Schizotypy facets, cognitive control, and emotion

Cold executive function processes and their hot analogs in schizotypy

OBJECTIVE

To examine cold (based on logical reasoning) versus hot (having emotional components) executive function processes in groups with high individual schizotypal traits.

METHOD

Two-hundred and forty-seven participants were administered the Schizotypal Personality Questionnaire and were allocated into schizotypal (cognitive-perceptual, paranoid, negative, disorganized) or control groups according to pre-specified criteria. Participants were also administered a battery of tasks examining working memory, complex selective attention, response inhibition, decision-making and fluid intelligence and their affective counterparts. The outcome measures of each task were reduced to one composite variable thus formulating five cold and five hot cognitive domains. Between-group differences in the cognitive domains were examined with repeated measures analyses of covariance.

RESULTS

For working memory, the control and the cognitive-perceptual groups outperformed negative schizotypes, while for affective working memory controls outperformed the disorganized group. Controls also scored higher compared with the disorganized group in complex selective attention, while both the control and the cognitive-perceptual groups outperformed negative schizotypes in complex affective selective attention. Negative schizotypes also had striking difficulties in response inhibition, as they scored lower compared with all other groups. Despite the lack of differences in fluid intelligence, controls scored higher compared with all schizotypal groups (except from cognitive-perceptual schizotypes) in emotional intelligence; the latter group reported higher emotional intelligence compared with negative schizotypes.

CONCLUSION

Results indicate that there is no categorical association between the different schizotypal dimensions with solely cold or hot executive function processes and support impoverished emotional intelligence as a core feature of schizotypy.

Nabilone Impairs Spatial and Verbal Working Memory in Healthy Volunteers

Background: Memory impairments and psychosis-like experiences can be adverse effects of cannabis use. However, reports on the cognitive impact of cannabis use are not consistent. There are also limited studies on the psychotomimetic effects of cannabinoid compounds to reveal the association between cannabis and psychosis. Therefore, we investigated the effect of acute cannabinoid intoxication on verbal working memory (VWM) and spatial working memory (SWM) following oral doses of the synthetic cannabinoid agonist, nabilone (1-2 mg, oral). We further investigated the effect of nabilone on psychosis-like experiences (schizotypy scores) and associations of schizotypy with VWM and SWM. Methods: Healthy participants (n=28) completed spatial and digit span tasks across different delay conditions (0, 6, 12, and 18 sec) after receiving nabilone (1-2 mg, PO) or placebo in a randomized, double-blind, counterbalanced, crossover manner. A subset of participants completed a short battery of schizotypy measures (n=25). Results: Nabilone impaired VWM (p=0.03, weak effect size η2=0.02) and SWM (p=0.00016, η2=0.08). Nabilone did not significantly change overall schizotypy scores. Schizotypy scores were negatively correlated with working memory (WM) averaged across all delays and both modalities, under placebo (ρ=-0.41, p=0.04). In addition, there were significant negative correlations between occasions of cannabis use and overall WM averaged scores across drug treatments (ρ=-0.49, p=0.007) and under placebo (ρ=-0.45, p=0.004). The results showed that the drug effect in the less frequent cannabis users was more pronounced on the SWM (p<0.01) and VWM (p<0.01), whereas there appeared to be little drug effect in the frequent cannabis users. Conclusion: Low doses of synthetic cannabinoid impaired SWM and VWM, indicating that exogenous activation of the cannabinoid system influences cognitive performance. Further, the results replicated previous findings that schizotypy is correlated with deficits in WM. Clinical Trial Registry Name: Nabilone and caffeine effects on the perceptions of visually, auditory, tactile and multimodal illusions in healthy volunteers. Clinical Trial Registration Number: CT-2018-CTN-02561 (Therapeutic Goods Administration Clinical Trial Registry) and ACTRN12618001292268 (The Australian New Zealand Clinical Trials Registry).

Assessing the diametrical model of schizotypal and autistic traits in emotion recognition and social functioning in a community sample

BACKGROUND

Some research suggests that schizotypal and autistic traits can produce opposing effects on the mentalizing domain of social cognition. Although such findings support a diametrical model proposing that psychotic and autistic traits represent opposite extremes of the social brain continuum, results from recent studies have been more inconsistent, and the applicability of this model to other social cognition domains remains unclear. To test the diametrical model more broadly, this study examined the interactions between schizotypal and autistic traits on emotion recognition and social functioning.

METHOD

A total of 791 participants recruited from the general population self-reported schizotypal traits using the Schizotypal Personality Questionnaire-Brief Revised (SPQ-BR) and autistic traits using the Broad Autism Phenotype Questionnaire (BAPQ). Participants also completed the Emotion Recognition 40 task and the Specific Levels of Functioning (SLOF) scale.

RESULTS

The SPQ subscales of interpersonal relationships and disorganized symptoms interacted significantly with social BAP on overall emotion recognition performance and the accuracy of identifying neutral faces. Supporting the diametrical model, elevated levels of both schizotypal and autistic traits contributed to higher emotion recognition accuracy compared to elevations on only one trait. For social functioning, however, the diametrical model was not supported. A main effect was found such that higher interpersonal relationship difficulties on SPQ predicted lower work skills on SLOF, and higher levels of both schizotypal and autistic traits combined to produce even lower social functioning.

CONCLUSIONS

These findings suggest that the diametrical model may be more relevant to social cognition than to social functioning.

People with high schizotypy experience more illusions in the Pattern Glare Test: Consistent with the hyperexcitability hypothesis

Individuals diagnosed with schizophrenia spectrum disorders (SSD) exhibit a constellation of sensory and perceptual impairments, including hyporeactivity to external input. However, individuals with SSD also report subjective experiences of sensory flooding, suggesting sensory hyperexcitability. To identify the extent to which behavioural indices of hyperexcitability are related to non-psychotic symptoms of schizophrenia, we tested a non-clinical population measured for schizophrenia-like traits (schizotypy), and a behavioural measure of sensory hyperexcitability, specifically the number of illusions seen in the Pattern Glare Test. Two samples totaling 913 individuals completed an online version of the Schizotypal Personality Questionnaire - Brief Revised (SPQ-BR) and the Pattern Glare Test. Individuals with higher schizotypy traits reported more illusions in the Pattern Glare Test. Additionally, one of the three SPQ-BR factors, the disorganized factor, significantly predicted the number of illusions reported. These data illustrate the potential for research in non-clinical samples to inform clinically relevant research.

Assessing the dimensionality of scores derived from the Revised Formal Thought Disorder Self-Report Scale in schizotypy

The current work explored the dimensionality and convergent validity of responses to Barrera et al.'s (2015) 29-item Formal Thought Disorder-Self Scale (FTD-SS) obtained in two non-clinical samples. Exploratory factor analyses were conducted in Sample 1 (n = 324), yielding evidence of three correlated factors, although simple structure was not achieved until nine items were removed. Support for the correlated three factors model of responses to the revised 20-item scale (FTD-SS-R) was replicated when a confirmatory factor analysis was conducted in Sample 2 (n = 610). Finally, convergent associations were found between FTD-SS-R scores and scores from other schizotypy measures across both samples, though these measures only explained half of the variance in FTD-SS-R scores. Additional research is needed to evaluate the appropriateness of the items and incremental validity of the scale in non-clinical samples.

Tensor factorization approach for ERP-based assessment of schizotypy in a novel auditory oddball task on perceived family stress

Objective. Schizotypy, a potential phenotype for schizophrenia, is a personality trait that depicts psychosis-like signs in the normal range of psychosis continuum. Family communication may affect the social functioning of people with schizotypy. Greater family stress, such as irritability, criticism and less praise, is perceived at a higher level of schizotypy. This study aims to determine the differences between people with high and low levels of schizotypy using electroencephalography (EEG) during criticism, praise and neutral comments. EEGs were recorded from 29 participants in the general community who varied from low schizotypy to high schizotypy (HS) during a novel emotional auditory oddball task.Approach. We consider the difference in event-related potential parameters, namely the amplitude and latency of P300 subcomponents (P3a and P3b), between pairs of target words (standard, positive, negative and neutral). A model based on tensor factorization is then proposed to detect these components from the EEG using the CANDECOMP/PARAFAC decomposition technique. Finally, we employ the mutual information estimation method to select influential features for classification.Main results.The highest classification accuracy, sensitivity, and specificity of 93.1%, 94.73%, and 90% are obtained via leave-one-out cross validation.Significance. This is the first attempt to investigate the identification of individuals with psychometrically-defined HS from brain responses that are specifically associated with perceiving family stress and schizotypy. By measuring these brain responses to social stress, we achieve the goal of improving the accuracy in detection of early episodes of psychosis.

Loneliness, positive, negative and disorganised Schizotypy before and during the COVID-19 pandemic

Loneliness is common in psychosis and occurs along a continuum. Here we investigate inter-relationships between loneliness, three-dimensional schizotypy, and depressive symptoms before and during the COVID-19 pandemic.

The sample included 507 university students (48.3% participated before and 51.7% during the COVID-19 pandemic) who completed the Multidimensional Schizotypy Scale-Brief, the Counseling Center Assessment of Psychological Symptoms depression scale and the University of California, Los Angeles Loneliness Scale. Schizotypy and depression scores were regressed onto loneliness individually and in multiple regressions.

The cohorts did not differ in any of the schizotypy domains (all p > .29). Depressive symptoms (p = .05) and loneliness (p = .006) were higher during the pandemic than before. Across cohorts, loneliness was significantly associated with positive (β = 0.23, p < .001), negative (β = 0.44, p < .001), and disorganised schizotypy (β = 0.44, p < .001), and with depression (β = 0.72, p < .001). Schizotypy together explained a significant amount of variance in loneliness (R² = 0.26), with significant associations with positive (β = −0.09, p = .047), negative (β = 0.31, p < .001) and disorganised schizotypy (β = 0.34, p < .001). When depression was included (β = 0.69, p < .001), only positive (β = −0.09, p = .008) and negative schizotypy (β = 0.22, p < .001) significantly predicted loneliness.

When all schizotypy dimensions and depression were considered together, only negative schizotypy and depression significantly predicted loneliness. Loneliness and depressive symptoms were higher during the pandemic, but this did not relate to cohort differences in schizotypy.

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Loneliness is uniquely associated with negative schizotypy and depression, but not disorganised schizotypy.

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Certain aspects of positive schizotypy may protect against loneliness.

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Loneliness and depressive symptoms were higher in students during the COVID-19 pandemic than before.

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Cohorts of students assessed before and during the pandemic showed similar levels of schizotypy.

Proneness to psychotic-like experiences as a basic personality trait complementing the HEXACO model-A preregistered cross-national study

The goal of the study is to investigate the relationship between the HEXACO personality model and Disintegration-representing a broad spectrum of psychotic-like experiences and behavioral tendencies (Perceptual Distortions, General Executive/Cognitive Impairment, Enhanced Awareness, Paranoia, Mania, Flattened Affect, Apathy/Depression, Somatoform Dysregulation, and Magical Thinking) that are reconceptualized as a personality trait. In this preregistered study, we predicted that the Disintegration factor would separate from HEXACO. The replicability of the factorial structures of HEXACO and Disintegration subcomponents is investigated across the three national samples (UK, Germany, and Serbia), matched on key socio-demographic variables. Exploratory Structural Equation Modeling (ESEM) is used to study the invariance of the hypothesized seven-factor structure (six HEXACO plus Disintegration). Support for the metric invariance of the seven-factor structure based on HEXACO and Disintegration subcomponents/facets across the three nations was found. The Disintegration factor lied outside the HEXACO personality space with each of its nine subcomponents. The Disintegration factor appeared to be among the most coherent and replicable of the seven across the samples and units of measurement (facets and items). A broad spectrum of psychotic-like experiences/behavioral tendencies relevant in understanding and explaining many aspects of everyday and long-term (mal)adaptations is not captured by the HEXACO model.

Schizotypy unfolding into the night? Schizotypal traits and daytime psychotic-like experiences predict negative and salient dreams

Symptoms of insomnia and frequent nightmares are prevalent in psychotic disorders, and are associated with psychotic-like experiences (PLEs) in the non-clinical population. Whereas the role of impaired sleep in psychosis was extensively examined by longitudinal and interventional approaches, studies on the association between psychosis and dream quality are scarce, and mainly cross-sectional. We conducted a three-week long prospective study in a group of healthy adults (N = 55), assessed schizotypal traits, daily PLEs, and the emotional quality of dreams recalled in the morning (N = 490). We extracted the latent factors of schizotypal traits and dream emotions, and examined the predictive value of trait-and state-like variables on day-to-day reports of PLEs and dream quality. PLEs reported in the evening predicted emotionally more negative and salient dream reports the following morning. On the other hand, the quality of dreams were not predictive of PLEs reported later during the day. Schizotypal personality traits were differentially associated with dream quality: Introvertive Anhedonia, Cognitive Disorganization, and General-Disorganized schizotypy were linked to more negative dream valence, whereas Unusual Experiences were associated with more salient dreams. Our findings highlight the relevance of the multidimensional nature of schizotypal traits, the role of different facets of schizotypy in daytime and nocturnal mental experiences, and the day-to-day associations between PLEs and dream affect. GENERAL SCIENTIFIC SUMMARIES (GSS): The aim of the study was to examine the temporal associations between psychotic-like experiences and dream emotions, taking into account the trait factors of schizotypy. Psychotic-like experiences during the evening hours predicted reporting more negative and salient dreams the following morning, and schizotypal personality traits were differentially associated with the dimensions of dream emotions.

Meta-Analysis of the Associations Among Constructs of Intrapersonal Emotion Knowledge

To better define the boundaries of conceptually overlapping constructs of intrapersonal emotion knowledge (EK), we examined meta-analytic correlations among five intrapersonal EK-related constructs (affect labelling, alexithymia, emotional awareness, emotional clarity, emotion differentiation) and attention to emotion. Affect labelling, alexithymia, and emotional clarity were strongly associated, and they were moderately associated with attention to emotion. Alexithymia and emotional awareness were weakly associated, and emotion differentiation was unrelated with emotional clarity. Sample characteristics and measures moderated some of the associations. Publication bias was not found, except for the alexithymia-emotional awareness association. This study helped to clarify the extent to which similarly defined constructs overlap or are distinct, which can inform our decision to adequately label important constructs and employ corresponding measures.

Shared and unique affective abnormalities in schizotypy dimensions

Attention to affect is theoretically a precursor to one's ideal affect (i.e., preference for feeling low- and high-arousal positive and negative affect) and emotion regulation (ER). In schizotypy, there have been mixed findings regarding abnormalities in attention to affect. At the same time, little is known about ideal affect in schizotypy or whether differences in ideal affect or ER difficulties in schizotypy are driven by attention to affect. Thus, this study aimed to identify shared and unique abnormalities in attention to affect, ideal affect, and ER difficulties in schizotypy, and to test whether attention to affect underlies differences in ideal affect and ER difficulties. Using groups of individuals with either extreme levels of social anhedonia (SocAnh; n = 181), extreme levels of perceptual aberrations/magical ideation (PerMag; n = 105), or individuals low on both (i.e., controls; n = 531), we tested group differences in attention to affect, ideal affect, and ER difficulties. Our findings suggest both shared and unique affective abnormalities; compared to controls, the SocAnh group paid the least attention to positive affect. Only PerMag had heightened attention to negative affect compared to controls. Additionally, we found unique abnormalities relating to ideal affect but mostly shared difficulties in ER in schizotypy. Abnormalities in ideal affect and ER remain largely consistent after accounting for attention to affect for PerMag, suggesting that attention to affect is not the primary mechanism driving these abnormalities. However, we found evidence that attention to affect underlies some SocAnh-control group differences in ideal affect and ER difficulties. Our work helps to clarify prior work and contributes to the understanding of shared and unique affective abnormalities in schizotypy. Future research may consider longitudinal approaches to test causal mechanisms of affective abnormalities in schizotypy.

Dissociation of Proactive and Reactive Cognitive Control in Individuals with Schizotypy: An Event-Related Potential Study

OBJECTIVE

Patients with schizophrenia and individuals with schizotypy, a subclinical group at risk for schizophrenia, have been found to have impairments in cognitive control. The Dual Mechanisms of Cognitive Control (DMC) framework hypothesises that cognitive control can be divided into proactive and reactive control. However, it is unclear whether individuals with schizotypy have differential behavioural impairments and neural correlates underlying these two types of cognitive control.

METHOD

Twenty-five individuals with schizotypy and 26 matched healthy controls (HCs) completed both reactive and proactive control tasks with electroencephalographic data recorded. The proportion of congruent and incongruent trials was manipulated in a classic colour-word Stroop task to induce proactive or reactive control. Proactive control was induced in a context with mostly incongruent (MI) trials and reactive control in a context with mostly congruent (MC) trials. Two event-related potential (ERP) components, medial frontal negativity (MFN, associated with conflict detection) and conflict sustained potential (conflict SP, associated with conflict resolution) were examined.

RESULTS

There was no significant difference between the two groups in terms of behavioural results. In terms of ERP results, in the MC context, HC exhibited significantly larger MFN (360-530 ms) and conflict SP (600-1000 ms) amplitudes than individuals with schizotypy. The two groups did not show any significant difference in MFN or conflict SP in the MI context.

CONCLUSIONS

The present findings provide initial evidence for dissociation of neural activation between proactive and reactive cognitive control in individuals with schizotypy. These findings help us understand cognitive control deficits in the schizophrenia spectrum.

Schizotypy is associated with difficulties detecting emotional facial expressions

People with schizophrenia or subclinical schizotypal traits exhibit impaired recognition of facial expressions. However, it remains unclear whether the detection of emotional facial expressions is impaired in people with schizophrenia or high levels of schizotypy. The present study examined whether the detection of emotional facial expressions would be associated with schizotypy in a non-clinical population after controlling for the effects of IQ, age, and sex. Participants were asked to respond to whether all faces were the same as quickly and as accurately as possible following the presentation of angry or happy faces or their anti-expressions among crowds of neutral faces. Anti-expressions contain a degree of visual change that is equivalent to that of normal emotional facial expressions relative to neutral facial expressions and are recognized as neutral expressions. Normal expressions of anger and happiness were detected more rapidly and accurately than their anti-expressions. Additionally, the degree of overall schizotypy was negatively correlated with the effectiveness of detecting normal expressions versus anti-expressions. An emotion-recognition task revealed that the degree of positive schizotypy was negatively correlated with the accuracy of facial expression recognition. These results suggest that people with high levels of schizotypy experienced difficulties detecting and recognizing emotional facial expressions.

Adaptive and maladaptive features of schizotypy clusters in a community sample

Schizotypal personality traits correlate with psychopathology and impaired functional outcome. Yet advantageous aspects of positive schizotypy may exist which could promote resilience and creativity, and several studies have identified a high positive but low negative schizotypy group with some signs of adaptation. The aim of our study was to clarify whether such individuals demonstrate only traits associated with well-being, or they also have traits that predict impairment. Participants (N = 643 students, 71.5% female) completed measures of schizotypy, resilience, self-esteem, self-concept clarity, and absorption. We identified four clusters: an overall low schizotypy, an overall high schizotypy, a disorganised-interpersonal schizotypy and a positive schizotypy cluster. The overall high schizotypy cluster seemed to be the most vulnerable as it was the least resilient and showed widespread maladaptation, whereas the high positive schizotypy cluster had intact self-esteem and high resilience and its elevated absorption may hold the promise for adaptive outcomes such as creativity and positive spirituality. However, the high positive schizotypy cluster lacked self-concept clarity. The results suggest that individuals showing high positive and low negative schizotypy demonstrate features promoting mental well-being to an extent that is higher than in all the other clusters, while their self-concept impairment is similar to that observed in the high and the disorganised-interpersonal schizotypy clusters. Better understanding of these factors could be informative for prevention and treatment of psychosis-spectrum disorders.

How did Tunisian university students cope with fear of COVID-19? A comparison across schizotypy features

Background

Little consideration has been given to the impact of COVID-19 on people at risk of psychosis despite their particular preexisting vulnerability. We aimed to examine the role of coping strategies in determining the levels of fear in nonclinical students with high levels of self-reported schizotypal personality traits as compared to low-schizotypy controls.

Method

This was a cross-sectional survey. The Schizotypal Personality Questionnaire, the Fear of COVID-19 Scale and The Brief-Coping Orientation to Problems Experienced were used.

Results

High-schizotypy students had significantly higher maladaptive strategies scores and higher levels of fear of COVID-19 as compared to low-schizotypy students. Multivariate analyses have shown that high-schizotypy individuals were likely to rely on coping responses that are maladaptive (venting) and have potential exacerbating effects on fear of COVID-19, whereas low-schizotypy individuals were likely to use adaptive responses (acceptance) that seemed to be effective in reducing fear of COVID-19.

Conclusion

This study provided preliminary cross-sectional evidence for a differential impact of COVID-19 on individuals according to their schizotypy features. However, larger longitudinal population-based studies are necessary to confirm our findings.

Social and physical anhedonia in relation to grandiose and vulnerable narcissism

BACKGROUND

Narcissism has two different dimensions which differ in terms of social functioning. Grandiose narcissism is associated with higher extraversion, while vulnerable narcissism is associated with greater introversion. Both forms of narcissism present numerous forms of social maladjustment. Anhedonia (social and physical) is associated with measures of social maladjustment and is one of the core symptoms of serious mental conditions. The aim of the current study was to investigate the relationship between social and physical anhedonia and the two forms of narcissism, grandiose and vulnerable.

PARTICIPANTS AND PROCEDURE

A sample of 339 young adults completed the Polish version of the Hypersensitive Narcissism Scale, the Narcissistic Personality Inventory, and two subscales of the Wisconsin Schizotypy Scales - Short Form: the Revised Social Anhedonia Scale and the Physical Anhedonia Scale.

RESULTS

We found a positive correlation between social anhedonia and vulnerable narcissism, and a negative correlation between social anhedonia and grandiose narcissism. Physical anhedonia was not related to any form of narcissism. Older people and men scored higher on the social anhedonia scale.

CONCLUSIONS

Vulnerable narcissistic personality is associated with social deficits, namely social anhedonia. Future research could investigate the relationship between vulnerable narcissism and schizotypy to establish whether vulnerable personality is a risk factor for developing serious mental illnesses.

Cognitive Failures and the Role of Emotion in Dimensional Schizotypy: A Replication and Extension

INTRODUCTION

Cognitive failures are commonplace within the general population but may be particularly heightened in those with higher levels of schizotypy. This is especially salient in the context of enduring trait and momentary state negative emotion which often contributes to increases in daily impairments, leading to a more debilitating and distracted life. Particularly, individuals with elevated levels of schizotypy may be more likely to experience cognitive failures, especially in the presence of negative trait emotion such as depression, anxiety, and stress. However, little is known about the influence of state emotion and the distinct roles that state and trait emotion may have with cognitive failures and schizotypy.

METHODS

To replicate and extend previous findings, 306 (58% males) undergraduate students aged 18-50 years (M = 19.343; SD = 2.493) completed self-report measures of cognitive failures, trait and state emotion, and schizotypy. Mediation and moderation analyses were performed in SPSS to examine the potential effects of trait and state emotion on the relationship between schizotypy and cognitive failures.

RESULTS

Consistent with previous findings, mood symptomology, in addition to negative affect, mediated cognitive failures in those with higher levels of schizotypy. However, in our sample, positive affect did not appear to buffer against cognitive failures.

CONCLUSION

The findings of the present study suggest there may be a nuanced relationship between both negative trait and state emotions on the relationships between cognitive failures and schizotypy. Understanding the interaction of enduring versus momentary emotion on cognition as they relate to an elevated risk for developing schizophrenia-spectrum phenomena may be a point for earlier and more targeted interventions.

Using questionnaires and task-related EEG signals to reveal hindered reappraisal and biased suppression in individuals with high schizotypal traits

Although impaired ability to regulate emotion is commonly reported in schizophrenic patients, the exact pattern of regulation of negative emotions in high-risk individuals remains unclear. In the current study, 26 high-schizotypy individuals paired with 26 controls completed an emotion regulation questionnaire (ERQ) and a laboratory emotion regulation task with electroencephalogram (EEG) recording. Two emotion regulation strategies, namely, reappraisal and expression suppression, were concurrently examined. The late positive potential (LPP) and frontal alpha asymmetry (FAA) were selected as two independent neural indicators of the emotion regulation effect. In the ERQ questionnaire, individuals in the high schizotypy group reported higher habitual use of suppression than the controls. During the emotion regulation task, the high  schizotypy group showed no early LPP reduction in reappraisal compared with the control group and exhibited a general negative FAA pattern (left-biased alpha). In conclusion, we found that individuals with high schizotypy exhibited maladaptive regulation of negative emotions, manifested in hindered reappraisal and biased suppression; this may exacerbate the negative affect of such emotions and further serve as a risk factor for psychosis conversion. Early interventions targeting the regulation of negative emotions may be beneficial for individuals with high schizotypal traits.

Checking the predictive accuracy of basic symptoms against ultra high-risk criteria and testing of a multivariable prediction model: Evidence from a prospective three-year observational study of persons at clinical high-risk for psychosis

Background:

The aim of this study was to critically examine the prognostic validity of various clinical high-risk (CHR) criteria alone and in combination with additional clinical characteristics.

Methods:

A total of 188 CHR positive persons from the region of Zurich, Switzerland (mean age 20.5 years; 60.2% male), meeting ultra high-risk (UHR) and/or basic symptoms (BS) criteria, were followed over three years. The test battery included the Structured Interview for Prodromal Syndromes (SIPS), verbal IQ and many other screening tools. Conversion to psychosis was defined according to ICD-10 criteria for schizophrenia (F20) or brief psychotic disorder (F23).

Results:

Altogether n = 24 persons developed manifest psychosis within three years and according to Kaplan–Meier survival analysis, the projected conversion rate was 17.5%. The predictive accuracy of UHR was statistically significant but poor (area under the curve [AUC] = 0.65, P < .05), whereas BS did not predict psychosis beyond mere chance (AUC = 0.52, P = .730). Sensitivity and specificity were 0.83 and 0.47 for UHR, and 0.96 and 0.09 for BS. UHR plus BS achieved an AUC = 0.66, with sensitivity and specificity of 0.75 and 0.56. In comparison, baseline antipsychotic medication yielded a predictive accuracy of AUC = 0.62 (sensitivity = 0.42; specificity = 0.82). A multivariable prediction model comprising continuous measures of positive symptoms and verbal IQ achieved a substantially improved prognostic accuracy (AUC = 0.85; sensitivity = 0.86; specificity = 0.85; positive predictive value = 0.54; negative predictive value = 0.97).

Conclusions:

We showed that BS have no predictive accuracy beyond chance, while UHR criteria poorly predict conversion to psychosis. Combining BS with UHR criteria did not improve the predictive accuracy of UHR alone. In contrast, dimensional measures of both positive symptoms and verbal IQ showed excellent prognostic validity. A critical re-thinking of binary at-risk criteria is necessary in order to improve the prognosis of psychotic disorders.

Implicit emotion regulation deficits in individuals with high schizotypal traits: an ERP study

Schizotypy is associated with poor emotion regulation that is thought to contribute to the development of psychotic symptoms and to indicate a predisposition to schizophrenia. Having focused primarily on the relationship between schizotypy and explicit emotion regulation, existing studies have, until now, neglected to acknowledge the potentially important role of implicit emotion regulation. Our aim in the current study was to investigate implicit emotion regulation deficits in schizotypy. To this end, we used a newly developed Priming-Identification (PI) ERP paradigm, consisting of a priming phase and an emotion identification phase, to test 30 individuals with schizotypy and 30 healthy controls while also acquiring EEG data. During the priming phase, we aimed to manipulate emotion regulation goals (i.e., to bring about an intended emotional state) by presenting a category of words related to emotion regulation alongside a category of control words. Associated brain responses occurring during the subsequent stage were indexed according to three ERP components: N170, early posterior negativity (EPN) and late positive potential (LPP). Results showed that, in the control group, priming words associated with emotion regulation led to enhancements in the early N170 amplitude and the middle EPN during expression identification. The same pattern was not observed in the schizotypy group. In summary, our results suggest the presence of deficits in the early and middle stages of the implicit emotion regulation process among individuals with high schizotypal traits.

Personality Traits and Disorders in Adolescents at Clinical High Risk for Psychosis: Toward a Clinically Meaningful Diagnosis

Aims: Recent meta-analytic data show that approximately 40% of individuals at clinical high risk for psychosis (CHR) receive at least one personality disorder (PD) diagnosis. Personality pathology could significantly influence CHR patients' prognosis and response to treatment. We aimed at exploring the PD traits of CHR adolescents, in order to outline a prototypic description of their most frequently observed personality characteristics. Methods: One hundred and twenty-three psychiatrists and psychologists used a Q-sort procedure [i.e., the Shedler-Westen Assessment Procedure-200 for Adolescents (SWAP-200-A)] to assess personality traits and disorders in 58 (30 male; mean age = 16 years, range = 13-19 years) CHR adolescents and two gender- and age-matched samples, respectively, with (n = 60) and without PDs (n = 59). Results: Differences between the CHR, PD, and clinical groups showed that CHR adolescents had pervasive and more clinically relevant schizoid, schizotypal, borderline, and avoidant traits, as well as poorer adaptive functioning. Moreover, by collecting the highest mean SWAP-200-A items, we empirically outlined a prototypic description of CHR youths, comprised of avoidance of social relationships; suspiciousness; obsessional thoughts; lack of psychological insight; dysphoric and overwhelming feelings of anxiety and depression; odd and anomalous reasoning processes or perceptual experiences; symptoms of depersonalization and derealization; and negative symptoms of avolition, abulia, blunted affects, and impaired role functioning. Conclusions: The results suggest that avoidant interpersonal strategies, impaired mentalization, and difficulties in emotional regulation could become important targets for psychosocial interventions with CHR adolescent populations.

The importance of loneliness in psychotic-like symptoms: Data from three studies

Poor social connection or loneliness is a prominent feature of schizotypy and may exacerbate psychosis risk. Previous studies have examined the inter-relationships between loneliness and psychosis risk, but critically, they have largely been conducted in non-clinical samples or exclusively used laboratory questionnaires with limited consideration of the heterogeneity within schizotypy (i.e., positive, negative, disorganized factors). The present study examined links between loneliness and psychotic-like symptoms across the dimensions of schizotypy through cross-sectional, laboratory-based questionnaires (Study 1; N = 160), ambulatory assessment (Study 2; N = 118) in undergraduates, and ambulatory assessment in inpatients in a substance abuse treatment program (Study 3; N = 48). Trait positive schizotypy consistently predicted cross-sectional and state psychotic-like symptoms. Loneliness, assessed via cross-sectional and ambulatory means, was largely linked with psychotic-like symptoms. Importantly, psychotic-like symptoms were dynamic: psychotic-like symptoms largely increased with loneliness in individuals with elevated positive and disorganized schizotypal traits, though there were some inconsistency related to disorganized schizotypy and state psychotic-like symptoms. Negative schizotypy and loneliness did not significantly interact to predict psychotic-like symptoms, suggesting specificity to positive schizotypy. Ambulatory approaches provide the opportunity for ecologically valid identification of risk states across psychopathology, thus informing early intervention.

Common Taxonomy of Traits and Symptoms: Linking Schizophrenia Symptoms, Schizotypy, and Normal Personality

The associations among normal personality and many mental disorders are well established, but it remains unclear whether and how symptoms of schizophrenia and schizotypal traits align with the personality taxonomy. This study examined the joint factor structure of normal personality, schizotypy, and schizophrenia symptoms in people with psychotic disorders (n = 288) and never-psychotic adults (n = 257) in the Suffolk County Mental Health Project. First, we evaluated the structure of schizotypal (positive schizotypy, negative schizotypy, and mistrust) and normal traits. In both the psychotic-disorder and never-psychotic groups, the best-fitting model had 5 factors: neuroticism, extraversion, conscientiousness, agreeableness, and psychoticism. The schizotypy traits were placed on different dimensions: negative schizotypy went on (low) extraversion, whereas positive schizotypy and mistrust went on psychoticism. Next, we added symptoms to the model. Numerous alternatives were compared, and the 5-factor model remained best-fitting. Reality distortion (hallucinations and delusions) and disorganization symptoms were placed on psychoticism, and negative symptoms were placed on extraversion. Models that separated symptom dimensions from trait dimensions did not fit well, arguing that taxonomies of symptoms and traits are aligned. This is the first study to show that symptoms of psychosis, schizotypy, and normal personality reflect the same underlying dimensions. Specifically, (low) extraversion, negative schizotypy, and negative symptoms form one spectrum, whereas psychoticism, positive schizotypy, and positive and disorganized symptoms form another. This framework helps to understand the heterogeneity of psychosis and comorbidity patterns found in psychotic disorders. It also underscores the importance of traits to understanding these disorders.

Psychosis risk is associated with decreased resting-state functional connectivity between the striatum and the default mode network

Psychosis is linked to aberrant salience or to viewing neutral stimuli as self-relevant, suggesting a possible impairment in self-relevance processing. Psychosis is also associated with increased dopamine in the dorsal striatum, especially the anterior caudate (Kegeles et al., 2010). Critically, the anterior caudate is especially connected to (a) the cortical default mode network (DMN), centrally involved in self-relevance processing, and (b) to a lesser extent, the cortical frontoparietal network (FPN; Choi, Yeo, & Buckner, 2012). However, no previous study has directly examined striatal-cortical DMN connectivity in psychosis risk. In Study 1, we examined resting-state functional connectivity in psychosis risk (n = 18) and control (n = 19) groups between (a) striatal DMN and FPN subregions and (b) cortical DMN and FPN. The psychosis risk group exhibited decreased connectivity between the striatal subregions and the cortical DMN. In contrast, the psychosis risk group exhibited intact connectivity between the striatal subregions and the cortical FPN. Additionally, recent distress was also associated with decreased striatal-cortical DMN connectivity. In Study 2, to determine whether the decreased striatal-cortical DMN connectivity was specific to psychosis risk or was related to recent distress more generally, we examined the relationship between connectivity and distress in individuals diagnosed with nonpsychotic emotional distress disorders (N = 25). In contrast to Study 1, here we found that distress was associated with evidence of increased striatal-cortical DMN connectivity. Overall, the present results suggest that decreased striatal-cortical DMN connectivity is associated with psychosis risk and could contribute to aberrant salience.

Differential emotional abnormalities among schizotypy clusters

Schizotypy, a multidimensional personality organization that reflects liability to develop schizophrenia-spectrum disorders, has been associated with a number of emotional abnormalities. Yet, the exact nature of any emotional abnormalities in schizotypy is relatively unclear. Using an ethnically diverse nonclinical sample (N = 2637), the present study identified homogenous clusters of individuals based on positive and negative schizotypy dimensions and explored three interrelated domains of emotion traits closely tied to functional outcomes and quality of life: affective experience, emotional awareness, and meta-level emotions. Consistent with prior research, four schizotypy clusters were obtained: low ("nonschizotypic"), high positive, high negative, and mixed (high positive and high negative). Regarding emotion correlates of schizotypy clusters, the mixed cluster was found to be the most deviant on almost all emotion traits (e.g., heightened trait negative affect, diminished emotional clarity), suggesting that the effects of positive and negative schizotypy are additive. In addition, positive and negative schizotypy clusters were associated with differential abnormalities, with the negative cluster presenting a wider range of, and more severe, impairments compared to the low cluster (e.g., reduced trait positive affect and reduced attention to positive emotion). The current study highlights the heterogeneity in emotional traits among schizotypy dimensions and the importance of studying the mixed schizotypy in terms of emotional dysfunction.

Centrality of Religiosity, Schizotypy, and Human Values: The Impact of Religious Affiliation

Previous research has established a reliable link between religiosity and schizotypy as well as schizophrenia. However, past research mainly measured religiosity as a one-dimensional construct. In the present research (N = 189), we aimed to get a better understanding of the religiosity–schizotypy link by measuring religiosity using Huber’s five-dimensional model of Centrality of Religiosity, while also testing for curvilinear relations and potential moderators. We found negative small-to-medium-sized correlations between all five dimensions of religiosity and the schizotypy dimension of impulsive nonconformity, but no reliable associations with the other three dimensions of schizotypy: unusual experiences, cognitive disorganization, and introverted anhedonia. Some of these associations were moderated by religious affiliation: Religiosity and schizotypy correlated positively among non-members, but negatively among members of religious communities, suggesting that affiliation has a positive impact on the well-being of religious people. In line with Huber’s predictions, we found a reversed U-shape association between the religious dimension of private religious practice and schizotypy. Unexpectedly, however, conformity and tradition values did not moderate the relations between religiosity and schizotypy. We discuss our findings in terms of person–environment fit, the prevention hypothesis of the schizotypy-religiosity link, and offer implications for mental health practitioners.

The subjective-objective deficit paradox in schizotypy extends to emotion regulation and awareness

There is an emerging subjective-objective deficit paradox in schizotypy. Individuals with schizotypy report severe subjective complaints in several key functional domains commensurate with that of individuals with schizophrenia. However, objective assessments of the same domains show relatively intact performance. We examined whether this subjective-objective deficit paradox extends to two closely linked affective processes: emotion regulation and awareness. Individuals with elevated social anhedonia (SocAnh; n = 61) and elevated perceptual aberration/magical ideation (PerMag; n = 73) were compared to control participants (n = 81) on subjective and objective measures of emotion regulation and awareness. Subjective measures included self-report questionnaires assessing regulatory ability, attention to emotion, and emotional clarity. Implicit emotion regulation was assessed by the Emotion Regulation-Implicit Association Test (ER-IAT) while objective emotional awareness was assessed by the Levels of Emotional Awareness Scale (LEAS), a performance-based test. Results showed that both SocAnh and PerMag groups reported notable deficits in almost all subjective measures relative to controls (composite ds > 0.55). In contrast, performance on ER-IAT and LEAS was very similar to controls (composite ds < 0.11). The current study suggests that the subjective-objective deficit paradox extends to emotion regulation and awareness, highlighting the importance of higher-order cognitive bias in understanding emotional abnormalities in schizotypy.

The interaction between positive schizotypy and high sensitivity C-reactive protein on response inhibition in female individuals

This study aimed to measure the associations between high sensitivity C-reactive protein (hsCRP), childhood maltreatment (CM), schizotypy and response inhibition, and to explore the interactions between hsCRP, CM and schizotypy on response inhibition. Two hundred and fourteen participants completed the Stop-Signal Task (SST), the Schizotypy Personality Questionnaire (SPQ) and the Childhood Trauma Questionnaire-Short Form (CTQ), which measured response inhibition, schizotypy and history of CM respectively. The level of hsCRP was also measured. The high schizotypy group (n = 114) had higher scores on SPQ and CTQ, higher hsCRP levels and longer SST reaction times (SSRTs) than the low schizotypy group (n = 100). In female participants, SSRT had a positive correlation with the SPQ positive factor and the disorganized SPQ factor and a positive correlation with physical neglect. HsCRP was positively correlated with the SPQ negative factor and positive SPQ factor. In male participants, SSRT was negatively correlated with emotional neglect and physical neglect. The majority of correlations between CTQ and SPQ variables were significant in both female and male participants. In female participants, hsCRP significantly predicted SSRT, and hsCRP significantly interacted with positive schizotypy in predicting SSRT.

Association of positive, negative, and disorganized schizotypy dimensions with affective symptoms and experiences

Schizotypy offers a useful construct for investigating the etiology, development, and expression of schizophrenia-spectrum psychopathology, as well as the comorbid expression of mood and anxiety disorders across the schizophrenia spectrum. The present study examined the associations of positive, negative, and disorganized schizotypy with affective symptoms and experiences in a sample of MTurk workers and college students (n = 575). Participants completed the Multidimensional Schizotypy Scale (MSS) and measures of depression, anxiety, social phobia, hypomanic traits, and state affect. As expected, positive schizotypy was significantly associated with hypomanic traits, whereas negative schizotypy was associated with reduced positive affect and reduced hypomanic traits. Although prior research has emphasized the association of positive schizotypy with depression and anxiety, the current results demonstrate that disorganized schizotypy is more strongly associated with elevated negative affect (over-and-above positive schizotypy). As such, these findings highlight the importance of examining disorganization of affect, in addition to the cognitive-behavioral deficits traditionally associated with disorganized schizotypy. Finally, the MSS and MSS-Brief demonstrated closely comparable findings. The present results provide further support for the construct validity of the MSS and the three-factor model of schizotypy.

Combining trait and state model systems of psychosis: The effect of sleep deprivation on cognitive functions in schizotypal individuals

Model systems of psychosis play an important role in pathophysiology and drug development research. Schizotypal individuals display similar cognitive impairments as schizophrenia patients in several domains. Therefore, schizotypy may be interpreted as a trait model system of psychosis. In addition, experimentally controlled sleep deprivation is a putative state psychosis model that evokes subclinical psychosis-like states. We aimed to further validate these model systems by examining them in relation to central cognitive biomarkers of schizophrenia. Most of all, we were interested in investigating, for the first time, effects of their combination on cognitive function. Healthy subjects with high (N = 17) or low (N = 19) levels of schizotypy performed a cognitive task battery after one night of normal sleep and after 24 h of sleep deprivation. Sleep deprivation impaired performance in the go/nogo and n-back tasks relative to the normal sleep control condition. No differences between groups or interactions of group with sleep condition were found. The role of sleep deprivation as a model of psychosis is thus supported to some extent by impairments in inhibitory control. However, classical measures of cognition may be less able to detect deficits in schizotypy, in line with evidence of more basic information processing dysfunctions in schizotypy.

Association of Schizotypy With Dimensions of Cognitive Control: A Meta-Analysis

Schizotypy is defined as a time-stable multidimensional personality trait consisting of positive, negative, and disorganized facets. Schizotypy is considered as a model system of psychosis, as there is considerable overlap between the 2 constructs. High schizotypy is associated with subtle but fairly widespread cognitive alterations, which include poorer performance in tasks measuring cognitive control. Similar but more pronounced impairments in cognitive control have been described extensively in psychosis. We here sought to provide a quantitative estimation of the effect size of impairments in schizotypy in the updating, shifting, and inhibition dimensions of cognitive control. We included studies of healthy adults from both general population and college samples, which used either categorical or correlative designs. Negative schizotypy was associated with significantly poorer performance on shifting (g = 0.32) and updating (g = 0.11). Positive schizotypy was associated with significantly poorer performance on shifting (g = 0.18). There were no significant associations between schizotypy and inhibition. The divergence in results for positive, negative, and disorganized schizotypy emphasizes the importance of examining relationships between cognition and the facets of schizotypy rather than using the overall score. Our findings also underline the importance of more detailed research to further understand and define this complex personality construct, which will also be of importance when applying schizotypy as a model system for psychosis.

Winter birth, urbanicity and immigrant status predict psychometric schizotypy dimensions in adolescents

BACKGROUND

Urbanicity, immigration and winter-birth are stable epidemiological risk factors for schizophrenia, but their relationship to schizotypy is unknown. This is a first examination of the association of these epidemiological risk factors with positive schizotypy, in nonclinical adolescents, controlling for a range of potential and known confounders.

METHODS

We collected socio-demographics, life-style, family and school circumstances, positive schizotypy dimensions and other personality traits from 445 high school pupils (192 males, 158 immigrants) from 9 municipalities in Athens and Heraklion, Greece, which covered a range of host population and migrant densities. Using multivariate hierarchical linear regressions models, we estimated the association of schizotypy dimensions with: (1) demographics of a priori interest (winter-birth, immigrant status, urban characteristics), including family financial and mental health status; (2) factors resulting from principal component analysis (PCA) of the demographic and personal data; (3) factors resulting from PCA of the personality questionnaires.

RESULTS

Adolescent women scored higher on schizotypy than men. High anxiety/neuroticism was the most consistent and significant predictor of all schizotypy dimensions in both sexes. In the fully adjusted models, urbanicity predicted magical thinking and unusual experiences in women, while winter-birth and immigration predicted paranoid ideation and unusual experiences respectively in men.

CONCLUSIONS

These results support the continuum hypothesis and offer potential insights in the nature of risk conferred by winter-birth, urbanicity and immigration and the nature of important sex differences. Controlling for a wide range of potential confounding factors increases the robustness of these results and confidence that these were not spurious associations.

Classifying Schizotypy Using an Audiovisual Emotion Perception Test and Scalp Electroencephalography

Schizotypy refers to the personality trait of experiencing "psychotic" symptoms and can be regarded as a predisposition of schizophrenia-spectrum psychopathology (Raine, 1991). Cumulative evidence has revealed that individuals with schizotypy, as well as schizophrenia patients, have emotional processing deficits. In the present study, we investigated multimodal emotion perception in schizotypy and implemented the machine learning technique to find out whether a schizotypy group (ST) is distinguishable from a control group (NC), using electroencephalogram (EEG) signals. Forty-five subjects (30 ST and 15 NC) were divided into two groups based on their scores on a Schizotypal Personality Questionnaire. All participants performed an audiovisual emotion perception test while EEG was recorded. After the preprocessing stage, the discriminatory features were extracted using a mean subsampling technique. For an accurate estimation of covariance matrices, the shrinkage linear discriminant algorithm was used. The classification attained over 98% accuracy and zero rate of false-positive results. This method may have important clinical implications in discriminating those among the general population who have a subtle risk for schizotypy, requiring intervention in advance.

Differential Item Functioning of the Full and Brief Wisconsin Schizotypy Scales in Asian, White, Hispanic, and Multiethnic Samples and Between Sexes

The Wisconsin Schizotypy Scales, including their brief versions, are among the most commonly used self-report measures of schizotypy. Although they have been used extensively in many ethnic groups, few studies have examined their differential item functioning (DIF) across groups. The current study included 1,056 Asian, 408 White, 476 Multiethnic, and 372 Hispanic undergraduates. Unidimensional models of the brief Magical Ideation Scale and Perceptual Aberration Scales fit the data well. For both scales, global tests of measurement invariance provided mixed evidence, but few of the items displayed DIF across ethnicities or between sexes within a multiple indicator multiple causes model. For the full versions of the scales and the brief Revised Social Anhedonia Scale, multiple indicator multiple causes models within an exploratory structural equation modeling framework found that few of the items had DIF. These findings suggest that some of the items may have different psychometric properties across groups, but most items do not.

Emotional word usage in groups at risk for schizophrenia-spectrum disorders: An objective investigation of attention to emotion

Both extreme levels of social anhedonia (SocAnh) and extreme levels of perceptual aberration/magical ideation (PerMag) indicate increased risk for schizophrenia-spectrum disorders and are associated with emotional deficits. For SocAnh, there is evidence of self-reported decreased trait positive affect and abnormalities in emotional attention. For PerMag, there is evidence of increased trait negative affect and increased attention to negative emotion. Yet, the nature of more objective emotional abnormalities in these groups is unclear. The goal of this study was to assess attention to emotions more objectively in a SocAnh, PerMag, and control group by using a positive (vs. neutral) mood induction procedure followed by a free writing period. Linguistic analyses revealed that the SocAnh group used fewer positive emotion words than the control group, with the PerMag group falling in between the others. In addition, both at-risk groups used more negative emotion words than the control group. Also, for the control group only, those in the positive mood induction used more positive emotion words, suggesting their emotions influenced their linguistic expression. Overall, SocAnh is associated with decreased positive emotional expression and at-risk groups are associated with increased negative emotional expression and a decreased influence of emotions on linguistic expression.

Neuropsychological correlates of schizotypy: a systematic review and meta-analysis of cross-sectional studies

INTRODUCTION

Cognitive deficits can precede the onset of psychotic episodes and predict the onset of the illness in individuals with schizotypy traits. In some studies, high levels of schizotypy were associated with impairments in memory, attention, executive functions, and verbal fluency. This review provides a more comprehensive understanding of cognitive impairments related to schizoytpy.

METHODS

 A systematic review of "schizotypy and neuropsychological measures" was conducted, and it retrieved 67 studies. All papers with case-control design showing means and standard deviations from neuropsychological measures were included in a meta-analysis (n = 40). A comparison between our finding and another metaanalysis with patients with schizophrenia-spectrum disorders [Fatouros-Bergman, H., Cervenka, S., Flyckt, L., Edman, G., & Farde, L. (2014). Meta-analysis of cognitive performance in drugnaive patients with schizophrenia. Schizophrenia Research. doi: 10.1016/j.schres.2014.06.034 ] was performed to study the similarities on the MATRICS domains between the two disorders.

RESULTS

We found evidence of worse functioning of verbal and visual-spatial working memory, and of language in people with schizotypy or with schizotypal traits. Working memory deficit is present in both schizotypy and schizophrenia with larger effect sizes compared to other domains.

CONCLUSIONS

 Working memory deficit might be a cognitive marker of the risk of psychosis. Interventions targeting cognitive deficits early may be crucial to the prevention of psychosis.

Emotion processing deficits in the different dimensions of psychometric schizotypy

Schizotypy refers to a personality structure indicating "proneness" to schizophrenia. Around 10% of the general population has increased schizotypal traits, they also share other core features with schizophrenia and are thus at heightened risk for developing schizophrenia and spectrum disorders. A key aspect in schizophrenia-spectrum pathology is the impairment observed in emotion-related processes. This review summarizes findings on impairments related to central aspects of emotional processes, such as emotional disposition, alexithymia, facial affect recognition and speech prosody, in high schizotypal individuals in the general population. Although the studies in the field are not numerous, the current findings indicate that all these aspects of emotional processing are deficient in psychometric schizotypy, in accordance to the schizophrenia-spectrum literature. A disturbed frontotemporal neural network seems to be the critical link between these impairments, schizotypy and schizophrenia. The limitations of the current studies and suggestions for future research are discussed.

Associations of differential schizotypal dimensions with executive working memory: A moderated-mediation analysis

BACKGROUND

Increased schizotypal traits are observed in a percentage of the general population and in the schizophrenia-spectrum and have been associated with impairments in working memory. In this study we examined the effects of four schizotypal dimensions [Negative (NegS), Paranoid (ParS), Cognitive-Perceptual (CPS), Disorganized (DiS)] on executive working memory (EWM), as mediated by set-shifting, planning and control inhibition. We also examined whether these associations are moderated by family-history of psychosis.

METHODS

Our sample consisted of 110 unaffected first-degree relatives of schizophrenia-spectrum patients and 120 control individuals. Schizotypy was assessed with the Schizotypal Personality Questionnaire. Participants were also tested with the Letter-Number Sequencing, Wisconsin Card Sorting, Stroop Color-Word and Stockings of Cambridge tasks. The effects of set-shifting, control inhibition and planning on the relationship between schizotypy and EWM were examined with mediation analyses. Moderated-mediation analyses examined potential moderating effects of group membership (unaffected relative/community participant).

RESULTS

All mediators were significant in the relationship between NegS and EWM. The effects of ParS were mediated only by set-shifting and planning. Planning and control inhibition were the only significant mediators on the effects of CPS and DiS on EWM, respectively. The moderated-mediation analyses revealed that these findings apply only in the community group.

CONCLUSIONS

We found that the effects of different schizotypal dimensions on EWM are mediated by other cognitive processes in individuals without personal/family history of psychosis. This is probably due to either more severe impairments in the cognitive processes of the relatives or restrictions in our sample and study-design.

Social Anhedonia Is Not Just Extreme Introversion: Empirical Evidence of Distinct Constructs

Social anhedonia and introversion, two closely related constructs associated with decreased positive emotions and decreased sociability, are common in schizophrenia-spectrum personality disorders. In light of a myriad of mixed findings regarding positive emotionality in anhedonia, there has been a call to reconceptualize "anhedonia." To clarify the nature of social anhedonia, we used confirmatory factor analysis to investigate the relationship between social anhedonia and introversion. Findings were consistent with the conceptualization of social anhedonia as a separate construct from introversion-the best fitting model was one in which social anhedonia and introversion measures loaded separately. Also consistent with the conceptualization of social anhedonia as separate, we found evidence that it was associated with aspects of alexithymia above and beyond any relationship with introversion. Overall, these results have implications for the understanding of social anhedonia and for the use of it as a discriminating factor between personality disorders characterized by introversion.

Individual differences in the executive control of attention, memory, and thought, and their associations with schizotypy

A large correlational study took a latent-variable approach to the generality of executive control by testing the individual-differences structure of executive-attention capabilities and assessing their prediction of schizotypy, a multidimensional construct (with negative, positive, disorganized, and paranoid factors) conveying risk for schizophrenia. Although schizophrenia is convincingly linked to executive deficits, the schizotypy literature is equivocal. Subjects completed tasks of working memory capacity (WMC), attention restraint (inhibiting prepotent responses), and attention constraint (focusing visual attention amid distractors), the latter 2 in an effort to fractionate the "inhibition" construct. We also assessed mind-wandering propensity (via in-task thought probes) and coefficient of variation in response times (RT CoV) from several tasks as more novel indices of executive attention. WMC, attention restraint, attention constraint, mind wandering, and RT CoV were correlated but separable constructs, indicating some distinctions among "attention control" abilities; WMC correlated more strongly with attentional restraint than constraint, and mind wandering correlated more strongly with attentional restraint, attentional constraint, and RT CoV than with WMC. Across structural models, no executive construct predicted negative schizotypy and only mind wandering and RT CoV consistently (but modestly) predicted positive, disorganized, and paranoid schizotypy; stalwart executive constructs in the schizophrenia literature-WMC and attention restraint-showed little to no predictive power, beyond restraint's prediction of paranoia. Either executive deficits are consequences rather than risk factors for schizophrenia, or executive failures barely precede or precipitate diagnosable schizophrenia symptoms. (PsycINFO Database Record

Evidence for the Discriminant Validity of the Revised Social Anhedonia Scale From Social Anxiety

Social anhedonia and social anxiety are two constructs with similar behaviors including avoidance of and withdrawal from social situations. In three studies, the current research aimed to test whether social anhedonia could be discriminated from social anxiety using the most common measure of social anhedonia, the Revised Social Anhedonia Scale (RSAS). In Study 1, an item-level factor analysis of the RSAS found two factors: Social Apathy/Aversion and Social Withdrawal. In Study 2, this two-factor structure was confirmed in a separate sample. In Study 3, a model with social anhedonia and anxiety scale scores loading on separate factors fit better than a model with social anhedonia and anxiety loading on a single factor. Social anhedonia and anxiety displayed differential associations with negative schizotypy and emotion processing. Findings suggest that the RSAS is successful in measuring social anhedonia distinct from social anxiety.

Disintegration as an Additional Trait in the Psychobiological Model of Personality

Abstract. This meta-analytic study investigates the relations between Disintegration-like phenomena (i.e., various aspects of symptomatology with the prefix “schizo-,” both at the clinical and the subclinical level) and the traits of the Psychobiological Model of Personality (PBMP). The empirically based benchmark for assuming the distinctness of the trait Disintegration was .30. The sample included 26 manuscripts with 30 studies and 424 effect sizes. By computing inverse sampling variance weighted mean correlation coefficients under a random-effects assumption, the following associations were found between Disintegration and Harm Avoidance, Novelty Seeking, Reward Dependence, Persistence, Self-Directedness, Cooperativeness, and Self-Transcendence: .23, .04, −.15, −.02, −.23, −.16, and .17, respectively. Two variables were found to moderate the Disintegration-Self-Transcendence correlation. Despite the theoretical expectation and some empirical evidence that Self-Transcendence (and other character traits) should capture variations in Disintegration-like phenomena, our results suggest that schizo-type phenomena are not adequately covered by the PBMP.

Negative symptoms in psychometrically defined schizotypy: The role of depressive symptoms

People high in schizotypy, a risk factor for schizophrenia-spectrum disorders, can have negative symptoms, including diminished experience of motivation/pleasure (MAP) and emotional expressivity (EXP). Additionally, people high in schizotypy often report elevated depressive symptoms, which are also associated with diminished MAP and EXP. In this study, we examined whether negative symptoms were related to schizotypy above and beyond the presence of depressive symptoms. Thirty-one people high in schizotypy and 24 people low in schizotypy were administered the Clinical Assessment Interview for Negative Symptoms (CAINS), an interview-based measure of MAP and EXP negative symptoms and completed a self-report measure of cognitive and somatic-affective depressive symptoms. People high in schizotypy had more MAP negative symptoms than people low in schizotypy, but we found no group differences in EXP negative symptoms. Importantly, the relationship between MAP negative symptoms and schizotypy was fully mediated by cognitive depressive symptoms. These findings suggest that depressive symptoms, specifically cognitive depressive symptoms, may be a pathway for motivation and pleasure impairment, in people at elevated risk for developing schizophrenia-spectrum disorders.