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Frattaroli N, Geljic M, Runkowska D, Darke H, Reddyhough C, Mills T, Mitchell M, Hill R, Carter O, Sundram S. Cognitive and perceptual impairments in schizophrenia extend to other psychotic disorders but not schizotypy. Schizophr Res Cogn 2022; 30:100266. [PMID: 35959485 PMCID: PMC9361330 DOI: 10.1016/j.scog.2022.100266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 07/22/2022] [Accepted: 07/25/2022] [Indexed: 11/16/2022] Open
Affiliation(s)
- Natalie Frattaroli
- Department of Psychiatry, School of Clinical Sciences, Monash University. Level 3 P-Block, Monash Medical Centre, 246 Clayton Road, Clayton, Victoria 3168, Australia
| | - Mia Geljic
- Department of Psychiatry, School of Clinical Sciences, Monash University. Level 3 P-Block, Monash Medical Centre, 246 Clayton Road, Clayton, Victoria 3168, Australia
| | - Dominika Runkowska
- Department of Psychiatry, School of Clinical Sciences, Monash University. Level 3 P-Block, Monash Medical Centre, 246 Clayton Road, Clayton, Victoria 3168, Australia
| | - Hayley Darke
- Department of Psychiatry, School of Clinical Sciences, Monash University. Level 3 P-Block, Monash Medical Centre, 246 Clayton Road, Clayton, Victoria 3168, Australia
| | - Caitlin Reddyhough
- Melbourne School of Psychological Sciences, Redmond Barry Building, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, VIC 3010, Australia
| | - Taylor Mills
- Department of Psychiatry, School of Clinical Sciences, Monash University. Level 3 P-Block, Monash Medical Centre, 246 Clayton Road, Clayton, Victoria 3168, Australia
- Melbourne School of Psychological Sciences, Redmond Barry Building, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, VIC 3010, Australia
| | - Matthew Mitchell
- Melbourne School of Psychological Sciences, Redmond Barry Building, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, VIC 3010, Australia
| | - Rachel Hill
- Department of Psychiatry, School of Clinical Sciences, Monash University. Level 3 P-Block, Monash Medical Centre, 246 Clayton Road, Clayton, Victoria 3168, Australia
| | - Olivia Carter
- Melbourne School of Psychological Sciences, Redmond Barry Building, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, VIC 3010, Australia
| | - Suresh Sundram
- Department of Psychiatry, School of Clinical Sciences, Monash University. Level 3 P-Block, Monash Medical Centre, 246 Clayton Road, Clayton, Victoria 3168, Australia
- Mental Health Program, Monash Health, Level 3 P-Block, Monash Medical Centre, 246 Clayton Road, Clayton, Victoria 3168, Australia
- Corresponding author at: Department of Psychiatry, School of Clinical Sciences, Monash University, Level 3 P-Block, Monash Medical Centre, 246 Clayton Road, Clayton, Victoria, Australia.
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Tan EJ, Toh WL, Rossell SL. Examining relationships between state and trait psychotic symptoms and quality of life in schizophrenia spectrum disorders. Psychiatry Res 2022; 310:114450. [PMID: 35183988 DOI: 10.1016/j.psychres.2022.114450] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 02/09/2022] [Accepted: 02/13/2022] [Indexed: 11/30/2022]
Abstract
Positive and negative symptoms are core aspects of schizophrenia and have been shown to influence patient quality of life (QOL). Previous studies have largely focused on current or state symptoms, with limited work on the contributions of trait symptoms to QOL. This study sought to examine the relationship between both state and trait symptoms and objective and subjective QOL. Fifty-three schizophrenia spectrum disorder patients and 47 healthy controls were recruited. State symptomatology was assessed using the Positive and Negative Syndrome Scale in the patients only. In all participants, trait symptoms were assessed using the Oxford-Liverpool Inventory of Feelings and Experiences, and QOL using Lehman's QOL Interview. Hierarchical linear regression analyses, controlling for depression and neurocognition, revealed that negative state symptoms were related to objective QOL within the patients, while negative trait symptoms were associated with both objective and subjective QOL in patients and healthy controls. No relationships were observed with positive state or trait symptoms and either QOL measure. The findings suggest a degree of complexity in the associations between symptoms and QOL, with primacy for negative symptoms at both state and trait levels. A greater appreciation of trait symptoms may help explain non-complementary QOL changes following symptom remission.
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Affiliation(s)
- Eric Josiah Tan
- Centre for Mental Health, Swinburne University of Technology, Hawthorn, Australia; Department of Psychiatry, St Vincent's Hospital, Melbourne, Australia.
| | - Wei Lin Toh
- Centre for Mental Health, Swinburne University of Technology, Hawthorn, Australia
| | - Susan Lee Rossell
- Centre for Mental Health, Swinburne University of Technology, Hawthorn, Australia; Department of Psychiatry, St Vincent's Hospital, Melbourne, Australia
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Abstract
Introduction: Deficits in social competence have been identified in schizotypy; however, most studies rely on self-reports of these skills. Deficits in introspective accuracy (IA) have been identified within schizophrenia, and recent work suggests IA is impaired in schizotypy as well. Thus, the perception of poorer social competence among individuals high in schizotypy may be due to inaccurate self-assessments rather than actual skill deficits.Method: This study examined the relationship between schizotypy, perceived social competence, and observed social competence in 137 undergraduate students.Results: Differences in self-reported social competence were found such that individuals high in schizotypy reported greater deficits than individuals low in schizotypy. However, the groups performed comparably on an objective assessment of social competence. Within groups, individuals high in schizotypy underestimated their social competence, whereas controls overestimated their social competence. Thus, both groups demonstrated impairments in IA.Conclusions: These findings demonstrate that individuals high in schizotypal traits perceive that they have poor social competence despite displaying skills that are on par with their peers. Such perceptions may lead to avoidance of social interactions or employment opportunities and could contribute to deficits in social functioning.
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Affiliation(s)
- Cassi R Springfield
- School of Behavioral and Brain Sciences, The University of Texas at Dallas, Richardson, TX, USA
| | - Amy E Pinkham
- School of Behavioral and Brain Sciences, The University of Texas at Dallas, Richardson, TX, USA.,Department of Psychiatry, University of Texas Southwestern Medical School, Dallas, TX, USA
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Beck AT, Himelstein R, Bredemeier K, Silverstein SM, Grant P. What accounts for poor functioning in people with schizophrenia: a re-evaluation of the contributions of neurocognitive v. attitudinal and motivational factors. Psychol Med 2018; 48:2776-2785. [PMID: 29501072 DOI: 10.1017/s0033291718000442] [Citation(s) in RCA: 37] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Neurocognitive deficits are often seen as core features of schizophrenia, and as primary determinants of poor functioning. Yet, our clinical observations suggest that individuals who score within the impaired range on standardized tests can reliably perform better in complex real-world situations, especially when performance is embedded within a positive socio-affective context. METHODS We analyzed literature on the influence of non-neurocognitive factors on test performance in order to clarify their contributions. RESULTS We identified seven non-neurocognitive factors that significantly contribute to neurocognitive test performance: avolition, dysfunctional attitudes, effort, stress, negative emotions, asociality, and disorganized symptoms. We then proposed an alternative model based on dysfunctional (e.g. defeatist) attitudes and their consequences for motivation and sustained task engagement. We demonstrated that these factors account for substantial variance in negative symptoms, neurocognitive test performance, and functional outcomes. We then demonstrated that recovery-oriented cognitive therapy - which is derived from this alternative model and primarily targets dysfunctional beliefs - has been successful in the treatment of low functioning individuals with schizophrenia. CONCLUSION The contributions of neurocognitive impairments to poor real-world functioning in people with schizophrenia may be overstated in the literature, and may even be limited relative to non-neurocognitive factors. We offer suggestions for further research to more precisely quantify the contributions of attitudinal/motivation v. neurocognitive factors in schizophrenia.
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Affiliation(s)
- Aaron T Beck
- Department of Psychiatry,University of Pennsylvania,Philadelphia,Pennsylvania,USA
| | - Robyn Himelstein
- Department of Psychiatry,University of Pennsylvania,Philadelphia,Pennsylvania,USA
| | - Keith Bredemeier
- Center for Assessment Research and Translation,University of Delaware,Newark,Delaware,USA
| | - Steven M Silverstein
- Department of Psychiatry,Rutgers - Robert Wood Johnson Medical School,Piscataway Township,New Jersey,USA
| | - Paul Grant
- Department of Psychiatry,University of Pennsylvania,Philadelphia,Pennsylvania,USA
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Steffens M, Meyhöfer I, Fassbender K, Ettinger U, Kambeitz J. Association of Schizotypy With Dimensions of Cognitive Control: A Meta-Analysis. Schizophr Bull 2018; 44:S512-S524. [PMID: 29554369 PMCID: PMC6188506 DOI: 10.1093/schbul/sby030] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
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.
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Affiliation(s)
- Maria Steffens
- Department of Psychology, University of Bonn, Kaiser-Karl-Ring, Bonn, Germany
| | - Inga Meyhöfer
- Department of Psychology, University of Bonn, Kaiser-Karl-Ring, Bonn, Germany
| | - Kaja Fassbender
- Department of Psychology, University of Bonn, Kaiser-Karl-Ring, Bonn, Germany
| | - Ulrich Ettinger
- Department of Psychology, University of Bonn, Kaiser-Karl-Ring, Bonn, Germany,To whom correspondence should be addressed; tel: +49-228-734208, e-mail:
| | - Joseph Kambeitz
- Department of Psychiatry and Psychotherapy, University of Munich, Munich, Germany
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Corcoran AW, Groot C, Bruno A, Johnston A, Cropper SJ. Individual differences in first- and second-order temporal judgment. PLoS One 2018; 13:e0191422. [PMID: 29401520 PMCID: PMC5798768 DOI: 10.1371/journal.pone.0191422] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Accepted: 01/04/2018] [Indexed: 11/19/2022] Open
Abstract
The ability of subjects to identify and reproduce brief temporal intervals is influenced by many factors whether they be stimulus-based, task-based or subject-based. The current study examines the role individual differences play in subsecond and suprasecond timing judgments, using the schizoptypy personality scale as a test-case approach for quantifying a broad range of individual differences. In two experiments, 129 (Experiment 1) and 141 (Experiment 2) subjects completed the O-LIFE personality questionnaire prior to performing a modified temporal-bisection task. In the bisection task, subjects responded to two identical instantiations of a luminance grating presented in a 4deg window, 4deg above fixation for 1.5 s (Experiment 1) or 3 s (Experiment 2). Subjects initiated presentation with a button-press, and released the button when they considered the stimulus to be half-way through (750/1500 ms). Subjects were then asked to indicate their 'most accurate estimate' of the two intervals. In this way we measure both performance on the task (a first-order measure) and the subjects' knowledge of their performance (a second-order measure). In Experiment 1 the effect of grating-drift and feedback on performance was also examined. Experiment 2 focused on the static/no-feedback condition. For the group data, Experiment 1 showed a significant effect of presentation order in the baseline condition (no feedback), which disappeared when feedback was provided. Moving the stimulus had no effect on perceived duration. Experiment 2 showed no effect of stimulus presentation order. This elimination of the subsecond order-effect was at the expense of accuracy, as the mid-point of the suprasecond interval was generally underestimated. Response precision increased as a proportion of total duration, reducing the variance below that predicted by Weber's law. This result is consistent with a breakdown of the scalar properties of time perception in the early suprasecond range. All subjects showed good insight into their own performance, though that insight did not necessarily correlate with the veridical bisection point. In terms of personality, we found evidence of significant differences in performance along the Unusual Experiences subscale, of most theoretical interest here, in the subsecond condition only. There was also significant correlation with Impulsive Nonconformity and Cognitive Disorganisation in the sub- and suprasecond conditions, respectively. Overall, these data support a partial dissociation of timing mechanisms at very short and slightly longer intervals. Further, these results suggest that perception is not the only critical mitigator of confidence in temporal experience, since individuals can effectively compensate for differences in perception at the level of metacognition in early suprasecond time. Though there are individual differences in performance, these are perhaps less than expected from previous reports and indicate an effective timing mechanism dealing with brief durations independent of the influence of significant personality trait differences.
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Affiliation(s)
- Andrew W. Corcoran
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, Australia
- School of Philosophical, Historical and International Studies, Monash University, Melbourne, Victoria, Australia
| | - Christopher Groot
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, Australia
| | - Aurelio Bruno
- Department of Experimental Psychology, University College London, London, United Kingdom
| | - Alan Johnston
- School of Psychology, University of Nottingham, Nottingham, United Kingdom
| | - Simon J. Cropper
- Melbourne School of Psychological Sciences, University of Melbourne, Melbourne, Victoria, Australia
- * E-mail:
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Giakoumaki SG. Emotion processing deficits in the different dimensions of psychometric schizotypy. Scand J Psychol 2017; 57:256-70. [PMID: 27119257 DOI: 10.1111/sjop.12287] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2015] [Accepted: 03/04/2016] [Indexed: 01/07/2023]
Abstract
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.
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