Attributional style and depression in schizophrenia

Exploring the relationship between attributional style measured in virtual reality and bullying among children at familial high risk of schizophrenia or bipolar disorder compared with controls

BACKGROUND

Children of parents with severe mental illness report bullying more often compared with controls. We hypothesized that deviations in attributional styles may explain the increased prevalence of bullying experiences. We aimed to assess real-time responses to standardized ambiguous social situations, bullying experiences by children, their primary caregivers, and teachers, and to investigate potential associations between attributional styles and bullying.

METHOD

The study included 465 children aged 11-12, born to parents with schizophrenia, N =179, bipolar disorder, N = 105, or population-based controls, N = 181. Attributional style was evaluated using virtual reality environments depicting ambiguous social everyday situations. We created a tailored assessment since no suitable assessments were found. Bullying was assessed through self-reports and reports from primary caregivers and teachers.

RESULTS

We observed no group differences in the attributional style of the children. Reports from children, primary caregivers, and teachers revealed that compared with controls, children born to parents with schizophrenia were more likely to perceive bullying victimization, with high consistency among reports. No associations were found between bullying reports and attributional style.

CONCLUSIONS

Children of parents with schizophrenia consistently experienced more bullying, as reported by the children themselves, primary caregivers, and teachers. No differences in attributional style were found, indicating that attributional style did not explain the increased prevalence of bullying reports. While it cannot be ruled out that our virtual environments were insufficient to trigger a sense of social exclusion, the results suggest that the observed differences in reported bullying are genuine and not a result of the child's attributional style.

Galvanic Skin Response Features in Psychiatry and Mental Disorders: A Narrative Review

This narrative review is aimed at presenting the galvanic skin response (GSR) Biofeedback method and possibilities for its application in persons with mental disorders as a modern form of neurorehabilitation. In the treatment of mental disorders of various backgrounds and courses, attention is focused on methods that would combine pharmacological treatment with therapies improving functioning. Currently, the focus is on neuronal mechanisms which, being physiological markers, offer opportunities for correction of existing deficits. One such indicator is electrodermal activity (EDA), providing information about emotions, cognitive processes, and behavior, and thus, about the function of various brain regions. Measurement of the galvanic skin response (GSR), both skin conductance level (SCL) and skin conductance responses (SCR), is used in diagnostics and treatment of mental disorders, and the training method itself, based on GSR Biofeedback, allows for modulation of the emotional state depending on needs occurring. Summary: It is relatively probable that neurorehabilitation based on GSR-BF is a method worth noticing, which-in the future-can represent an interesting area of rehabilitation supplementing a comprehensive treatment for people with mental disorders.

Initial Results of Tests Using GSR Biofeedback as a New Neurorehabilitation Technology Complementing Pharmacological Treatment of Patients with Schizophrenia

Galvanic skin response (GSR) Biofeedback uses training to reduce tension and anxiety and improve concentration and self-regulation. The study was aimed to evaluate this method as a form of rehabilitation and quantify the outcomes achieved by patients undergoing training using this technique. Six schizophrenic patients were enrolled in the study and underwent training based on the relaxation training module (CENTER), concentration training module (BALANCE), and self-regulation training module (INSECTS). Training sessions were held twice a week for 6 weeks. From the total group of subjects involved in the study, two patients had a statistically significant increase in measured values after the CENTER exercise, indicating that relaxation was achieved. Four patients showed a statistically significant decrease in measured values after the BALANCE exercise, which was reflective of an improvement in concentration. Three patients had a statistically significant decrease in measured values after the INSECTS exercise, which indicated an improvement in self-regulation. GSR Biofeedback may be used to complement the pharmacological treatment of patients diagnosed with schizophrenia.

Attributional style of Egyptians with schizophrenia

The attributional style is one domain of social cognition that involves perceiving, interpreting, and generating responses to others' intentions and behaviours in different situations. This study describes the attributional style of Egyptians with schizophrenia. The study took place in a psychiatric hospital in Egypt. Eight psychiatric wards were randomly selected, and all participants (150) with a diagnosis of schizophrenia participated. Data were collected using the Ambiguous Intention Hostility Questionnaire (AIHQ), the attributional style interview schedule, and the sociodemographic/clinical data sheet. Participants' scores on the AIHQ varied significantly between different situations (intentional, accidental, and ambiguous). The attributional style of the studied participants regarding their perceived psychosocial problems tended to be related to specific causes. These causes were mostly externally attributed to other people and to circumstances, and were perceived not to persist in the future. It would seem that Egyptians with schizophrenia tend to blame other people for negative events if these events are perceived to cause intentional harm.

Attributional style, symptomatology and awareness of illness in schizophrenia

The objective was to evaluate the relationship among symptomatology, awareness of illness, and attributional style in patients with schizophrenia. Fifty-six patients who were receiving outpatient psychiatric care gave their consent to fill out questionnaires designed to assess symptomatology, awareness of illness, and self-serving bias (SSB), which is a tendency to excessively attribute positive events to internal causes. Questionnaires were successfully completed by 44 patients (31 males and 13 females between the ages of 18 and 62). The following measures were used: Positive and Negative Symptoms Scale (PANSS), Scale to assess Unawareness of Mental Disorders (SUMD), and Attributional Style Questionnaire (ASQ). The results showed that emotional discomfort, which is directly related to the depressive syndrome, and the cognitive syndrome were significantly associated with a reversed SSB (tendency to excessively attribute positive events to external causes and negative events to internal causes). Emotional discomfort accounted for 23.5% of the variance in reversed SSB and the cognitive syndrome for 9.7% of the variance in reversed SSB. No relationship was found to exist between unawareness of illness and SSB. These findings reveal that in patients with schizophrenia, reversed SSB is closely related to the presence of depressive symptoms.

Differential diagnosis of depressed mood in patients with schizophrenia: a diagnostic algorithm based on a review

OBJECTIVE

To review the available literature on depressive symptomatology in schizophrenia in order to establish a diagnostic algorithm of depressive syndromes in schizophrenia.

METHOD

A literature search was performed using PubMed and Medline. Additional information was gained by cross-referencing from papers found in the database. Data from controlled studies as well as supplementary information from review articles and psychiatric manuals pertinent to the topic were used. Depressive symptoms were classified with respect to their temporal relationship to acute psychotic symptoms before the background of nosological entities as operationalized by Diagnostic Statistical Manual IV (DSM IV).

RESULTS

Depression is a common and devastating comorbid syndrome in patients suffering from schizophrenic disorder. The paper summarizes the relevant diagnostic steps to guide the clinician towards therapeutic interventions, which differ depending on the nature of the depressive syndrome.

CONCLUSION

Differentiating depressives states in schizophrenia has consequences in terms of choosing therapeutic strategies. An algorithm which leads the practitioner to a reliable diagnosis and in consequence to a valid therapy is presented.