ASST of Pavia, Pavia, Italy
| | - Fabrizio Starace
- Department of Mental Health and Pathological Addiction, AUSL di Modena, Modena, Italy
| | - Giovanni de Girolamo
- Unit of Epidemiological and Evaluation Psychiatry, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.
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Randhawa A, Kühn S, Schöttle D, Moritz S, Gallinat J, Ascone L. The effects of assessing character strengths vs. psychopathology on mood, hope, perceived stigma and cognitive performance in individuals with psychosis. PLoS One 2023; 18:e0289872. [PMID: 37561694 PMCID: PMC10414607 DOI: 10.1371/journal.pone.0289872] [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: 09/24/2022] [Accepted: 07/27/2023] [Indexed: 08/12/2023] Open
Abstract
OBJECTIVES The main objective of the present study was to investigate whether assessments of psychopathology vs. character strengths were associated with systematic differences concerning transient psychological states (i.e., cognitive performance, state mood, optimism, therapy motivation, perceived stigma) in individuals with psychotic disorders. An additional goal was to evaluate the acceptance and appraisal of a subsequent online character-strength intervention, consisting of top-two strengths feedback, and to explore associations between character strengths and psychotic symptoms. The study thus aimed to contribute to the discussion on the extension of current treatment approaches for schizophrenia through positive psychological interventions. METHODS The study was implemented online applying a randomized within-subject cross-over design in N = 39 patients with self-reported psychosis. After a baseline assessment, briefly capturing psychological states (including cognition: TMT A/B, positive and negative affect, motivation for change/ therapy, optimism, and self-stigma) participants were randomly assigned to a first questionnaire block, which addressed either individual character strengths (VIA-IS) or psychopathology (CAPE & BSI). This was followed by a second, brief assessment of transient psychological states, whereafter the second questionnaire block was conducted, this time with the respective opposite (strengths or psychopathology) assessment. A final psychological states assessment was conducted. Afterwards, participants received feedback on their top-two strengths and a brief psycho-education, followed by a qualitative assessment. RESULTS Contrary to expectations, there were no differences between the psychological states after the pathology vs. character strengths assessment blocks. Character strengths mainly correlated negatively with negative symptoms, with medium to large effect sizes. Participants were generally satisfied with the intervention and rated a focus on personal strengths in psychotherapy as highly important. CONCLUSION Our main hypothesis stating that the assessment of character strengths (vs. psychopathology) is associated with differences in subsequent psychological states could not be confirmed. Qualitative findings indicate that the emphasis on individual character strengths interventions is well accepted and viewed as important. The associations of character strengths with negative symptoms are important from the background of the cognitive model or defeatist beliefs (e.g., amotivation due to perceiving the self as 'incapable'), which could be addressed in experimental or intervention studies targeting character strengths.
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Affiliation(s)
- Aman Randhawa
- Universitätsklinikum Hamburg-Eppendorf, Clinic and Policlinic for Psychiatry and Psychotherapy, Hamburg, Germany
| | - Simone Kühn
- Universitätsklinikum Hamburg-Eppendorf, Clinic and Policlinic for Psychiatry and Psychotherapy, Hamburg, Germany
- Lise-Meitner Group for Environmental Neuroscience, Max Planck Institute for Human Development, Berlin, Germany
| | - Daniel Schöttle
- Universitätsklinikum Hamburg-Eppendorf, Clinic and Policlinic for Psychiatry and Psychotherapy, Hamburg, Germany
| | - Steffen Moritz
- Universitätsklinikum Hamburg-Eppendorf, Clinic and Policlinic for Psychiatry and Psychotherapy, Hamburg, Germany
| | - Jürgen Gallinat
- Universitätsklinikum Hamburg-Eppendorf, Clinic and Policlinic for Psychiatry and Psychotherapy, Hamburg, Germany
| | - Leonie Ascone
- Universitätsklinikum Hamburg-Eppendorf, Clinic and Policlinic for Psychiatry and Psychotherapy, Hamburg, Germany
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Moses DG, Palaniappan P, Ponraj PC. Residual experiential symptoms mediate the effect of expressive symptoms over the social functioning in remitted schizophrenia. Ind Psychiatry J 2023; 32:309-316. [PMID: 38161473 PMCID: PMC10756619 DOI: 10.4103/ipj.ipj_30_23] [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] [Received: 02/09/2023] [Accepted: 02/23/2023] [Indexed: 01/03/2024] Open
Abstract
Context Impairment in social functioning had been consistently found in remitted schizophrenia; yet, predictors of social dysfunction had been hardly explored and intervention trials had rarely included remitted schizophrenia. Methods 60 subjects with schizophrenia (diagnosed based on DSM5), currently in remission (SAPS and SANS global rating ≤2, for a minimum period of 12 weeks) and 46 age and gender-matched healthy controls were recruited after obtaining informed consent. The socio-demographic details, illness characteristics, depressive symptoms, positive and negative symptoms [using Scale for assessment of positive symptoms (SAPS), and scale for assessment of negative symptoms (SANS)] were assessed. The Theory of Mind (ToM) score was derived from the ToM tasks of a culturally validated tool, Social Cognition Rating Tools in Indian Setting. The social functioning was assessed using Groningen social disabilities schedule II (GSDSSII). Results The mean SAPS summary and SANS summary scores were 3.01 ± 2.99 and 4.32 ± 2.94, respectively. The social functioning was significantly impaired in remitted schizophrenia when compared to healthy controls. In the hierarchical regression, experiential dimension (β =1.941, t = 6.097, P < 0.001), followed by expressive dimension predicted social functioning (explained 70.5% of variance) after controlling for confounders. On mediation analysis, the effect of expressive dimension over the social functioning was significantly mediated by experiential dimension (E = 1.1821, Boot SE = 0.2895, C.I: 0.6934 to 1.7862). Conclusion The experiential dimension mediates the effect of expressive dimension over the social dysfunction in remitted schizophrenia. Future studies should focus on targeting the experiential dimension and thereby social functioning.
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Affiliation(s)
- Dinesh G. Moses
- Department of Psychiatry, PSG Institute of Medical Sciences and Research, Peelamedu, Coimbatore, Tamil Nadu, India
| | - Pradeep Palaniappan
- Department of Psychiatry, PSG Institute of Medical Sciences and Research, Peelamedu, Coimbatore, Tamil Nadu, India
| | - Pratap Chander Ponraj
- Department of Psychiatry, PSG Institute of Medical Sciences and Research, Peelamedu, Coimbatore, Tamil Nadu, India
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8
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Oomen PP, Begemann MJH, Brand BA, de Haan L, Veling W, Koops S, van Os J, Smit F, Bakker PR, van Beveren N, Boonstra N, Gülöksüz S, Kikkert M, Lokkerbol J, Marcelis M, Rosema BS, de Beer F, Gangadin SS, Geraets CNW, van ‘t Hag E, Haveman Y, van der Heijden I, Voppel AE, Willemse E, van Amelsvoort T, Bak M, Batalla A, Been A, van den Bosch M, van den Brink T, Faber G, Grootens KP, de Jonge M, Knegtering R, Kurkamp J, Mahabir A, Pijnenborg GHM, Staring T, Veen N, Veerman S, Wiersma S, Graveland E, Hoornaar J, Sommer IEC. Longitudinal clinical and functional outcome in distinct cognitive subgroups of first-episode psychosis: a cluster analysis. Psychol Med 2023; 53:2317-2327. [PMID: 34664546 PMCID: PMC10123843 DOI: 10.1017/s0033291721004153] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Revised: 09/16/2021] [Accepted: 09/23/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND Cognitive deficits may be characteristic for only a subgroup of first-episode psychosis (FEP) and the link with clinical and functional outcomes is less profound than previously thought. This study aimed to identify cognitive subgroups in a large sample of FEP using a clustering approach with healthy controls as a reference group, subsequently linking cognitive subgroups to clinical and functional outcomes. METHODS 204 FEP patients were included. Hierarchical cluster analysis was performed using baseline brief assessment of cognition in schizophrenia (BACS). Cognitive subgroups were compared to 40 controls and linked to longitudinal clinical and functional outcomes (PANSS, GAF, self-reported WHODAS 2.0) up to 12-month follow-up. RESULTS Three distinct cognitive clusters emerged: relative to controls, we found one cluster with preserved cognition (n = 76), one moderately impaired cluster (n = 74) and one severely impaired cluster (n = 54). Patients with severely impaired cognition had more severe clinical symptoms at baseline, 6- and 12-month follow-up as compared to patients with preserved cognition. General functioning (GAF) in the severely impaired cluster was significantly lower than in those with preserved cognition at baseline and showed trend-level effects at 6- and 12-month follow-up. No significant differences in self-reported functional outcome (WHODAS 2.0) were present. CONCLUSIONS Current results demonstrate the existence of three distinct cognitive subgroups, corresponding with clinical outcome at baseline, 6- and 12-month follow-up. Importantly, the cognitively preserved subgroup was larger than the severely impaired group. Early identification of discrete cognitive profiles can offer valuable information about the clinical outcome but may not be relevant in predicting self-reported functional outcomes.
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Affiliation(s)
- Priscilla P. Oomen
- Department of Biomedical Sciences of Cells and Systems, and Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Marieke J. H. Begemann
- Department of Biomedical Sciences of Cells and Systems, and Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Bodyl A. Brand
- Department of Biomedical Sciences of Cells and Systems, and Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Lieuwe de Haan
- Department of Early Psychosis, Amsterdam UMC, Academic Medical Center, Amsterdam, The Netherlands
| | - Wim Veling
- Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Sanne Koops
- Department of Biomedical Sciences of Cells and Systems, and Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Jim van Os
- Department of Psychiatry, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MheNS), Maastricht University Medical Centre, Maastricht, The Netherlands
- King's College London, King's Health Partners Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, London, UK
| | - Filip Smit
- Department of Epidemiology and Biostatistics, Amsterdam Public Health Research Institute, Amsterdam University Medical Centers, location VUmc, Amsterdam, The Netherlands
- Department of Clinical, Neuro and Developmental Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit, Amsterdam, The Netherlands
- Centre of Economic Evaluation & Machine Learning, Trimbos Institute (Netherlands Institute of Mental Health), Utrecht, The Netherlands
| | - P. Roberto Bakker
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MheNS), Maastricht University Medical Centre, Maastricht, The Netherlands
- Department of Research, Arkin Mental Health Care, Amsterdam, The Netherlands
| | - Nico van Beveren
- Antes Center for Mental Health Care, Rotterdam, The Netherlands
- Department of Neuroscience, Erasmus MC, Rotterdam, The Netherlands
- Department of Psychiatry, Erasmus MC, Rotterdam, The Netherlands
| | - Nynke Boonstra
- NHL/Stenden, University of Applied Sciences, Leeuwarden, The Netherlands
- KieN VIP Mental Health Care Services, Leeuwarden, The Netherlands
| | - Sinan Gülöksüz
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MheNS), Maastricht University Medical Centre, Maastricht, The Netherlands
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Martijn Kikkert
- Department of Research, Arkin Mental Health Care, Amsterdam, The Netherlands
| | - Joran Lokkerbol
- Centre of Economic Evaluation & Machine Learning, Trimbos Institute (Netherlands Institute of Mental Health), Utrecht, The Netherlands
| | - Machteld Marcelis
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, EURON, Maastricht University Medical Center, Maastricht, The Netherlands
- Institute for Mental Health Care Eindhoven (GGzE), Eindhoven, The Netherlands
| | - Bram-Sieben Rosema
- Department of Biomedical Sciences of Cells and Systems, and Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Franciska de Beer
- Department of Biomedical Sciences of Cells and Systems, and Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Shiral S. Gangadin
- Department of Biomedical Sciences of Cells and Systems, and Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Chris N. W. Geraets
- Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Erna van ‘t Hag
- Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Yudith Haveman
- Department of Biomedical Sciences of Cells and Systems, and Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Inge van der Heijden
- Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Janssen-Cilag B.V., Breda, the Netherlands
| | - Alban E. Voppel
- Department of Biomedical Sciences of Cells and Systems, and Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Elske Willemse
- Department of Biomedical Sciences of Cells and Systems, and Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Therese van Amelsvoort
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MheNS), Maastricht University Medical Centre, Maastricht, The Netherlands
- Mondriaan Mental Health Care, Heerlen, The Netherlands
| | - Maarten Bak
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience (MheNS), Maastricht University Medical Centre, Maastricht, The Netherlands
- Mondriaan Mental Health Care, Heerlen, The Netherlands
| | - Albert Batalla
- Department of Psychiatry, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Agaath Been
- Dimence Institute for Mental Health, Deventer, Zwolle, The Netherlands
| | | | | | - Gunnar Faber
- Yulius, Mental Health Institute, Dordrecht, The Netherlands
| | - Koen P. Grootens
- Reinier van Arkel Institute for Mental Health Care, ‘s Hertogenbosch, The Netherlands
| | - Martin de Jonge
- Program for Psychosis & Severe Mental Illness, Pro Persona Mental Health, Wolfheze, The Netherlands
| | - Rikus Knegtering
- Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
- Lentis Research, Lentis Psychiatric Institute, Groningen, The Netherlands
| | - Jörg Kurkamp
- Center for Youth with Psychosis, Mediant ABC Twente, Enschede, The Netherlands
| | | | - Gerdina H. M. Pijnenborg
- Department of Psychotic Disorders, GGZ-Drenthe, Assen, The Netherlands
- Department of Clinical and Developmental Neuropsychology, Faculty BSS, University of Groningen, Groningen, The Netherlands
| | - Tonnie Staring
- Department ABC Early Psychosis, Altrecht Psychiatric Institute, Utrecht, The Netherlands
| | - Natalie Veen
- GGZ Delfland, Delfland Institute for Mental Health Care, Delft, The Netherlands
| | - Selene Veerman
- Community Mental Health, Mental Health Service Noord-Holland Noord, Alkmaar, The Netherlands
| | - Sybren Wiersma
- Early Intervention Psychosis Team, GGZ inGeest Specialized Mental Health Care, Hoofddorp, The Netherlands
| | | | - Joelle Hoornaar
- Antes Center for Mental Health Care, Rotterdam, The Netherlands
| | - Iris E. C. Sommer
- Department of Biomedical Sciences of Cells and Systems, and Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
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Veleva I, Stoychev K, Stoimenova-Popova M, Stoyanov L, Mineva-Dimitrova E, Angelov I. Toxoplasma gondii seropositivity and cognitive function in adults with schizophrenia. Schizophr Res Cogn 2022; 30:100269. [PMID: 36065435 PMCID: PMC9440062 DOI: 10.1016/j.scog.2022.100269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2022] [Revised: 08/22/2022] [Accepted: 08/22/2022] [Indexed: 11/29/2022] Open
Abstract
Introduction and methods Based on the limited research focusing on the severity of cognitive deterioration in schizophrenia with preceding toxoplasmosis, we sampled 89 demographically matched paranoid schizophrenia patients (mean age 38.97 years) with (n = 42) and without (n = 47) seroprevalence of IgG type anti T. gondii antibodies as marker of past infection. They underwent examination of verbal memory (10 words Luria test), logical memory and visual memory (BVRT), processing speed (TMT-A/DSST) and executive functions (TMT-B/verbal fluency). We compared the results of both groups, taking into account the normative values for the Bulgarian population where available. We also compared the two groups in terms of clinical severity as evidenced by positive, negative and disorganization sub-scores of the PANSS. Results While both groups were expectedly under the population norms for verbal and logical memory, seropositive patients showed significantly bigger impairment in verbal memory (Luria Smax = 72.85 vs 78.51; p = 0.029), psychomotor speed (TMT-A 50.98 s vs 44.64 s; p = 0.017), semantic verbal fluency (27.12 vs 30.02; p = 0.011) and literal verbal fluency (17.17 vs 18.78; p = 0.014) compared to the seronegative ones. In addition to that, they gave less correct answers on the BVRT (2.98 vs 4.09; p = 0.006) while making markedly more errors (13.95 vs 10.21; p = 0.002). Despite not reaching statistical significance, past toxoplasmosis was associated with higher score on the PANSS disorganization sub-scale (16.50 points vs 14.72 points) and with lower educational attainment. Conclusion Our results suggest a more profound neuropathological insult(s) resulting in greater cognitive impairment in schizophrenia cases that are exposed to T. gondii infection.
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Mwesiga EK, Ssemata AS, Gumikiriza J, Nanteza A, Nakitende AJ, Nakku J, Akena D, Nakasujja N. The association of cognitive impairment with quality of life and functional impairment in Ugandan first-episode psychosis patients: a cross sectional study. Health Qual Life Outcomes 2022; 20:113. [PMID: 35870969 PMCID: PMC9308281 DOI: 10.1186/s12955-022-02020-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Accepted: 07/15/2022] [Indexed: 11/16/2022] Open
Abstract
Introduction Cognitive impairment is common in first-episode psychosis patients and often associated with poor quality of life and functional impairment. However, most literature on this association is from high income countries and not low resource countries like Uganda. We aimed to determine the association between cognitive impairment with quality of life and functional impairment in Ugandan first-episode psychosis patients. Methods At Butabika national psychiatric hospital of Uganda, we enrolled 94 first-episode psychosis patients aged 18–60 years with a confirmed first-episode of psychosis and no previous treatment with antipsychotic medication. Neuropsychological assessment was performed using the MATRICS consensus cognitive battery (MCCB). Quality of life and functional impairment were assessed using the brief version of the World Health Organisation Quality of Life scale (WHOQOL-BREF) and the MINI International Neuropsychiatric Inventory (MINI) respectively. Linear regression analyses determined the association between impairment in different cognitive domains with various quality of life and functional impairment domains while controlling for age, gender and level of education. Results High scores in the reasoning and problem solving cognitive domain were associated with better quality of life in the psychological domain of WHOQOL-BREF (p = 0.029). For functional impairment, high cognitive scores in the domains of speed of processing (p = 0.018), reasoning and problem solving (p = 0.015), working memory (p = 0.017) and visual learning and memory (p = 0.002) were associated with psychosis “having a greater impact on other members of the family” on the MINI. Higher scores in the social cognition domain were associated with “less aggressive and disruptive behaviour” (p = 0.003). Conclusion Cognitive impairment in Ugandan first-episode psychotic patients is associated with both poorer quality of life and functional impairment. Remediation of cognitive function may be a plausible intervention to improve outcomes in Ugandan first-episode psychosis patients.
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11
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Shimada T, Inagaki Y, Shimooka Y, Kawano K, Tanaka S, Kobayashi M. Effect of individualized occupational therapy on social functioning in patients with schizophrenia: A five-year follow-up of a randomized controlled trial. J Psychiatr Res 2022; 156:476-484. [PMID: 36347107 DOI: 10.1016/j.jpsychires.2022.10.066] [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: 04/26/2022] [Revised: 10/18/2022] [Accepted: 10/28/2022] [Indexed: 11/06/2022]
Abstract
This study aimed to evaluate the long-term effects of adding individualized occupational therapy (IOT) to a three-months group occupational therapy (GOT) on social functioning in inpatients with schizophrenia or schizoaffective disorder at a follow-up investigation five-years after discharge. Initially, patients were randomly assigned to GOT + IOT or GOT alone, with 102 patients, 48 in GOT + IOT and 54 in GOT alone, completing the five years follow-up. The primary outcome was change in social functioning assessed by the Social Functioning Scale (SFS) from baseline to five-year follow-up. Other outcomes included Brief Assessment of Cognition in Schizophrenia (BACS), Schizophrenia Cognition Rating Scale (SCoRS), Intrinsic Motivation Inventory (IMI), Global Assessment of Functioning (GAF), Positive and Negative Syndrome Scale (PANSS), and Client Satisfaction Questionnaire-8 (CSQ-8). There were significant improvements for the GOT + IOT group over GOT in the SFS total score, which could be explained by improvements in withdrawal/social engagement, interpersonal communication, pro-social activities, recreation, and independence-competence. Multiple regression analysis showed that the period from hospitalization to commencing occupational therapy, type of occupational therapy, BACS motor speed, BACS executive function, and IMI interest/enjoyment were significantly associated with SFS total score. Our findings suggest that adding IOT to GOT may improve the long-term outcome on social functioning in schizophrenic patients. However, the long time period between intervention and follow-up and the unavailability of treatment information during the follow-up period has to be mentioned as a limiting factor of this study.
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Affiliation(s)
- Takeshi Shimada
- Medical Corporation Seitaikai Mental Support Soyokaze Hospital, Nagano, Japan.
| | - Yusuke Inagaki
- Nagano Prefectural Mental Wellness Center Komagane, Nagano, Japan
| | - Yuko Shimooka
- Social Medical Corporation Ritsuzankai Iida Hospital, Nagano, Japan
| | - Kojiro Kawano
- Medical Corporation Yuaikai Tikumaso Mental Hospital, Nagano, Japan
| | - Sachie Tanaka
- Department of Health Sciences, Graduate School of Medicine, Shinshu University, Nagano, Japan
| | - Masayoshi Kobayashi
- Department of Health Sciences, Graduate School of Medicine, Shinshu University, Nagano, Japan
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12
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Moderators of metacognitive strategy training for executive functioning in early schizophrenia and psychosis risk. Schizophr Res Cogn 2022; 31:100275. [PMCID: PMC9713365 DOI: 10.1016/j.scog.2022.100275] [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: 08/11/2022] [Revised: 11/19/2022] [Accepted: 11/21/2022] [Indexed: 12/03/2022] Open
Abstract
Goal Management Training (GMT) improved self-reported executive functioning in a recent randomized, controlled trial in early intervention for psychosis participants. Little is known about the mechanism for this benefit, so this study investigates objectively measured executive function, the difference between subjective and objective executive function, independent living and employment status as potential moderators of efficacy of GMT. Baseline scores from 81 participants (GMT n = 39 vs Treatment-as-usual; TAU n = 42) were analyzed in a linear mixed model analysis for repeated measures as predictors of improvement on the self-reported Behavior Rating Inventory of Executive Function–Adult version (BRIEF-A) immediately and 30 weeks after GMT. Potential moderators were scores from objective measures of executive functioning, discrepancy between subjective and objective measures, independent living and employment status. Discrepancy was assessed by comparing four clusters of participants with differing patterns of scores. The effect of GMT remained significant regardless of initial objective executive functioning at baseline. Those with higher subjective complaints at baseline in two clusters with (i) both objective and subjective executive dysfunction, and (ii) mostly subjective executive dysfunction experienced greater change after treatment. Living arrangements or participation in education or work did not significantly moderate the effects of GMT. Poor performance on neuropsychological tasks is not an obstacle to making use of GMT, but further knowledge is needed about the benefits of strategy training for individuals with a combination of poor performance with few subjective complaints.
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13
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Uchino T, Okubo R, Takubo Y, Aoki A, Wada I, Hashimoto N, Ikezawa S, Nemoto T. Perceptions of and subjective difficulties with social cognition in schizophrenia from an internet survey: Knowledge, clinical experiences, and awareness of association with social functioning. Psychiatry Clin Neurosci 2022; 76:429-436. [PMID: 35768180 PMCID: PMC9543578 DOI: 10.1111/pcn.13435] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 05/12/2022] [Accepted: 05/23/2022] [Indexed: 12/14/2022]
Abstract
AIM Social cognition impacts social functioning in schizophrenia; however, little is known about how patients with schizophrenia themselves perceive social cognition. This study, using an internet survey, aimed to investigate their knowledge of social cognition, clinical experiences related to social cognition, awareness of social cognition's role in one's social life, and the relationships between subjective difficulties with social cognition and social functioning. METHODS Data from 232 outpatients with schizophrenia (SZ) and 494 healthy controls (HC) were obtained through an internet survey and were weighted according to the demographics of the national population. A newly developed survey questionnaire on knowledge, experience, and awareness of social cognition was administered. Subjective difficulties were evaluated using the Self-Assessment of Social Cognition Impairments and the Observable Social Cognition Rating Scale. RESULTS Less than a quarter of both groups were familiar with the term or concept of social cognition. Less than 5% of both groups had experienced being assessed or treated for social cognition. More than half of both groups were aware of the relationship between social cognition and social functioning. The SZ group had higher levels of subjective difficulties than the HC group across all social cognitive domains. The attributional bias domain of subjective difficulties was negatively associated with social functioning. CONCLUSION Patients with schizophrenia had substantial subjective difficulties in social cognition, which they perceived as being related to social functioning. However, their knowledge of social cognition was limited, and the assessment and treatment might not be widespread in regular clinical practice.
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Affiliation(s)
- Takashi Uchino
- Department of Neuropsychiatry, Toho University Faculty of Medicine, Tokyo, Japan
| | - Ryo Okubo
- Department of Clinical Epidemiology, Translational Medical Center, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Youji Takubo
- Department of Neuropsychiatry, Toho University Faculty of Medicine, Tokyo, Japan
| | - Akiko Aoki
- Department of Neuropsychiatry, Toho University Faculty of Medicine, Tokyo, Japan
| | - Izumi Wada
- Department of Neuropsychiatry, Toho University Faculty of Medicine, Tokyo, Japan
| | - Naoki Hashimoto
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Satoru Ikezawa
- Endowed Institute for Empowering Gifted Minds, University of Tokyo Graduate School of Arts and Sciences, Tokyo, Japan
| | - Takahiro Nemoto
- Department of Neuropsychiatry, Toho University Faculty of Medicine, Tokyo, Japan
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14
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Chau AKC, So SH, Sun X, Zhu C, Chiu CD, Chan RCK, Leung PWL. A network analysis on the relationship between loneliness and schizotypy. J Affect Disord 2022; 311:148-156. [PMID: 35594977 DOI: 10.1016/j.jad.2022.05.057] [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: 07/26/2021] [Revised: 05/06/2022] [Accepted: 05/12/2022] [Indexed: 11/18/2022]
Abstract
BACKGROUND Schizotypy is a multidimensional personality trait related to the heightened risk for the development of schizophrenia spectrum disorders. While it has been suggested that loneliness may be associated with schizotypy in general, whether it relates to the specific schizotypal traits differentially remains unknown. Besides, as loneliness often co-occurs with depression and anxiety, it is important to delineate its relationship with schizotypy in consideration of these co-occurring emotional disturbances. METHODS A demographically diverse sample of young people was obtained from multiple sources. The validated sample consisted of 2089 participants (68.4% female, age range: 18-30). The structural relationship between loneliness and schizotypy was modelled using a network analytic approach. The Gaussian graphical model with loneliness and nine schizotypal traits as nodes was first estimated without, and then with adjustment for the levels of depressive and anxiety symptoms. Edges were estimated as unique associations between nodes. RESULTS 'Suspiciousness', 'odd beliefs or magical thinking', 'no close friends', 'constricted affect' and 'excessive social anxiety' were linked to loneliness directly. Loneliness was found to be more strongly associated with 'suspiciousness' and 'no close friends' than other schizotypal traits. After adjustment for the levels of depressive and anxiety symptoms, the above direct edges remained robust. LIMITATIONS The use of cross-sectional data indicated only undirected associations between variables. CONCLUSIONS Loneliness was more strongly linked to some schizotypal traits than others, with the relationships maintaining above and beyond the effects of anxiety and depression. These findings warrant further investigation of the specific relationships between loneliness and individual schizotypal traits.
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Affiliation(s)
- Anson Kai Chun Chau
- Department of Psychology, The Chinese University of Hong Kong, Hong Kong Special Administrative Region
| | - Suzanne H So
- Department of Psychology, The Chinese University of Hong Kong, Hong Kong Special Administrative Region.
| | - Xiaoqi Sun
- Department of Psychology, Hunan Normal University, Hunan, China
| | - Chen Zhu
- Department of Psychology, The Chinese University of Hong Kong, Hong Kong Special Administrative Region
| | - Chui-De Chiu
- Department of Psychology, The Chinese University of Hong Kong, Hong Kong Special Administrative Region
| | - Raymond C K Chan
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Patrick Wing-Leung Leung
- Department of Psychology, The Chinese University of Hong Kong, Hong Kong Special Administrative Region
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Giordano GM, Caporusso E, Pezzella P, Galderisi S. Updated perspectives on the clinical significance of negative symptoms in patients with schizophrenia. Expert Rev Neurother 2022; 22:541-555. [PMID: 35758871 DOI: 10.1080/14737175.2022.2092402] [Citation(s) in RCA: 17] [Impact Index Per Article: 8.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
INTRODUCTION Negative symptoms in schizophrenia are associated with poor response to available treatments, poor quality of life, and functional outcome. Therefore, they represent a substantial burden for people with schizophrenia, their families, and health-care systems. AREAS COVERED In this manuscript, we will provide an update on the conceptualization, assessment, and treatment of this complex psychopathological dimension of schizophrenia. EXPERT OPINION Despite the progress in the conceptualization of negative symptoms and in the development of state-of-the-art assessment instruments made in the last decades, these symptoms are still poorly recognized, and not always assessed in line with current conceptualization. Every effort should be made to disseminate the current knowledge on negative symptoms, on their assessment instruments and available treatments whose efficacy is supported by research evidence. Longitudinal studies should be promoted to evaluate the natural course of negative symptoms, improve our ability to identify the different sources of secondary negative symptoms, provide effective interventions, and target primary and persistent negative symptoms with innovative treatment strategies. Further research is needed to identify pathophysiological mechanisms of primary negative symptoms and foster the development of new treatments.
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16
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Décombe A, Brinkmann K, Merenciano M, Capdevielle D, Gendolla GHE, Raffard S. Cognitive effort in Schizophrenia: Dissimilar effects on cardiovascular activity and subjective effort. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-022-03145-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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17
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Abram SV, Weittenhiller LP, Bertrand CE, McQuaid JR, Mathalon DH, Ford JM, Fryer SL. Psychological Dimensions Relevant to Motivation and Pleasure in Schizophrenia. Front Behav Neurosci 2022; 16:827260. [PMID: 35401135 PMCID: PMC8985863 DOI: 10.3389/fnbeh.2022.827260] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 02/22/2022] [Indexed: 11/13/2022] Open
Abstract
Motivation and pleasure deficits are common in schizophrenia, strongly linked with poorer functioning, and may reflect underlying alterations in brain functions governing reward processing and goal pursuit. While there is extensive research examining cognitive and reward mechanisms related to these deficits in schizophrenia, less attention has been paid to psychological characteristics that contribute to resilience against, or risk for, motivation and pleasure impairment. For example, psychological tendencies involving positive future expectancies (e.g., optimism) and effective affect management (e.g., reappraisal, mindfulness) are associated with aspects of reward anticipation and evaluation that optimally guide goal-directed behavior. Conversely, maladaptive thinking patterns (e.g., defeatist performance beliefs, asocial beliefs) and tendencies that amplify negative cognitions (e.g., rumination), may divert cognitive resources away from goal pursuit or reduce willingness to exert effort. Additionally, aspects of sociality, including the propensity to experience social connection as positive reinforcement may be particularly relevant for pursuing social goals. In the current review, we discuss the roles of several psychological characteristics with respect to motivation and pleasure in schizophrenia. We argue that individual variation in these psychological dimensions is relevant to the study of motivation and reward processing in schizophrenia, including interactions between these psychological dimensions and more well-characterized cognitive and reward processing contributors to motivation. We close by emphasizing the value of considering a broad set of modulating factors when studying motivation and pleasure functions in schizophrenia.
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Affiliation(s)
- Samantha V. Abram
- Mental Health Service, Veterans Affairs San Francisco Healthcare System, San Francisco, CA, United States
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United States
| | | | - Claire E. Bertrand
- Mental Health Service, Veterans Affairs San Francisco Healthcare System, San Francisco, CA, United States
| | - John R. McQuaid
- Mental Health Service, Veterans Affairs San Francisco Healthcare System, San Francisco, CA, United States
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United States
| | - Daniel H. Mathalon
- Mental Health Service, Veterans Affairs San Francisco Healthcare System, San Francisco, CA, United States
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United States
| | - Judith M. Ford
- Mental Health Service, Veterans Affairs San Francisco Healthcare System, San Francisco, CA, United States
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United States
| | - Susanna L. Fryer
- Mental Health Service, Veterans Affairs San Francisco Healthcare System, San Francisco, CA, United States
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, United States
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18
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Aritio-Solana R, Fonseca-Pedrero E, Pérez-Albéniz A, Mason O, Ortuño-Sierra J. Study of Positive and Negative Affect and Neurocognitive Functioning in Adolescents. THE SPANISH JOURNAL OF PSYCHOLOGY 2022; 25:e13. [PMID: 35272742 DOI: 10.1017/sjp.2022.9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
The main purpose of the present work was to study neurocognitive performance of adolescents at risk for emotional difficulties. The sample included a total of 1,509 adolescents from stratified random cluster sampling. Derived from this sample, a group of high-risk (n = 92) and a comparison group (n = 92) were selected based on the short version of the Positive and Negative Affect Schedule (PANAS) for comparison on the University of Pennsylvania computerized neuropsychological test battery for children (PENN). A Multivariate analysis of covariance (MANCOVA) was performed taking the scores on the PENN as dependent variables and the two groups derived from the scores of the PANAS (at risk vs. comparison) as a fixed factor. Adolescents at high risk of presenting affectivity problems showed statistically significant differences in several different neurocognitive domains, in accuracy, λ = .820, F(9, 160,000) = 3.913, p < .01, partial η² = .180; speed, λ = .502, F(5, 88,000)= 17.493, p < .01, partial η² = .498; and efficiency, λ = .485, F(4, 89,000) = 23.599, p <.01, partial η² = .515. The high risk group showed lower neurocognitive performance than the comparison group. In addition, a positive statistically significant correlation was found between all the neurocognitive competences (p < .05). Results found in this study reveal that neurocognitive impairments can be shown in adolescents at psychometric high risk for emotional problems before transition to more severe psychological problems.
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Steele P, Cheng N, Phillips LJ, Bryce S, Alvarez-Jimenez M, Allott K. Cognitive strengths in first episode psychosis: a thematic analysis of clinicians' perspectives. BMC Psychiatry 2021; 21:612. [PMID: 34876068 PMCID: PMC8653580 DOI: 10.1186/s12888-021-03627-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2021] [Accepted: 11/24/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Cognitive deficits are associated with poor functional outcomes in individuals recovering from a first episode of psychosis (FEP). Existing treatments that target cognitive deficits in FEP may enhance cognitive function, but improvements to real-world functioning are less consistent. Furthermore, these treatments may not adequately address the personal recovery goals of young people attending FEP services. A novel cognitive strengths-based approach may overcome these shortcomings. METHODS This qualitative study used semi-structured interviews to explore clinicians' (N = 12) perspectives toward the potential development of a cognitive strengths-based assessment or treatment in FEP. The interviews were analysed using thematic analysis. RESULTS Five higher-order themes emerged: (1) pro-strengths attitude despite unfamiliarity and minimal use, (2) default to a cognitive deficit lens, (3) potential benefits of a cognitive strengths approach, (4) potential risks and barriers, and (5) considerations for successful implementation. While clinicians acknowledged their current deficit approach, they supported implementing a cognitive strengths assessment or treatment and highlighted their potential benefits for the personal recovery needs of young people with FEP. CONCLUSIONS These findings suggest that a deficit-focused approach to cognitive function amongst clinicians may be common practice in FEP services. Nevertheless, a cognitive strengths approach was viewed favourably by clinicians and may represent a novel method of supporting personal recovery. Thus, the design and implementation of a cognitive strengths approach may be worthwhile. Future exploration of other stakeholder perspectives, such as young people with FEP, is essential.
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Affiliation(s)
- Peter Steele
- grid.1008.90000 0001 2179 088XMelbourne School of Psychological Sciences, The University of Melbourne, 35 Poplar Road, Parkville, VIC 3052 Australia
| | - Nicholas Cheng
- grid.488501.0Orygen, Parkville, Victoria Australia ,grid.1008.90000 0001 2179 088XCentre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
| | - Lisa J. Phillips
- grid.1008.90000 0001 2179 088XMelbourne School of Psychological Sciences, The University of Melbourne, 35 Poplar Road, Parkville, VIC 3052 Australia
| | - Shayden Bryce
- grid.488501.0Orygen, Parkville, Victoria Australia ,grid.1008.90000 0001 2179 088XCentre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
| | - Mario Alvarez-Jimenez
- grid.488501.0Orygen, Parkville, Victoria Australia ,grid.1008.90000 0001 2179 088XCentre for Youth Mental Health, The University of Melbourne, Melbourne, Australia
| | - Kelly Allott
- Orygen, Parkville, Victoria, Australia. .,Centre for Youth Mental Health, The University of Melbourne, Melbourne, Australia.
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Mazumder AH, Barnett J, Isometsä ET, Lindberg N, Torniainen-Holm M, Lähteenvuo M, Lahdensuo K, Kerkelä M, Ahola-Olli A, Hietala J, Kampman O, Kieseppä T, Jukuri T, Häkkinen K, Cederlöf E, Haaki W, Kajanne R, Wegelius A, Männynsalo T, Niemi-Pynttäri J, Suokas K, Lönnqvist J, Tiihonen J, Paunio T, Vainio SJ, Palotie A, Niemelä S, Suvisaari J, Veijola J. Reaction Time and Visual Memory in Connection to Alcohol Use in Persons with Bipolar Disorder. Brain Sci 2021; 11:brainsci11091154. [PMID: 34573174 PMCID: PMC8467646 DOI: 10.3390/brainsci11091154] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Revised: 08/23/2021] [Accepted: 08/27/2021] [Indexed: 11/17/2022] Open
Abstract
The purpose of this study was to explore the association of cognition with hazardous drinking and alcohol-related disorder in persons with bipolar disorder (BD). The study population included 1268 persons from Finland with bipolar disorder. Alcohol use was assessed through hazardous drinking and alcohol-related disorder including alcohol use disorder (AUD). Hazardous drinking was screened with the Alcohol Use Disorders Identification Test for Consumption (AUDIT-C) screening tool. Alcohol-related disorder diagnoses were obtained from the national registrar data. Participants performed two computerized tasks from the Cambridge Automated Neuropsychological Test Battery (CANTAB) on A tablet computer: the 5-choice serial reaction time task, or reaction time (RT) test and the Paired Associative Learning (PAL) test. Depressive symptoms were assessed with the Mental Health Inventory with five items (MHI-5). However, no assessment of current manic symptoms was available. Association between RT-test and alcohol use was analyzed with log-linear regression, and eβ with 95% confidence intervals (CI) are reported. PAL first trial memory score was analyzed with linear regression, and β with 95% CI are reported. PAL total errors adjusted was analyzed with logistic regression and odds ratios (OR) with 95% CI are reported. After adjustment of age, education, housing status and depression, hazardous drinking was associated with lower median and less variable RT in females while AUD was associated with a poorer PAL test performance in terms of the total errors adjusted scores in females. Our findings of positive associations between alcohol use and cognition in persons with bipolar disorder are difficult to explain because of the methodological flaw of not being able to separately assess only participants in euthymic phase.
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Affiliation(s)
- Atiqul Haq Mazumder
- Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, 90014 Oulu, Finland; (M.K.); (T.J.); (J.V.)
- Correspondence:
| | - Jennifer Barnett
- Cambridge Cognition, University of Cambridge, Cambridge CB25 9TU, UK;
| | - Erkki Tapio Isometsä
- Department of Psychiatry, University Hospital and University of Helsinki, 00029 Helsinki, Finland; (E.T.I.); (N.L.); (T.K.); (A.W.); (T.P.)
- Department of Psychiatry, University of Helsinki, 00014 Helsinki, Finland;
| | - Nina Lindberg
- Department of Psychiatry, University Hospital and University of Helsinki, 00029 Helsinki, Finland; (E.T.I.); (N.L.); (T.K.); (A.W.); (T.P.)
| | - Minna Torniainen-Holm
- Mental Health Unit, Finnish Institute for Health and Welfare (THL), 00271 Helsinki, Finland; (M.T.-H.); (E.C.); (J.S.)
| | - Markku Lähteenvuo
- Department of Forensic Psychiatry, Niuvanniemi Hospital, University of Eastern Finland, 70240 Kuopio, Finland; (M.L.); (K.H.); (J.T.)
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, 00014 Helsinki, Finland; (K.L.); (A.A.-O.); (W.H.); (R.K.); (T.M.); (J.N.-P.); (K.S.); (A.P.)
| | - Kaisla Lahdensuo
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, 00014 Helsinki, Finland; (K.L.); (A.A.-O.); (W.H.); (R.K.); (T.M.); (J.N.-P.); (K.S.); (A.P.)
- Mehiläinen, Pohjoinen Hesperiankatu 17 C, 00260 Helsinki, Finland
| | - Martta Kerkelä
- Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, 90014 Oulu, Finland; (M.K.); (T.J.); (J.V.)
| | - Ari Ahola-Olli
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, 00014 Helsinki, Finland; (K.L.); (A.A.-O.); (W.H.); (R.K.); (T.M.); (J.N.-P.); (K.S.); (A.P.)
| | - Jarmo Hietala
- Department of Psychiatry, University of Turku, 20014 Turku, Finland; (J.H.); (S.N.)
- Department of Psychiatry, Turku University Hospital, 20521 Turku, Finland
| | - Olli Kampman
- Faculty of Medicine and Health Technology, Tampere University, 33014 Tampere, Finland;
- Department of Psychiatry, Pirkanmaa Hospital District, 33521 Tampere, Finland
| | - Tuula Kieseppä
- Department of Psychiatry, University Hospital and University of Helsinki, 00029 Helsinki, Finland; (E.T.I.); (N.L.); (T.K.); (A.W.); (T.P.)
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, 00014 Helsinki, Finland; (K.L.); (A.A.-O.); (W.H.); (R.K.); (T.M.); (J.N.-P.); (K.S.); (A.P.)
- Mehiläinen, Pohjoinen Hesperiankatu 17 C, 00260 Helsinki, Finland
| | - Tuomas Jukuri
- Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, 90014 Oulu, Finland; (M.K.); (T.J.); (J.V.)
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, 00014 Helsinki, Finland; (K.L.); (A.A.-O.); (W.H.); (R.K.); (T.M.); (J.N.-P.); (K.S.); (A.P.)
| | - Katja Häkkinen
- Department of Forensic Psychiatry, Niuvanniemi Hospital, University of Eastern Finland, 70240 Kuopio, Finland; (M.L.); (K.H.); (J.T.)
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, 00014 Helsinki, Finland; (K.L.); (A.A.-O.); (W.H.); (R.K.); (T.M.); (J.N.-P.); (K.S.); (A.P.)
| | - Erik Cederlöf
- Mental Health Unit, Finnish Institute for Health and Welfare (THL), 00271 Helsinki, Finland; (M.T.-H.); (E.C.); (J.S.)
| | - Willehard Haaki
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, 00014 Helsinki, Finland; (K.L.); (A.A.-O.); (W.H.); (R.K.); (T.M.); (J.N.-P.); (K.S.); (A.P.)
- Department of Psychiatry, University of Turku, 20014 Turku, Finland; (J.H.); (S.N.)
| | - Risto Kajanne
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, 00014 Helsinki, Finland; (K.L.); (A.A.-O.); (W.H.); (R.K.); (T.M.); (J.N.-P.); (K.S.); (A.P.)
| | - Asko Wegelius
- Department of Psychiatry, University Hospital and University of Helsinki, 00029 Helsinki, Finland; (E.T.I.); (N.L.); (T.K.); (A.W.); (T.P.)
- Mental Health Unit, Finnish Institute for Health and Welfare (THL), 00271 Helsinki, Finland; (M.T.-H.); (E.C.); (J.S.)
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, 00014 Helsinki, Finland; (K.L.); (A.A.-O.); (W.H.); (R.K.); (T.M.); (J.N.-P.); (K.S.); (A.P.)
| | - Teemu Männynsalo
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, 00014 Helsinki, Finland; (K.L.); (A.A.-O.); (W.H.); (R.K.); (T.M.); (J.N.-P.); (K.S.); (A.P.)
- Social Services and Health Care Sector, City of Helsinki, 00099 Helsinki, Finland
| | - Jussi Niemi-Pynttäri
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, 00014 Helsinki, Finland; (K.L.); (A.A.-O.); (W.H.); (R.K.); (T.M.); (J.N.-P.); (K.S.); (A.P.)
- Social Services and Health Care Sector, City of Helsinki, 00099 Helsinki, Finland
| | - Kimmo Suokas
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, 00014 Helsinki, Finland; (K.L.); (A.A.-O.); (W.H.); (R.K.); (T.M.); (J.N.-P.); (K.S.); (A.P.)
- Faculty of Medicine and Health Technology, Tampere University, 33014 Tampere, Finland;
| | - Jouko Lönnqvist
- Department of Psychiatry, University of Helsinki, 00014 Helsinki, Finland;
- Mental Health Unit, Finnish Institute for Health and Welfare (THL), 00271 Helsinki, Finland; (M.T.-H.); (E.C.); (J.S.)
| | - Jari Tiihonen
- Department of Forensic Psychiatry, Niuvanniemi Hospital, University of Eastern Finland, 70240 Kuopio, Finland; (M.L.); (K.H.); (J.T.)
- Department of Clinical Neuroscience, Karolinska Institute, 17177 Stockholm, Sweden
- Center for Psychiatry Research, Stockholm City Council, 11364 Stockholm, Sweden
| | - Tiina Paunio
- Department of Psychiatry, University Hospital and University of Helsinki, 00029 Helsinki, Finland; (E.T.I.); (N.L.); (T.K.); (A.W.); (T.P.)
- Mental Health Unit, Finnish Institute for Health and Welfare (THL), 00271 Helsinki, Finland; (M.T.-H.); (E.C.); (J.S.)
- Social Services and Health Care Sector, City of Helsinki, 00099 Helsinki, Finland
| | - Seppo Juhani Vainio
- Infotech Oulu, University of Oulu, 90014 Oulu, Finland;
- Northern Finland Biobank Borealis, Oulu University Hospital, 90220 Oulu, Finland
- Faculty of Biochemistry and Molecular Medicine, University of Oulu, 90014 Oulu, Finland
- Kvantum Institute, University of Oulu, 90014 Oulu, Finland
| | - Aarno Palotie
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, 00014 Helsinki, Finland; (K.L.); (A.A.-O.); (W.H.); (R.K.); (T.M.); (J.N.-P.); (K.S.); (A.P.)
- Mehiläinen, Pohjoinen Hesperiankatu 17 C, 00260 Helsinki, Finland
- Stanley Center for Psychiatric Research, The Broad Institute of MIT (Massachusetts Institute of Technology) and Harvard, Cambridge, MA 02142, USA
- Analytical and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Solja Niemelä
- Department of Psychiatry, University of Turku, 20014 Turku, Finland; (J.H.); (S.N.)
- Department of Psychiatry, Turku University Hospital, 20521 Turku, Finland
| | - Jaana Suvisaari
- Mental Health Unit, Finnish Institute for Health and Welfare (THL), 00271 Helsinki, Finland; (M.T.-H.); (E.C.); (J.S.)
| | - Juha Veijola
- Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, 90014 Oulu, Finland; (M.K.); (T.J.); (J.V.)
- Department of Psychiatry, Oulu University Hospital, 90220 Oulu, Finland
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21
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Anxiety and executive functions relationships in schizophrenia: A meta-analysis. PERSONALITY AND INDIVIDUAL DIFFERENCES 2021. [DOI: 10.1016/j.paid.2021.110643] [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: 11/19/2022]
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Haugen I, Stubberud J, Ueland T, Haug E, Øie MG. Executive dysfunction in schizophrenia: Predictors of the discrepancy between subjective and objective measures. SCHIZOPHRENIA RESEARCH-COGNITION 2021; 26:100201. [PMID: 34189060 PMCID: PMC8217703 DOI: 10.1016/j.scog.2021.100201] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 05/19/2021] [Accepted: 05/20/2021] [Indexed: 01/10/2023]
Abstract
This study aimed to investigate what characterizes individuals with schizophrenia who experience more or less subjective executive dysfunction in everyday life compared to objective executive performance on neuropsychological tests. Sixty-six participants with broad schizophrenia spectrum disorders completed a comprehensive assessment of executive function. Discrepancies between performance on neuropsychological tests (objective) and an extensive self-report questionnaire (subjective) of central executive functions (inhibition, shifting and working memory) were calculated. Higher level of self-efficacy was the best predictor of experiencing fewer subjective cognitive complaints compared to objective performance, followed by higher levels of disorganized symptoms. Depressive symptoms did not predict discrepancy between subjective and objective executive function. Higher estimated IQ predicted greater subjective working memory difficulties in everyday life despite better objective performance. Results may aid clinicians in the assessment and remediation of cognitive impairment. Low self-efficacy may identify individuals who are not able to utilize their potential executive functions in daily life. Interventions aimed at fostering self-efficacy ought to be included in cognitive remediation for these individuals. Disorganized symptoms could prove useful in identifying individuals who are in need of cognitive remediation for executive dysfunction, despite that they overestimate their skills. These individuals may benefit from efforts to increase insight into cognitive dysfunction.
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Affiliation(s)
- Ingvild Haugen
- Research Division, Innlandet Hospital Trust, P.O. Box 104, 2381 Brumunddal, Norway
- Department of Psychology, University of Oslo, P.O. Box 1094, 0317 Oslo, Norway
- Corresponding author at: Research Division, Innlandet Hospital Trust, P.O. Box 104, 2381 Brumunddal, Norway.
| | - Jan Stubberud
- Department of Psychology, University of Oslo, P.O. Box 1094, 0317 Oslo, Norway
- Department of Research, Lovisenberg Diaconal Hospital, P.O. Box 4970, Nydalen, 0440 Oslo, Norway
| | - Torill Ueland
- Department of Psychology, University of Oslo, P.O. Box 1094, 0317 Oslo, Norway
- Norwegian Centre for Mental Disorders Research, Oslo University Hospital, Postboks 4956, Nydalen, 0424 Oslo, Norway
| | - Elisabeth Haug
- Research Division, Innlandet Hospital Trust, P.O. Box 104, 2381 Brumunddal, Norway
| | - Merete Glenne Øie
- Research Division, Innlandet Hospital Trust, P.O. Box 104, 2381 Brumunddal, Norway
- Department of Psychology, University of Oslo, P.O. Box 1094, 0317 Oslo, Norway
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23
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Beck AT, Finkel MR, Beck JS. The Theory of Modes: Applications to Schizophrenia and Other Psychological Conditions. COGNITIVE THERAPY AND RESEARCH 2021. [DOI: 10.1007/s10608-020-10098-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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24
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Mazumder AH, Barnett J, Lindberg N, Torniainen-Holm M, Lähteenvuo M, Lahdensuo K, Kerkelä M, Hietala J, Isometsä ET, Kampman O, Kieseppä T, Jukuri T, Häkkinen K, Cederlöf E, Haaki W, Kajanne R, Wegelius A, Männynsalo T, Niemi-Pynttäri J, Suokas K, Lönnqvist J, Niemelä S, Tiihonen J, Paunio T, Palotie A, Suvisaari J, Veijola J. Reaction Time and Visual Memory in Connection with Alcohol Use in Schizophrenia and Schizoaffective Disorder. Brain Sci 2021; 11:brainsci11060688. [PMID: 34071123 PMCID: PMC8224767 DOI: 10.3390/brainsci11060688] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 05/17/2021] [Accepted: 05/21/2021] [Indexed: 11/16/2022] Open
Abstract
The purpose of this study was to explore the association between cognition and hazardous drinking and alcohol use disorder in schizophrenia and schizoaffective disorder. Cognition is more or less compromised in schizophrenia, and schizoaffective disorder and alcohol use might aggravate this phenomenon. The study population included 3362 individuals from Finland with diagnoses of schizophrenia or schizoaffective disorder. Hazardous drinking was screened with the AUDIT-C (Alcohol Use Disorders Identification Test for Consumption) screening tool. Alcohol use disorder (AUD) diagnoses were obtained from national registrar data. Participants performed two computerized tasks from the Cambridge Automated Neuropsychological Test Battery (CANTAB) on a tablet computer: The Five-Choice Serial Reaction Time Task (5-CSRTT) or the reaction time (RT) test and the Paired Associative Learning (PAL) test. The association between alcohol use and the RT and PAL tests was analyzed with log-linear regression and logistic regression, respectively. After adjustment for age, education, housing status, and the age at which the respondents had their first psychotic episodes, hazardous drinking was associated with a lower median RT in females and less variable RT in males, while AUD was associated with a poorer PAL test performance in terms of the total errors adjusted scores (TEASs) in females. Our findings of positive associations between alcohol and cognition in schizophrenia and schizoaffective disorder are unique.
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Affiliation(s)
- Atiqul Haq Mazumder
- Department of Psychiatry, University of Oulu, 90014 Oulu, Finland; (M.K.); (T.J.); (J.V.)
- Correspondence: or
| | - Jennifer Barnett
- Cambridge Cognition, University of Cambridge, Cambridge CB25 9TU, UK;
| | - Nina Lindberg
- Department of Psychiatry, Helsinki University Hospital, University of Helsinki, 00029 Helsinki, Finland; (N.L.); (E.I.); (T.K.); (A.W.); (T.P.)
| | - Minna Torniainen-Holm
- Mental Health Unit, Finnish Institute for Health and Welfare (THL), 00271 Helsinki, Finland; (M.T.-H.); (E.C.); (J.L.); (J.S.)
| | - Markku Lähteenvuo
- Department of Forensic Psychiatry, Niuvanniemi Hospital, University of Eastern Finland, 70240 Kuopio, Finland; (M.L.); (K.H.); (J.T.)
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, 00014 Helsinki, Finland; (K.L.); (W.H.); (R.K.); (T.M.); (J.N.-P.); (K.S.); (A.P.)
| | - Kaisla Lahdensuo
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, 00014 Helsinki, Finland; (K.L.); (W.H.); (R.K.); (T.M.); (J.N.-P.); (K.S.); (A.P.)
- Mehiläinen, Pohjoinen Hesperiankatu 17 C, 00260 Helsinki, Finland
| | - Martta Kerkelä
- Department of Psychiatry, University of Oulu, 90014 Oulu, Finland; (M.K.); (T.J.); (J.V.)
| | - Jarmo Hietala
- Department of Psychiatry, University of Turku, 20014 Turku, Finland; (J.H.); (S.N.)
- Department of Psychiatry, Turku University Hospital, 20521 Turku, Finland
| | - Erkki Tapio Isometsä
- Department of Psychiatry, Helsinki University Hospital, University of Helsinki, 00029 Helsinki, Finland; (N.L.); (E.I.); (T.K.); (A.W.); (T.P.)
| | - Olli Kampman
- Faculty of Medicine and Health Technology, Tampere University, 33014 Tampere, Finland;
- Department of Psychiatry, Pirkanmaa Hospital District, 33521 Tampere, Finland
| | - Tuula Kieseppä
- Department of Psychiatry, Helsinki University Hospital, University of Helsinki, 00029 Helsinki, Finland; (N.L.); (E.I.); (T.K.); (A.W.); (T.P.)
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, 00014 Helsinki, Finland; (K.L.); (W.H.); (R.K.); (T.M.); (J.N.-P.); (K.S.); (A.P.)
- Mehiläinen, Pohjoinen Hesperiankatu 17 C, 00260 Helsinki, Finland
| | - Tuomas Jukuri
- Department of Psychiatry, University of Oulu, 90014 Oulu, Finland; (M.K.); (T.J.); (J.V.)
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, 00014 Helsinki, Finland; (K.L.); (W.H.); (R.K.); (T.M.); (J.N.-P.); (K.S.); (A.P.)
| | - Katja Häkkinen
- Department of Forensic Psychiatry, Niuvanniemi Hospital, University of Eastern Finland, 70240 Kuopio, Finland; (M.L.); (K.H.); (J.T.)
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, 00014 Helsinki, Finland; (K.L.); (W.H.); (R.K.); (T.M.); (J.N.-P.); (K.S.); (A.P.)
| | - Erik Cederlöf
- Mental Health Unit, Finnish Institute for Health and Welfare (THL), 00271 Helsinki, Finland; (M.T.-H.); (E.C.); (J.L.); (J.S.)
| | - Willehard Haaki
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, 00014 Helsinki, Finland; (K.L.); (W.H.); (R.K.); (T.M.); (J.N.-P.); (K.S.); (A.P.)
- Department of Psychiatry, University of Turku, 20014 Turku, Finland; (J.H.); (S.N.)
| | - Risto Kajanne
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, 00014 Helsinki, Finland; (K.L.); (W.H.); (R.K.); (T.M.); (J.N.-P.); (K.S.); (A.P.)
| | - Asko Wegelius
- Department of Psychiatry, Helsinki University Hospital, University of Helsinki, 00029 Helsinki, Finland; (N.L.); (E.I.); (T.K.); (A.W.); (T.P.)
- Mental Health Unit, Finnish Institute for Health and Welfare (THL), 00271 Helsinki, Finland; (M.T.-H.); (E.C.); (J.L.); (J.S.)
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, 00014 Helsinki, Finland; (K.L.); (W.H.); (R.K.); (T.M.); (J.N.-P.); (K.S.); (A.P.)
| | - Teemu Männynsalo
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, 00014 Helsinki, Finland; (K.L.); (W.H.); (R.K.); (T.M.); (J.N.-P.); (K.S.); (A.P.)
- Social Services and Health Care Sector, City of Helsinki, 00099 Helsinki, Finland
| | - Jussi Niemi-Pynttäri
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, 00014 Helsinki, Finland; (K.L.); (W.H.); (R.K.); (T.M.); (J.N.-P.); (K.S.); (A.P.)
- Social Services and Health Care Sector, City of Helsinki, 00099 Helsinki, Finland
| | - Kimmo Suokas
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, 00014 Helsinki, Finland; (K.L.); (W.H.); (R.K.); (T.M.); (J.N.-P.); (K.S.); (A.P.)
- Faculty of Medicine and Health Technology, Tampere University, 33014 Tampere, Finland;
| | - Jouko Lönnqvist
- Mental Health Unit, Finnish Institute for Health and Welfare (THL), 00271 Helsinki, Finland; (M.T.-H.); (E.C.); (J.L.); (J.S.)
- Department of Psychiatry, University of Helsinki, 00014 Helsinki, Finland
| | - Solja Niemelä
- Department of Psychiatry, University of Turku, 20014 Turku, Finland; (J.H.); (S.N.)
- Department of Psychiatry, Turku University Hospital, 20521 Turku, Finland
| | - Jari Tiihonen
- Department of Forensic Psychiatry, Niuvanniemi Hospital, University of Eastern Finland, 70240 Kuopio, Finland; (M.L.); (K.H.); (J.T.)
- Department of Clinical Neuroscience, Karolinska Institute, 17177 Stockholm, Sweden
- Center for Psychiatry Research, Stockholm City Council, 11364 Stockholm, Sweden
| | - Tiina Paunio
- Department of Psychiatry, Helsinki University Hospital, University of Helsinki, 00029 Helsinki, Finland; (N.L.); (E.I.); (T.K.); (A.W.); (T.P.)
- Mental Health Unit, Finnish Institute for Health and Welfare (THL), 00271 Helsinki, Finland; (M.T.-H.); (E.C.); (J.L.); (J.S.)
- Department of Psychiatry, University of Helsinki, 00014 Helsinki, Finland
| | - Aarno Palotie
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, 00014 Helsinki, Finland; (K.L.); (W.H.); (R.K.); (T.M.); (J.N.-P.); (K.S.); (A.P.)
- Mehiläinen, Pohjoinen Hesperiankatu 17 C, 00260 Helsinki, Finland
- Stanley Center for Psychiatric Research, The Broad Institute of MIT (Massachusetts Institute of Technology) and Harvard, Cambridge, MA 02142, USA
- Analytical and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Jaana Suvisaari
- Mental Health Unit, Finnish Institute for Health and Welfare (THL), 00271 Helsinki, Finland; (M.T.-H.); (E.C.); (J.L.); (J.S.)
| | - Juha Veijola
- Department of Psychiatry, University of Oulu, 90014 Oulu, Finland; (M.K.); (T.J.); (J.V.)
- Department of Psychiatry, Oulu University Hospital, 90220 Oulu, Finland
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25
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Reckziegel R, Czepielewski LS, Hasse-Sousa M, Martins DS, de Britto MJ, Lapa CDO, Schwartzhaupt AW, Gama CS. Heterogeneous trajectories in schizophrenia: insights from neurodevelopment and neuroprogression models. ACTA ACUST UNITED AC 2021; 44:74-80. [PMID: 33886948 PMCID: PMC8827372 DOI: 10.1590/1516-4446-2020-1670] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2020] [Accepted: 02/08/2021] [Indexed: 12/18/2022]
Abstract
The notion that schizophrenia is a neuroprogressive disorder is based on clinical perception of cumulative impairments over time and is supported by neuroimaging and biomarker research. Nevertheless, increasing evidence has indicated that schizophrenia first emerges as a neurodevelopmental disorder that could follow various pathways, some of them neuroprogressive. The objective of this review is to revisit basic research on cognitive processes and neuroimaging findings in a search for candidate keys to the intricate connections between neurodevelopment and neuroprogression in schizophrenia. In the complete panorama, schizophrenia is a neurodevelopmental disorder, possibly associated with an additional burden over the course of the disease through pathologically accelerated aging, and cognitive heterogeneity may explain the different trajectories of each patient.
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Affiliation(s)
- Ramiro Reckziegel
- Laboratório de Psiquiatria Molecular, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil.,Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, Departamento de Psiquiatria e Medicina Legal, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Letícia S Czepielewski
- Laboratório de Psiquiatria Molecular, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil.,Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, Departamento de Psiquiatria e Medicina Legal, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil.,Programa de Pós-Graduação em Psicologia, Departamento de Psicologia do Desenvolvimento e da Personalidade, Instituto de Psicologia, UFRGS, Porto Alegre, RS, Brazil
| | - Mathias Hasse-Sousa
- Laboratório de Psiquiatria Molecular, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil.,Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, Departamento de Psiquiatria e Medicina Legal, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Dayane S Martins
- Laboratório de Psiquiatria Molecular, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil.,Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, Departamento de Psiquiatria e Medicina Legal, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Maria J de Britto
- Laboratório de Psiquiatria Molecular, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil.,Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, Departamento de Psiquiatria e Medicina Legal, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Clara de O Lapa
- Laboratório de Psiquiatria Molecular, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil.,Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, Departamento de Psiquiatria e Medicina Legal, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Alexandre W Schwartzhaupt
- Laboratório de Psiquiatria Molecular, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil.,Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, Departamento de Psiquiatria e Medicina Legal, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
| | - Clarissa S Gama
- Laboratório de Psiquiatria Molecular, Hospital de Clínicas de Porto Alegre (HCPA), Porto Alegre, RS, Brazil.,Programa de Pós-Graduação em Psiquiatria e Ciências do Comportamento, Departamento de Psiquiatria e Medicina Legal, Universidade Federal do Rio Grande do Sul (UFRGS), Porto Alegre, RS, Brazil
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Motivation in schizophrenia: preliminary findings of a theory-driven approach using time-series network analysis. CURRENT PSYCHOLOGY 2021. [DOI: 10.1007/s12144-020-01321-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
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Ebrahimi A, Poursharifi H, Dolatshahi B, Rezaee O, Hassanabadi HR, Naeem F. The Cognitive Model of Negative Symptoms in Schizophrenia: A Hierarchical Component Model With PLS-SEM. Front Psychiatry 2021; 12:707291. [PMID: 34366940 PMCID: PMC8339582 DOI: 10.3389/fpsyt.2021.707291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/09/2021] [Accepted: 06/24/2021] [Indexed: 11/13/2022] Open
Abstract
The cognitive model of negative symptoms suggests that some dysfunctional beliefs mediate the relationship between neurocognitive deficits and negative symptoms and disability. This study tested the hypothesis that dysfunctional performance beliefs mediate neurocognitive deficits, negative symptoms, and disability. We used a hierarchal component model with 85 men patients diagnosed with chronic schizophrenia. Results showed a moderate to strong correlation between dysfunctional performance beliefs, neurocognitive deficits, negative symptoms, and disability. These results support the Hierarchal component model (HCM) of the cognitive model of negative symptoms. Our results indicated that the disability in schizophrenia is mediated through dysfunctional performance beliefs, neurocognitive deficits, and negative symptoms pathway. Further, dysfunctional performance beliefs have a crucial role in this pathway. Therefore, targeting this vicious cycle of dysfunctional beliefs can improve disability in patients with schizophrenia.
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Affiliation(s)
- Ali Ebrahimi
- Department of Clinical Psychology, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Hamid Poursharifi
- Department of Clinical Psychology, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Behrooz Dolatshahi
- Department of Clinical Psychology, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Omid Rezaee
- Department of Psychiatry, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Hamid Reza Hassanabadi
- Department of Clinical Psychology, Faculty of Psychology and Educational Sciences, Kharazmi University, Tehran, Iran
| | - Farooq Naeem
- Department of Psychiatry, University of Toronto & Centre for Addiction and Mental Health, Toronto, ON, Canada
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28
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González-Blanch C, Medrano LA, Bendall S, D'Alfonso S, Cagliarini D, McEnery C, O'Sullivan S, Valentine L, Gleeson JF, Alvarez-Jimenez M. The role of social relatedness and self-beliefs in social functioning in first-episode psychosis: Are we overestimating the contribution of illness-related factors? Eur Psychiatry 2020; 63:e92. [PMID: 33032679 PMCID: PMC7681152 DOI: 10.1192/j.eurpsy.2020.90] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Objective Numerous research studies have demonstrated an association between higher symptom severity and cognitive impairment with poorer social functioning in first-episode psychosis (FEP). By contrast, the influence of subjective experiences, such as social relatedness and self-beliefs, has received less attention. Consequently, a cohesive understanding of how these variables interact to influence social functioning is lacking. Method We used structural equation modeling to examine the direct and indirect relationships among neurocognition (processing speed) and social cognition, symptoms, and social relatedness (perceived social support and loneliness) and self-beliefs (self-efficacy and self-esteem) in 170 individuals with FEP. Results The final model yielded an acceptable model fit (χ2 = 45.48, comparative fit index = 0.96; goodness of fit index = 0.94; Tucker–Lewis index = 0.94; root mean square error of approximation = 0.06) and explained 45% of social functioning. Negative symptoms, social relatedness, and self-beliefs exerted a direct effect on social functioning. Social relatedness partially mediated the impact of social cognition and negative symptoms on social functioning. Self-beliefs also mediated the relationship between social relatedness and social functioning. Conclusions The observed associations highlight the potential value of targeting social relatedness and self-beliefs to improve functional outcomes in FEP. Explanatory models of social functioning in FEP not accounting for social relatedness and self-beliefs might be overestimating the effect of the illness-related factors.
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Affiliation(s)
- César González-Blanch
- Mental Health Centre, University Hospital Marqués de Valdecilla - IDIVAL, Santander, Spain
| | - Leonardo A Medrano
- Faculty of Psychology, Pontificia Universidad Católica Madre y Maestra, Santiago de los Caballeros, Dominican Republic
| | - Sarah Bendall
- Orygen, Melbourne, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Simon D'Alfonso
- Orygen, Melbourne, Victoria, Australia.,School of Computing and Information Systems, University of Melbourne, Parkville, Victoria, Australia
| | - Daniela Cagliarini
- Orygen, Melbourne, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Carla McEnery
- Orygen, Melbourne, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Shaunagh O'Sullivan
- Orygen, Melbourne, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - Lee Valentine
- Orygen, Melbourne, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
| | - John F Gleeson
- Healthy Brain and Mind Research Centre and School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, Victoria, Australia
| | - Mario Alvarez-Jimenez
- Orygen, Melbourne, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Melbourne, Victoria, Australia
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29
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Cognition, negative symptoms, and functional outcome in psychosis. Schizophr Res 2020; 224:22-23. [PMID: 32646802 DOI: 10.1016/j.schres.2020.06.029] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Accepted: 06/26/2020] [Indexed: 11/23/2022]
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30
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Thonon B, Van Aubel E, Lafit G, Della Libera C, Larøi F. Idiographic analyses of motivation and related processes in participants with schizophrenia following a therapeutic intervention for negative symptoms. BMC Psychiatry 2020; 20:464. [PMID: 32977798 PMCID: PMC7517640 DOI: 10.1186/s12888-020-02824-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 08/17/2020] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Motivational negative symptoms hinder quality of life and daily functioning of individuals with schizophrenia spectrum disorders. A recently developed intervention, Switch, has shown promising effects on negative symptoms and functional outcomes. Switch targets multiple cognitive, emotional and behavioural processes associated with motivation and goal directed behaviours. We aimed to investigate its effects on motivation and associated processes in a naturalistic setting, and to explore the dynamics between the processes. METHODS We used a single case approach (n = 3), with a pre-post and follow-up assessment design, which also included ambulatory assessments (experience sampling method, ESM; and step count). We computed autoregressive lag 1 models to evaluate the effects of the intervention on daily motivation levels and related processes, descriptive pie-charts, and vector autoregressive modelling to reveal the dynamics of the processes over time. RESULTS The intervention was beneficial for each participant according to traditional evaluations of motivational negative symptoms, apathy, daily functioning and quality of life. The effects on the ESM variables revealed distinct outcomes for each individual. The dynamics between the various processes differed between participants, and fluctuated within participants (when comparing baseline, intervention phase, and follow-up). CONCLUSIONS This study used an innovative approach to look at the effectiveness of an intervention. The intervention seems to lead to meaningful improvements in motivational negative symptoms and functional outcomes. The mechanisms of change need to be further investigated. TRIAL REGISTRATION NUMBER ClinicalTrials.gov, NCT04325100 . Registered 27 March 27, 2020 -retrospectively registered. REPORTING Guidelines from the Transparent Reporting of Evaluations with Non-randomized Designs (TREND) statement were followed.
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Affiliation(s)
- Bénédicte Thonon
- grid.4861.b0000 0001 0805 7253Faculty of Psychology, Speech and Laguage Therapy and Education Sciences, Psychology and Neuroscience of Cognition Research Unit, University of Liège, Place des Orateurs 1, 4000 Liège, Belgium
| | - Evelyne Van Aubel
- Department of Neurosciences, Center for Contextual Psychiatry (CCP), Katholieke Universiteit Leuven, Kapucijnenvoer 7, 3000 Leuven, Belgium
| | - Ginette Lafit
- Department of Neurosciences, Center for Contextual Psychiatry (CCP), Katholieke Universiteit Leuven, Kapucijnenvoer 7, 3000 Leuven, Belgium ,grid.5596.f0000 0001 0668 7884Department of Psychology, Research Group of Quantitative Psychology and Individual, Differences, Katholieke Universiteit Leuven, Kapucijnenvoer 7, 3000 Leuven, Belgium
| | - Clara Della Libera
- grid.4861.b0000 0001 0805 7253Faculty of Psychology, Speech and Laguage Therapy and Education Sciences, Psychology and Neuroscience of Cognition Research Unit, University of Liège, Place des Orateurs 1, 4000 Liège, Belgium
| | - Frank Larøi
- Faculty of Psychology, Speech and Laguage Therapy and Education Sciences, Psychology and Neuroscience of Cognition Research Unit, University of Liège, Place des Orateurs 1, 4000, Liège, Belgium. .,Department of Biological and Medical Psychology, University of Bergen, Jonas Lies vei 91, 5009, Bergen, Norway. .,NORMENT - Norwegian Center of Excellence for Mental Disorders Research, University of Oslo, Kirkeveien 166, 0450, Oslo, Norway.
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31
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Balzan RP, Moritz S. Cognitive biases and psychosis: From bench to bedside. Schizophr Res 2020; 223:368-369. [PMID: 32739344 DOI: 10.1016/j.schres.2020.07.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2020] [Revised: 07/20/2020] [Accepted: 07/21/2020] [Indexed: 11/30/2022]
Affiliation(s)
- Ryan P Balzan
- College of Education, Psychology & Social Work, Flinders University, Australia.
| | - Steffen Moritz
- University Medical Center Hamburg-Eppendorf, Department of Psychiatry and Psychotherapy, Hamburg, Germany
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32
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Bègue I, Kaiser S, Kirschner M. Pathophysiology of negative symptom dimensions of schizophrenia – Current developments and implications for treatment. Neurosci Biobehav Rev 2020; 116:74-88. [DOI: 10.1016/j.neubiorev.2020.06.004] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 04/13/2020] [Accepted: 06/02/2020] [Indexed: 02/06/2023]
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33
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Zhou C, Li Z. Modelling of self‐management in schizophrenia: The role of neurocognition, self‐efficacy and motivation. J Clin Nurs 2020; 29:3966-3976. [DOI: 10.1111/jocn.15407] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2020] [Revised: 05/29/2020] [Accepted: 06/27/2020] [Indexed: 11/27/2022]
Affiliation(s)
- Chenxi Zhou
- School of Nursing Peking Union Medical College Beijing China
| | - Zheng Li
- School of Nursing Peking Union Medical College Beijing China
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34
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Allott K, Steele P, Boyer F, de Winter A, Bryce S, Alvarez-Jimenez M, Phillips L. Cognitive strengths-based assessment and intervention in first-episode psychosis: A complementary approach to addressing functional recovery? Clin Psychol Rev 2020; 79:101871. [DOI: 10.1016/j.cpr.2020.101871] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Revised: 05/14/2020] [Accepted: 05/24/2020] [Indexed: 12/14/2022]
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35
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Clouston SAP, Jonas K, Fochtmann LJ, Bromet EJ, Kotov R. Physical Functional Limitations in a First-Admission Cohort at Midlife: Findings From the Suffolk County Mental Health Project. J Gerontol A Biol Sci Med Sci 2020; 75:1424-1430. [PMID: 31566202 DOI: 10.1093/gerona/glz227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2019] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Psychosis is a risk factor for aging-related conditions and early mortality. Little is known about the age-specific risk of objectively measured physical functional limitations among individuals with serious mental illness. METHODS The Suffolk County Mental Health Project is a prospective study of individuals hospitalized for the first time for psychosis. To assess physical functioning at midlife and to identify emerging risk factors for older-age changes, 101 participants with schizophrenia (mean age = 47.2, SD = 8.0 years; 41.6% female) and 112 participants with other psychoses (mean age = 48.2, SD = 9.5 years; 45.5% female) were assessed for chair-rise and balance limitations 20 years after diagnosis. A never-psychotic comparison group of 237 age/sex/geographically matched community controls was similarly assessed (mean age = 50.3, SD = 8.8 years; 44.7% female). Logistic regression was used to examine group differences in prevalence of poor performance and demographic, medical, and treatment correlates. RESULTS Chair-rise limitations (45.5% [35.8-55.3]) and balance limitations (17.2% [9.8-24.5]) were common in individuals with schizophrenia. Prevalence of chair-rise limitations was higher in schizophrenia (46.3%) than in other psychotic disorders (31.9%) and never-psychotic group (22.1%), whereas risk of balance limitations was higher in schizophrenia (17.2%) compared with never-psychotic controls (8.1%). Schizophrenia was a significant risk factor for chair-rise (adjusted odds ratio = 3.01 [1.79-5.08], p < .001) and balance limitations (adjusted odds ratio = 2.63, [1.25-5.51], p = .010). Multivariable analysis of symptom severity found avolition was associated with chair-rise limitations, but not balance, independent of diagnosis. CONCLUSION Physical limitations are crucial because they identify existing problems with mobility and portend an increased risk of disability and death. Because participants with schizophrenia were at increased risk of physical limitations, assessments of chair-rise and balance limitations may be critical to monitoring individuals with psychosis.
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Affiliation(s)
- Sean A P Clouston
- Department of Family, Population, and Preventive Medicine/Program in Public Health, New York
| | | | | | | | - Roman Kotov
- Department of Psychiatry, Stony Brook University, New York
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36
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Moritz S, Silverstein SM, Dietrichkeit M, Gallinat J. Neurocognitive deficits in schizophrenia are likely to be less severe and less related to the disorder than previously thought. World Psychiatry 2020; 19:254-255. [PMID: 32394552 PMCID: PMC7215075 DOI: 10.1002/wps.20759] [Citation(s) in RCA: 30] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Affiliation(s)
- Steffen Moritz
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Stephen M Silverstein
- Department of Psychiatry, University of Rochester Medical Center, Rochester, New York, NY, USA
| | - Mona Dietrichkeit
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Jürgen Gallinat
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
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37
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Luther L, Suor JH, Rosen C, Jobe TH, Faull RN, Harrow M. Clarifying the direction of impact of negative symptoms and neurocognition on prospective work functioning in psychosis: A 20-year longitudinal study. Schizophr Res 2020; 220:232-239. [PMID: 32201031 PMCID: PMC8523216 DOI: 10.1016/j.schres.2020.03.012] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2019] [Revised: 03/06/2020] [Accepted: 03/07/2020] [Indexed: 11/16/2022]
Abstract
Both neurocognition and negative symptoms have demonstrated strong links to functional outcomes, such as work functioning, among those with severe mental illness (SMI). Prior models have suggested that reduced neurocognition 1) precedes or predicts greater negative symptoms and 2) indirectly influences functional outcomes via its impact on negative symptoms. The current study sought to also test a divergent model: whether greater negative symptoms predict reduced neurocognition and indirectly influence work functioning through their impact on neurocognition. Both models were tested using cross-sectional and prospective data spanning 20-years in a sample of 277 people with a SMI with psychotic features. Results showed that both models were supported in cross-sectional analyses. However, in prospective models predicting work functioning, only the models examining the indirect influence of negative symptoms on work functioning (7.5 to up to 20-years later) through neurocognition demonstrated significant mediation (i.e., a significant indirect effect); further, higher negative symptoms significantly predicted lower prospective neurocognition, while lower neurocognition did not significantly predict greater prospective negative symptoms. Although cross-sectional data were consistent with prior models, our prospective models offered greater support for a putative causal pathway running from negative symptoms to neurocognition-rather than the reverse-to work functioning. Findings have implications for mechanisms contributing to longitudinal work functioning and suggest that targeting negative symptoms prior to neurocognition could be more beneficial for long-term work outcomes.
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Affiliation(s)
- Lauren Luther
- Massachusetts General Hospital, Department of Psychiatry, 149 13th Street, Charlestown, MA 02129, USA; Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA; University of Illinois at Chicago, Department of Psychiatry, 1601 West Taylor, Chicago, IL 60612, USA.
| | - Jennifer H. Suor
- University of Illinois at Chicago, Department of Psychiatry; 1601 West Taylor, Chicago, IL 60612, U.S.A
| | - Cherise Rosen
- University of Illinois at Chicago, Department of Psychiatry, 1601 West Taylor, Chicago, IL 60612, USA.
| | - Thomas H. Jobe
- University of Illinois at Chicago, Department of Psychiatry; 1601 West Taylor, Chicago, IL 60612, U.S.A
| | - Robert N. Faull
- University of Illinois at Chicago, Department of Psychiatry; 1601 West Taylor, Chicago, IL 60612, U.S.A
| | - Martin Harrow
- University of Illinois at Chicago, Department of Psychiatry, 1601 West Taylor, Chicago, IL 60612, USA.
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38
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New Evidences about Subjective Well-Being in Adolescence and Its Links with Neurocognitive Performance. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17061866. [PMID: 32183084 PMCID: PMC7143396 DOI: 10.3390/ijerph17061866] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Accepted: 03/06/2020] [Indexed: 12/12/2022]
Abstract
The main purpose of the present work was to study the neurocognitive endophenotypes of adolescents at risk for low personal wellbeing. The sample included a total of 1588 adolescents from stratified random cluster sampling; derived from this sample, a group of high-risk (n = 84) and a control group (n = 84) were selected. The personal well-being index–school children (PWI–SC), the University of Pennsylvania computerized neuropsychological test battery for children (included 14 tasks assessing five neurobehavioral domains: executive functions, episodic memory, complex cognition, social cognition and sensorimotor speed), and the strengths and difficulties questionnaire (SDQ) were used. Adolescents with low personal wellbeing showed statistically significant impairments across the different neurocognitive domains. In particular, adolescents at risk showed lower accuracy scores on executive function and complex cognition and lower speed scores on episodic memory, complex cognition and social cognition scores. The results of the present study contribute relevant information about the nature of neurocognitive impairments associated with subjective wellbeing and allow implementing preventive treatments.
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39
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Yanos PT, Lysaker PH, Silverstein SM, Vayshenker B, Gonzales L, West ML, Roe D. A randomized-controlled trial of treatment for self-stigma among persons diagnosed with schizophrenia-spectrum disorders. Soc Psychiatry Psychiatr Epidemiol 2019; 54:1363-1378. [PMID: 30937510 PMCID: PMC6773531 DOI: 10.1007/s00127-019-01702-0] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Accepted: 03/22/2019] [Indexed: 01/01/2023]
Abstract
PURPOSE A substantial body of research indicates that self-stigma is associated with poorer outcomes related to recovery among people with severe mental illnesses. Narrative Enhancement and Cognitive Therapy (NECT) is a structured, group-based approach which targets the effects of self-stigma. A randomized-controlled trial was conducted to examine the efficacy of NECT. METHODS One hundred and seventy persons, recruited from both outpatient and comprehensive treatment settings, meeting criteria for schizophrenia-spectrum disorders and moderate-to-elevated self-stigma, were randomly assigned to NECT or supportive group therapy and assessed at four time points over the course of nearly a year. Participants completed measures of self-stigma, hope, self-esteem, functioning, psychiatric symptoms, coping with symptoms, and narrative insight. RESULTS Analyses indicated that NECT participants in outpatient sites improved significantly more over time in self-stigma compared to supportive group therapy participants in outpatient sites, while NECT participants in comprehensive (including day treatment and psychiatric rehabilitation program) sites improved significantly more in hopelessness and narrative insight than other participants. NECT participants as a group showed decreases in the social withdrawal component of self-stigma, decreased in their use of avoidant coping strategies, and were more engaged in treatment than supportive group therapy participants. There was no evidence for effects of NECT on social functioning or psychiatric symptoms. CONCLUSIONS Findings suggest that NECT primarily impacts self-stigma and related outcomes, and that the degree of its effects is partially dependent on the treatment context in which it is offered.
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Affiliation(s)
- Philip T. Yanos
- John Jay College of Criminal Justice, City University of New York, USA
| | - Paul H. Lysaker
- Roudebush VA Medical Center and Indiana University School of Medicine, USA
| | | | | | - Lauren Gonzales
- Gordon F. Derner School of Psychology, Adelphi University, USA
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Mote J, Gard DE, Gonzalez R, Fulford D. How did that interaction make you feel? The relationship between quality of everyday social experiences and emotion in people with and without schizophrenia. PLoS One 2019; 14:e0223003. [PMID: 31568483 PMCID: PMC6768461 DOI: 10.1371/journal.pone.0223003] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Accepted: 09/11/2019] [Indexed: 12/27/2022] Open
Abstract
People with schizophrenia report positive emotion during social interactions in ecological momentary assessment (EMA) studies; however, few of these studies examine the qualities of social interactions (e.g., intimacy) that may affect emotion experience. In the current EMA study, people with (n = 20) and without schizophrenia (n = 15) answered questions about the quality of their social interactions, including their emotion experiences. We also explored the relationship between EMA-reported social experiences and trait loneliness, negative symptoms, and social functioning. People with and without schizophrenia did not differ in EMA-reported proportion of time spent with others, extent of involvement during social interactions, intimacy of interactions, or average number of social interactions. Both people with and without schizophrenia reported more positive than negative emotion during social experiences. However, people with schizophrenia reported more loneliness, more severe negative symptoms, and impaired social functioning compared to people without schizophrenia. Further, specific qualities of social interactions (intimacy of interaction, involvement during interaction) were related to happiness during interactions only in people without schizophrenia. These results suggest that while people with and without schizophrenia report similar rates of in-the-moment social emotion experiences, the impact of social interaction quality on emotion may differ between groups.
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Affiliation(s)
- Jasmine Mote
- Sargent College of Health & Rehabilitation Sciences, Boston University, Boston, Massachusetts, United States of America
- * E-mail:
| | - David E. Gard
- Department of Psychology, San Francisco State University, San Francisco, California, United States of America
| | - Rachel Gonzalez
- Department of Psychology, San Francisco State University, San Francisco, California, United States of America
| | - Daniel Fulford
- Sargent College of Health & Rehabilitation Sciences, Boston University, Boston, Massachusetts, United States of America
- Department of Psychological & Brain Sciences, Boston University, Boston, Massachusetts, United States of America
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41
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Grant PM, Best M W, Beck AT. The meaning of group differences in cognitive test performance. World Psychiatry 2019; 18:163-164. [PMID: 31059607 PMCID: PMC6502459 DOI: 10.1002/wps.20645] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Affiliation(s)
- Paul M. Grant
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Michael W. Best
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Aaron T. Beck
- Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
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