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Hachtel H, Deuring G, Graf M, Vogel T. Impact of psychosocial stress on facial emotion recognition in schizophrenia and controls: an experimental study in a forensic sample. Front Psychiatry 2024; 15:1358291. [PMID: 39081531 PMCID: PMC11287427 DOI: 10.3389/fpsyt.2024.1358291] [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: 12/19/2023] [Accepted: 06/03/2024] [Indexed: 08/02/2024] Open
Abstract
Introduction Psychotic disorders have been associated with dysregulated stress reactions and adaptation. Little is known about the neuroendocrine responses to psychosocial stress in justice-involved individuals with schizophrenia. Methods Using an experimental research design, the present study aims to examine differences in the subjective and neuroendocrine responses to psychosocial stress and its impact on facial emotion recognition (FER) and performance on an arithmetic task in chronically ill justice-involved individuals with schizophrenia (PAT) and a healthy control group. PAT undergoing treatment in forensic psychiatric inpatient wards (n = 17) and a healthy control group (n = 17) were assessed regarding sociodemographic and clinical characteristics. Additionally, salivary cortisol levels, measured before and after performing a psychosocial stress task [Montreal Imaging Stress Task (MIST)], and performance on an arithmetic problem-solving task and two FER tasks were recorded. Two participants dropped out, one from each group. Therefore, the final sample consisted of 32 individuals. Results Significant group differences in FER were recorded. There was a significant rise in subjective perception of momentary strain relating to the induction of psychosocial stress in both groups. Notably, the pre-stress level of subjective strain was higher in the PAT group than controls. Acute psychosocial stress induced an increase in FER performance in a sub-task related to naming emotions in individuals with schizophrenia spectrum disorder. Discussion The results underline the importance of psychosocial and therapeutic interventions aimed at strengthening stress resilience in individuals with schizophrenia spectrum disorders.
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Affiliation(s)
- Henning Hachtel
- Forensic Department, University Psychiatric Clinic Basel, Basel, Switzerland
- Medical Faculty, University of Basel, Basel, Switzerland
| | - Gunnar Deuring
- Forensic Department, University Psychiatric Clinic Basel, Basel, Switzerland
| | - Marc Graf
- Medical Faculty, University of Basel, Basel, Switzerland
| | - Tobias Vogel
- Medical Faculty, University of Basel, Basel, Switzerland
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Debs SR, Rothmond DA, Zhu Y, Weickert CS, Purves-Tyson TD. Molecular evidence of altered stress responsivity related to neuroinflammation in the schizophrenia midbrain. J Psychiatr Res 2024; 177:118-128. [PMID: 39004003 DOI: 10.1016/j.jpsychires.2024.07.004] [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: 12/04/2023] [Revised: 06/12/2024] [Accepted: 07/02/2024] [Indexed: 07/16/2024]
Abstract
Stress and inflammation are risk factors for schizophrenia. Chronic psychosocial stress is associated with subcortical hyperdopaminergia, a core feature of schizophrenia. Hyperdopaminergia arises from midbrain neurons, leading us to hypothesise that changes in stress response pathways may occur in this region. To identify whether transcriptional changes in glucocorticoid and mineralocorticoid receptors (NR3C1/GR, NR3C2/MR) or other stress signalling molecules (FKBP4, FKBP5) exist in schizophrenia midbrain, we measured gene expression in the human brain (N = 56) using qRT-PCR. We assessed whether alterations in these mRNAs were related to previously identified high/low inflammatory status. We investigated relationships between stress-related transcripts themselves, and between FKBP5 mRNA, dopaminergic, and glial cell transcripts in diagnostic and inflammatory subgroups. Though unchanged by diagnosis, GR mRNA levels were reduced in high inflammatory compared to low inflammatory schizophrenia cases (p = 0.026). We found no effect of diagnosis or inflammation on MR mRNA. FKBP4 mRNA was decreased and FKBP5 mRNA was increased in schizophrenia (p < 0.05). FKBP5 changes occurred in high inflammatory (p < 0.001), whereas FKBP4 changes occurred in low inflammatory schizophrenia cases (p < 0.05). The decrease in mRNA encoding the main stress receptor (GR), as well as increased transcript levels of the stress-responsive negative regulator (FKBP5), may combine to blunt the midbrain response to stress in schizophrenia when neuroinflammation is present. Negative correlations between FKBP5 mRNA and dopaminergic transcripts in the low inflammatory subgroup suggest higher levels of FKBP5 mRNA may also attenuate dopaminergic neurotransmission in schizophrenia even when inflammation is absent. We report alterations in GR-mediated stress signalling in the midbrain in schizophrenia.
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Affiliation(s)
- Sophie R Debs
- Preclinical Neuropsychiatry Laboratory, Neuroscience Research Australia, Randwick, New South Wales, 2031, Australia; Discipline of Psychiatry & Mental Health, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, 2052, Australia
| | - Debora A Rothmond
- Schizophrenia Research Laboratory, Neuroscience Research Australia, Randwick, New South Wales, 2031, Australia
| | - Yunting Zhu
- Department of Neuroscience & Physiology, Upstate Medical University, Syracuse, NY, 13210, USA
| | - Cynthia Shannon Weickert
- Schizophrenia Research Laboratory, Neuroscience Research Australia, Randwick, New South Wales, 2031, Australia; Discipline of Psychiatry & Mental Health, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, 2052, Australia; Department of Neuroscience & Physiology, Upstate Medical University, Syracuse, NY, 13210, USA
| | - Tertia D Purves-Tyson
- Preclinical Neuropsychiatry Laboratory, Neuroscience Research Australia, Randwick, New South Wales, 2031, Australia; Discipline of Psychiatry & Mental Health, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, 2052, Australia.
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Tarbox-Berry SI, Devoe DJA, Gupta R. Editorial: Advances in identifying individuals at clinical high risk (CHR) for psychosis: perspectives from North America. Front Psychiatry 2024; 14:1357838. [PMID: 38293589 PMCID: PMC10824947 DOI: 10.3389/fpsyt.2023.1357838] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2023] [Accepted: 12/27/2023] [Indexed: 02/01/2024] Open
Affiliation(s)
- Sarah I. Tarbox-Berry
- Department of Neurology, School of Medicine, Wayne State University, Detroit, MI, United States
- Department of Psychiatry, School of Medicine, Yale University, New Haven, CT, United States
| | - Daniel J. A. Devoe
- Department of Psychology, Mount Royal University, Calgary, AB, Canada
- Department of Psychiatry, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Rishab Gupta
- Department of Psychiatry, Harvard Medical School, Boston, MA, United States
- Department of Psychiatry, Brigham and Women's Faulkner Hospital and Harvard Medical School, Boston, MA, United States
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Tseng ST, Georgiades A. A phenomenological comparison of auditory hallucinations between borderline personality disorder and schizophrenia: A systematic review. Clin Psychol Psychother 2024; 31:e2958. [PMID: 38358078 DOI: 10.1002/cpp.2958] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Revised: 01/19/2024] [Accepted: 01/22/2024] [Indexed: 02/16/2024]
Abstract
OBJECTIVE Borderline personality disorder (BPD) with auditory hallucinations (AHs) may inadvertently be misdiagnosed with a primary psychotic disorder, such as schizophrenia (SZ). This misidentification can lead to challenges in providing effective psychological treatment. This review therefore aims to identify the phenomenological characteristics of AHs in BPD in comparison to SZ, as well as psychological interventions that explicitly target AHs in BPD. METHODS A systematic review was conducted to summarise the existing evidence base regarding the phenomenological similarities and differences of AHs in BPD and SZ, along with the identification of psychological interventions for AHs in BPD. RESULTS Eighteen studies were eligible for inclusion. Compared to the SZ group, BPD clients were characterised by more persistent and repetitive AHs, significantly more voice-related distress and appraisals of omnipotence, and an earlier age of onset of AHs. The BPD group also reported more severe depression and anxiety, a higher incidence of childhood trauma, and more negative self-schema. Cognitive Behaviour Therapy Coping Strategy Enhancement (CBT-CSE) might be a promising intervention to reduce AH-related distress in BPD, although further studies are required to determine its effectiveness. CONCLUSION In order to prevent misdiagnosis of AHs in BPD, the DSM-5 may need to acknowledge the broader and more frequent occurrence of psychosis symptoms in BPD clients. Such clarification may enhance diagnostic practices and facilitate more timely access to treatment. There is also a need to develop and trial psychological interventions that explicitly target AHs in BPD.
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Affiliation(s)
- Shih-Ting Tseng
- Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience (IoPPN), King's College London, London, UK
- Brent Early Intervention Service, CNWL, NHS Foundation Trust, London, UK
| | - Anna Georgiades
- Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience (IoPPN), King's College London, London, UK
- Brent Early Intervention Service, CNWL, NHS Foundation Trust, London, UK
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Long J, Hull R. Conceptualizing a less paranoid schizophrenia. Philos Ethics Humanit Med 2023; 18:14. [PMID: 37936219 PMCID: PMC10631169 DOI: 10.1186/s13010-023-00142-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 10/11/2023] [Indexed: 11/09/2023] Open
Abstract
Schizophrenia stands as one of the most studied and storied disorders in the history of clinical psychology; however, it remains a nexus of conflicting and competing conceptualizations. Patients endure great stigma, poor treatment outcomes, and condemnatory prognosis. Current conceptualizations suffer from unstable categorical borders, heterogeneity in presentation, outcome and etiology, and holes in etiological models. Taken in aggregate, research and clinical experience indicate that the class of psychopathologies oriented toward schizophrenia are best understood as spectra of phenomenological, cognitive, and behavioral modalities. These apparently taxonomic expressions are rooted in normal human personality traits as described in both psychodynamic and Five Factor personality models, and more accurately represent explicable distress reactions to biopsychosocial stress and trauma. Current categorical approaches are internally hampered by axiomatic bias and systemic inertia rooted in the foundational history of psychological inquiry; however, when such axioms are schematically decentralized, convergent cross-disciplinary evidence outlines a more robust explanatory construct. By reconceptualizing these disorders under a dimensional and cybernetic model, the aforementioned issues of instability and inaccuracy may be resolved, while simultaneously opening avenues for both early detection and intervention, as well as for more targeted and effective treatment approaches.
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Affiliation(s)
- James Long
- Department of Psychology, Chestnut Hill College, 7113 Valley Avenue, Philadelphia, PA, 19128, USA.
| | - Rachel Hull
- Chestnut Hill College Department of Professional Psychology, 9601 Germantown Avenue, Philadelphia, PA, 19118, USA
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Liu X, Zhang H, Yu X. Effects of Workplace Ostracism on Pro-Job Unethical Behavior: The Role of Moral Disengagement, Interpersonal Sensitivity and Self-Serving Political Will. Psychol Rep 2023:332941231207775. [PMID: 37913779 DOI: 10.1177/00332941231207775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2023]
Abstract
Drawing on social cognition theory, this study aims to investigate the impact of workplace ostracism on pro-job unethical behavior by studying the mediating function of moral disengagement and the moderating function of interpersonal sensitivity and self-serving political will. Data were congregated from 527 Chinese employees. A positive effect of workplace ostracism on pro-job unethical behavior was found, which was partially mediated by moral disengagement. In addition, interpersonal sensitivity strengthened the connection between workplace ostracism and moral disengagement, and self-serving political will strengthened the connection between moral disengagement and pro-job unethical behavior. Both theoretical and practical value are discussed in the study.
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Affiliation(s)
- Xin Liu
- Business School, Sichuan University, Chengdu, China
| | - Hantai Zhang
- Business School, Sichuan University, Chengdu, China
| | - Xuan Yu
- School of Economics and Management, Southwest Petroleum University, Chengdu, China
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