1
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Strauss GP. Environmental factors contributing to negative symptoms in youth at clinical high risk for psychosis and outpatients with schizophrenia. Soc Psychiatry Psychiatr Epidemiol 2024; 59:1167-1175. [PMID: 37624464 DOI: 10.1007/s00127-023-02556-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2023] [Accepted: 08/18/2023] [Indexed: 08/26/2023]
Abstract
BACKGROUND A bioecosystem theory was recently proposed positing that negative symptoms of schizophrenia (SZ) are influenced by environmental factors. These environmental processes reflect sources of resource deprivation that manifest across multiple systems that impact individuals directly through microsystems and indirectly through the exosystem and macrosystem. As an initial test of this theory, the current study examined whether self-reported environmental resource deprivation was associated with anhedonia, avolition, and asociality. METHOD Two samples were collected: (1) outpatients with schizophrenia or schizoaffective disorder (SZ: n = 38) and matched psychiatrically heathy controls (CN: n = 31); (2) youth at clinical high risk for psychosis (CHR: n = 34) and matched CN (n = 30). Measures of negative symptoms and environmental factors influencing the frequency of recreational, goal-directed, and social activities were collected. RESULTS Negative symptoms were associated with environmental deprivation factors in the microsystem (number of social and activity settings) and exosystem (economy, mass media, politics/laws, neighborhood crime). These associations did not appear due to depression and were greater among those with SZ than CHR. CONCLUSIONS These findings provide preliminary support for the bioecosystem theory and highlight an under-recognized role for environmental factors underlying negative symptoms across phases of psychotic illness. Environmental systems-focused treatment approaches may offer a novel means of treating negative symptoms, which could be promising when coupled with person-level pharmacological and psychosocial treatments.
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Affiliation(s)
- Gregory P Strauss
- Department of Psychology, University of Georgia, 125 Baldwin St., Athens, GA, 30602, USA.
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2
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Monette MA, Russell MT, Abel DB, Lewis JT, Mickens JL, Myers EJ, Hricovec MM, Cicero DC, Wolny J, Hetrick WP, Masucci MD, Cohen AS, Burgin CJ, Kwapil TR, Minor KS. Differential Risk: Gender and Racial Differences in the Relationship between Trauma, Discrimination, and Schizotypy. Behav Sci (Basel) 2024; 14:363. [PMID: 38785854 PMCID: PMC11117737 DOI: 10.3390/bs14050363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2024] [Revised: 04/15/2024] [Accepted: 04/23/2024] [Indexed: 05/25/2024] Open
Abstract
Traumatic experiences are associated with increased experiences of positive schizotypy. This may be especially important for People of Color, who experience higher rates of trauma and racial discrimination. No study to date has examined how racial disparities in traumatic experiences may impact schizotypy. Furthermore, of the studies that have examined the relationship between trauma and schizotypy, none have examined racial discrimination as a potential moderator. The present study examined if racial discrimination moderates the relationship between trauma and multidimensional (positive, negative, and disorganized) schizotypy. In a sample of 770 college students, we conducted chi-squared analyses, analyses of variance, and stepwise regressions. We found that Black students experienced significantly higher racial discrimination and trauma than Latinx and Asian students. Furthermore, Black and Latinx students experienced significantly more multidimensional schizotypy items than Asian students. Trauma and racial discrimination explained 8 to 23% of the variance in each dimension of schizotypy. Racial discrimination did not moderate the relationships between trauma and multidimensional schizotypy. Our findings suggest that we need to examine risk factors that may prevent recovery from psychotic disorders. Additionally, disorganized schizotypy showed the most robust associations and may be a critical site of intervention.
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Affiliation(s)
- Mahogany A. Monette
- Department of Psychology, Indiana University Indianapolis, Indianapolis, IN 46202, USA; (M.T.R.); (J.L.M.); (E.J.M.); (K.S.M.)
| | - Madisen T. Russell
- Department of Psychology, Indiana University Indianapolis, Indianapolis, IN 46202, USA; (M.T.R.); (J.L.M.); (E.J.M.); (K.S.M.)
| | - Danielle B. Abel
- Department of Psychology, Indiana University Indianapolis, Indianapolis, IN 46202, USA; (M.T.R.); (J.L.M.); (E.J.M.); (K.S.M.)
| | - Jarrett T. Lewis
- Department of Educational Psychology, University of Illinois Urbana-Champaign, Champaign, IL 61820, USA;
| | - Jessica L. Mickens
- Department of Psychology, Indiana University Indianapolis, Indianapolis, IN 46202, USA; (M.T.R.); (J.L.M.); (E.J.M.); (K.S.M.)
| | - Evan J. Myers
- Department of Psychology, Indiana University Indianapolis, Indianapolis, IN 46202, USA; (M.T.R.); (J.L.M.); (E.J.M.); (K.S.M.)
| | - Megan M. Hricovec
- Department of Psychology, University of North Texas, Denton, TX 76201, USA (D.C.C.)
| | - David C. Cicero
- Department of Psychology, University of North Texas, Denton, TX 76201, USA (D.C.C.)
| | - J. Wolny
- Department of Psychological and Brain Sciences, Indiana University, Bloomington, IN 47405, USA; (J.W.)
| | - William P. Hetrick
- Department of Psychological and Brain Sciences, Indiana University, Bloomington, IN 47405, USA; (J.W.)
| | - Michael D. Masucci
- Department of Psychology, Louisiana State University, Baton Rouge, LA 70803, USA
| | - Alex S. Cohen
- Department of Psychology, Louisiana State University, Baton Rouge, LA 70803, USA
| | - Christopher J. Burgin
- Department of Psychology, Tennessee Technological University, Cookeville, TN 38505, USA;
| | - Thomas R. Kwapil
- Department of Psychology, University of Illinois Urbana-Champaign, Champaign, IL 61820, USA;
- Department of Psychology, University of North Carolina at Greensboro, Greensboro, NC 27412, USA
| | - Kyle S. Minor
- Department of Psychology, Indiana University Indianapolis, Indianapolis, IN 46202, USA; (M.T.R.); (J.L.M.); (E.J.M.); (K.S.M.)
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3
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Sun L, Li A, Chen M, Li L, Zhao Y, Zhu A, Hu P. Mediating and moderating effects of authoritative parenting styles on adolescent behavioral problems. Front Psychol 2024; 15:1336354. [PMID: 38362246 PMCID: PMC10868391 DOI: 10.3389/fpsyg.2024.1336354] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Accepted: 01/05/2024] [Indexed: 02/17/2024] Open
Abstract
Introduction This study aimed to analyze how authoritative parenting affects behavioral problems among primary, junior high, and secondary high school students. Today, parental educational anxiety and parent-child relationship conflicts are common in China and are resulting in a high incidence of child behavioral problems. High-quality family education is becoming increasingly important in China. This study sought to provide a reference for developing responsive family education services. Methods A total of 10,441 parents in Hubei Province, including urban and rural areas, were evaluated using the Parents' Education Anxiety Questionnaire, Parental Authority Parenting Questionnaire, Parent-Child Relationship Scale, and Self-Made Behavior Problem Scale to determine the internal mechanisms of child behavioral problems in the family system. To make the sample more representative, this study collected data from primary and secondary schools representative of the southeast, northwest, and center of Hubei Province; further, the number of parents involved in each school was controlled at approximately 300 to ensure that the final sample had analytical value. Results Educational anxiety directly affected children's behavioral problems and indirectly affected them through the conflicts between parent and child. This conflict partially mediated educational anxiety and child behavioral problems, and authoritative parenting played a significant regulatory role in this relationship. Discussion Higher levels of educational anxiety among parents increased the likelihood of a depressed family environment. This can lead to deteriorating parent-child relationships, which can result in children's problem behaviors. Parents can address these problems by changing their approach to education and adjusting their emotions accordingly.
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Affiliation(s)
- Li Sun
- College of Education Sciences, Hubei Second Normal College, Wuhan, Hubei, China
| | - Ao Li
- College of Education Sciences, Hubei Second Normal College, Wuhan, Hubei, China
- College of Educational Sciences, Hubei Normal University, Huangshi, Hubei, China
| | - Meng Chen
- College of Education Sciences, Hubei Second Normal College, Wuhan, Hubei, China
| | - LuYao Li
- College of Education Sciences, Hubei Second Normal College, Wuhan, Hubei, China
| | - Yan Zhao
- College of Education Sciences, Hubei Second Normal College, Wuhan, Hubei, China
| | - AnQi Zhu
- College of Education Sciences, Hubei Second Normal College, Wuhan, Hubei, China
| | - Peng Hu
- College of Education Sciences, Hubei Second Normal College, Wuhan, Hubei, China
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4
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Luther L, Raugh IM, Collins DE, Berglund A, Knippenberg AR, Mittal VA, Walker EF, Strauss GP. Environmental context predicts state fluctuations in negative symptoms in youth at clinical high risk for psychosis. Psychol Med 2023; 53:7609-7618. [PMID: 37246568 PMCID: PMC10755225 DOI: 10.1017/s0033291723001393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2022] [Revised: 03/17/2023] [Accepted: 04/26/2023] [Indexed: 05/30/2023]
Abstract
BACKGROUND Negative symptoms (avolition, anhedonia, asociality) are a prevalent symptom in those across the psychosis-spectrum and also occur at subclinical levels in the general population. Recent work has begun to examine how environmental contexts (e.g. locations) influence negative symptoms. However, limited work has evaluated how environments may contribute to negative symptoms among youth at clinical high risk for psychosis (CHR). The current study uses Ecological Momentary Assessment to assess how four environmental contexts (locations, activities, social interactions, social interaction method) impact state fluctuations in negative symptoms in CHR and healthy control (CN) participants. METHODS CHR youth (n = 116) and CN (n = 61) completed 8 daily surveys for 6 days assessing negative symptoms and contexts. RESULTS Mixed-effects modeling demonstrated that negative symptoms largely varied across contexts in both groups. CHR participants had higher negative symptoms than CN participants in most contexts, but groups had similar symptom reductions during recreational activities and phone call interactions. Among CHR participants, negative symptoms were elevated in several contexts, including studying/working, commuting, eating, running errands, and being at home. CONCLUSIONS Results demonstrate that negative symptoms dynamically change across some contexts in CHR participants. Negative symptoms were more intact in some contexts, while other contexts, notably some used to promote functional recovery, may exacerbate negative symptoms in CHR. Findings suggest that environmental factors should be considered when understanding state fluctuations in negative symptoms among those at CHR participants.
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Affiliation(s)
- Lauren Luther
- Department of Psychology, University of Georgia, Athens, GA, USA
| | - Ian M. Raugh
- Department of Psychology, University of Georgia, Athens, GA, USA
| | | | - Alysia Berglund
- Department of Psychology, University of Georgia, Athens, GA, USA
| | | | - Vijay A. Mittal
- Department of Psychology, Northwestern University, Evanston, IL, USA
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5
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Strauss GP, Zamani-Esfahlani F, Raugh IM, Luther L, Sayama H. Network analysis of discrete emotional states measured via ecological momentary assessment in schizophrenia. Eur Arch Psychiatry Clin Neurosci 2023; 273:1863-1871. [PMID: 37278749 DOI: 10.1007/s00406-023-01623-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/14/2022] [Accepted: 05/22/2023] [Indexed: 06/07/2023]
Abstract
Prior studies demonstrate that schizophrenia (SZ) is associated with abnormalities in positive and negative emotional experience that predict clinical presentation. However, it is unclear whether specific discrete emotions within the broader positive/negative categories are driving those symptom associations. Further, it is also unclear whether specific emotions contribute to symptoms in isolation or via networks of emotional states that dynamically interact across time. The current study used network analysis to evaluate temporally dynamic interactions among discrete emotional states experienced in the real world as assessed via Ecological Momentary Assessment (EMA). Participants included 46 outpatients with chronic SZ and 52 demographically matched healthy controls (CN) who completed 6 days of EMA that captured reports of emotional experience and symptoms derived from monetary surveys and geolocation based symptom markers of mobility and home location. Results indicated that less dense emotion networks were associated with greater severity of negative symptoms, whereas more dense emotion networks were associated with more severe positive symptoms and mania. Additionally, SZ evidenced greater centrality for shame, which was associated with greater severity of positive symptoms. These findings suggest that positive and negative symptoms are associated with distinct profiles of temporally dynamic and interactive emotion networks in SZ. Findings have implications for adapting psychosocial therapies to target specific discrete emotional states in the treatment of positive versus negative symptoms.
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Affiliation(s)
- Gregory P Strauss
- Department of Psychology, University of Georgia, 125 Baldwin St., Athens, GA, 30602, USA.
| | | | - Ian M Raugh
- Department of Psychology, University of Georgia, 125 Baldwin St., Athens, GA, 30602, USA
| | - Lauren Luther
- Department of Psychology, University of Georgia, 125 Baldwin St., Athens, GA, 30602, USA
| | - Hiroki Sayama
- Department of Systems Science and Industrial Engineering, Binghamton University, Binghamton, NY, USA
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6
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Luther L, Raugh IM, Collins DE, Knippenberg AR, Strauss GP. Negative symptoms in schizophrenia differ across environmental contexts in daily life. J Psychiatr Res 2023; 161:10-18. [PMID: 36893666 PMCID: PMC10149609 DOI: 10.1016/j.jpsychires.2023.02.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 01/23/2023] [Accepted: 02/28/2023] [Indexed: 03/11/2023]
Abstract
A recent environmental theory of negative symptoms posits that environmental contexts (e.g., location, social partner) play a significant-yet often unaccounted for-role in negative symptoms of schizophrenia (SZ). "Gold-standard" clinical rating scales offer limited precision for evaluating how contexts impact symptoms. To overcome some of these limitations, Ecological Momentary Assessment (EMA) was used to determine whether there were state fluctuations in experiential negative symptoms (anhedonia, avolition, and asociality) in SZ across contexts (locations, activities, social interaction partner, social interaction method). Outpatients with SZ (n = 52) and healthy controls (CN: n = 55) completed 8 daily EMA surveys for 6 days assessing negative symptom domains (anhedonia, avolition, and asociality) and contexts. Multilevel modeling demonstrated that negative symptoms varied across location, activity, social interaction partner, and social interaction method. For the majority of contexts, SZ and CN did not report significantly different levels of negative symptoms, with SZ only reporting higher negative symptoms than CN while eating, resting, interacting with a significant other, or being at home. Further, there were several contexts where negative symptoms were similarly reduced (e.g., recreation, most social interactions) or elevated (e.g., using the computer, working, running errands) in each group. Results demonstrate that experiential negative symptoms dynamically change across contexts in SZ. Some contexts may "normalize" experiential negative symptoms in SZ, while other contexts, notably some used to promote functional recovery, may increase experiential negative symptoms.
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Affiliation(s)
- Lauren Luther
- Department of Psychology, University of Georgia, Athens, GA, USA.
| | - Ian M Raugh
- Department of Psychology, University of Georgia, Athens, GA, USA
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7
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Almuqrin A, Georgiades A, Mouhitzadeh K, Rubinic P, Mechelli A, Tognin S. The association between psychosocial stress, interpersonal sensitivity, social withdrawal and psychosis relapse: a systematic review. SCHIZOPHRENIA (HEIDELBERG, GERMANY) 2023; 9:22. [PMID: 37037858 PMCID: PMC10086007 DOI: 10.1038/s41537-023-00349-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/29/2022] [Accepted: 03/15/2023] [Indexed: 04/12/2023]
Abstract
Psychosis is associated with a high risk of relapse, with 67% of clients relapsing within one year following a first episode. In light of the high personal, social, and healthcare costs of the illness, it is paramount to understand the risk factors associated with psychosis relapse. The current systematic review aims to critically review the role of psychosocial stress in psychosis relapse in individuals with an established psychotic disorder. This review systematically searched Ovid (PsycINFO, EMBASE, MEDLINE) literature databases from inception until 28th February 2022. Sixteen studies were eligible for inclusion. Most studies found that individuals with psychosis demonstrate high levels of psychosocial stress and are more likely to be socially withdrawn compared to healthy controls or other clinical presentations. Most studies reported a statistically significant association between psychosocial stress and psychosis relapse, as well as between social withdrawal and psychosis relapse. However, no studies examined the association between high levels of interpersonal sensitivity and psychosis relapse. Individuals with psychosis tend to experience high levels of psychosocial stress and social withdrawal, and these appear to increase the risk of psychosis relapse. Due to high levels of heterogeneity within the literature, we could only conduct a narrative synthesis of the findings. Future studies would benefit from employing a meta-analytic approach.
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Affiliation(s)
- A Almuqrin
- Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience (IoPPN), King's College London, London, UK
- Department of Health Sciences, College of Health and Rehabilitation Sciences, Princess Nourah bint Abdulrahman University, Riyadh, Saudi Arabia
| | - A Georgiades
- Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience (IoPPN), King's College London, London, UK
- Brent Early Intervention Service, 27-29 Fairlight Avenue, London, NW10 8AL, CNWL, NHS Foundation Trust, London, UK
| | - K Mouhitzadeh
- Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience (IoPPN), King's College London, London, UK
| | - P Rubinic
- Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience (IoPPN), King's College London, London, UK
| | - A Mechelli
- Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience (IoPPN), King's College London, London, UK
| | - S Tognin
- Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience (IoPPN), King's College London, London, UK.
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8
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Chai J, Liu F, Liu L, Hu N, Huang W, Wang H, Cui Y, Liu H, Li X, Li Y. The efficacy of homestyle rehabilitation on negative symptoms in chronic schizophrenia: A randomized controlled trial. Front Psychiatry 2023; 14:1138794. [PMID: 37139315 PMCID: PMC10149672 DOI: 10.3389/fpsyt.2023.1138794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2023] [Accepted: 03/20/2023] [Indexed: 05/05/2023] Open
Abstract
Objective Schizophrenia is a debilitating mental disorder with a high disability rate that is characterized by negative symptoms such as apathy, hyperactivity, and anhedonia that can make daily life challenging and impair social functioning. In this study, we aim to investigate the effectiveness of homestyle rehabilitation in mitigating these negative symptoms and associated factors. Methods A randomized controlled trial was conducted to compare the efficacy of hospital rehabilitation and homestyle rehabilitation for negative symptoms in 100 individuals diagnosed with schizophrenia. The participants were divided randomly into two groups, each persisting for 3 months. The primary outcome measures were the Scale for Assessment of Negative Symptoms (SANS) and Global Assessment of Functioning (GAF). The secondary outcome measures included the Positive Symptom Assessment Scale (SAPS), Calgary Schizophrenia Depression Scale (CDSS), Simpson-Angus Scale (SAS), and Abnormal Involuntary Movement Scale (AIMS). The trial aimed to compare the effectiveness of the two rehabilitation methods. Results Homestyle rehabilitation for negative symptoms was found to be more effective than hospital rehabilitation, according to the changes in SANS (T = 2.07, p = 0.04). Further analysis using multiple regression indicated that improvements in depressive symptoms (T = 6.88, p < 0.001) and involuntary motor symptoms (T = 2.75, p = 0.007) were associated with a reduction in negative symptoms. Conclusion Homestyle rehabilitation may have greater potential than hospital rehabilitation in improving negative symptoms, making it an effective rehabilitation model. Further research is necessary to investigate factors such as depressive symptoms and involuntary motor symptoms, which may be associated with the improvement of negative symptoms. Additionally, more attention should be given to addressing secondary negative symptoms in rehabilitation interventions.
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Affiliation(s)
- Jiabao Chai
- Beijing Huilongguan Hospital, Peking University Huilongguan Clinical Medical School, Beijing, China
| | - Fuquan Liu
- Department of Psychiatry, Beijing Jishuitan Hospital, Beijing, China
| | - Lin Liu
- Beijing Huilongguan Hospital, Peking University Huilongguan Clinical Medical School, Beijing, China
| | - Na Hu
- Beijing Huilongguan Hospital, Peking University Huilongguan Clinical Medical School, Beijing, China
| | - Wenqian Huang
- Beijing Huilongguan Hospital, Peking University Huilongguan Clinical Medical School, Beijing, China
| | - Hong Wang
- Beijing Huilongguan Hospital, Peking University Huilongguan Clinical Medical School, Beijing, China
| | - Yonghua Cui
- Department of Psychiatry, Beijing Children’s Hospital, Capital Medical University, National Center for Children Healthy, Beijing, China
| | - Hongyan Liu
- Mental Health Center of Haidian in Beijing, Beijing, China
| | - Xiaojun Li
- Department of Psychiatry, Beijing Jishuitan Hospital, Beijing, China
- *Correspondence: Xiaojun Li, ; Ying Li,
| | - Ying Li
- Department of Psychiatry, Beijing Children’s Hospital, Capital Medical University, National Center for Children Healthy, Beijing, China
- *Correspondence: Xiaojun Li, ; Ying Li,
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9
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Longitudinal association between falls and motoric cognitive risk syndrome among community-dwelling older adults. Geriatr Nurs 2023; 49:1-7. [PMID: 36399977 DOI: 10.1016/j.gerinurse.2022.11.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 11/03/2022] [Accepted: 11/04/2022] [Indexed: 11/17/2022]
Abstract
The motoric cognitive risk (MCR) syndrome is a predementia syndrome associated with dementia and mortality risk. This longitudinal study aimed to investigated the longitudinal association between MCR and falls in older adults, including 3,720 participants in the China Health and Retirement Longitudinal Study. A total of 482 participants (13.0%) met the MCR requirements at baseline. There were 226 incident cases of MCR (13.0%) throughout follow-up (duration: 4 years). Controlling for microsystem factors, a single fall (OR: 2.412, 95 % CI: 1.100-5.290; p < .05) was associated with incident MCR at baseline and to almost 2.0 times (HR: 2.021, 95 % CI: 1.031-3.961; p < .05) more inclined to develop MCR over time, compared to those without falls. These associations remained significant when meso/ exosystem factors and macrosystem factors were included in the analytic models. Falls may be useful in predicting MCR risk in the near future among Chinese older adults.
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Sabe M, Chen C, Perez N, Solmi M, Mucci A, Galderisi S, Strauss GP, Kaiser S. Thirty years of research on negative symptoms of schizophrenia: A scientometric analysis of hotspots, bursts, and research trends. Neurosci Biobehav Rev 2023; 144:104979. [PMID: 36463972 DOI: 10.1016/j.neubiorev.2022.104979] [Citation(s) in RCA: 20] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2022] [Revised: 11/19/2022] [Accepted: 11/28/2022] [Indexed: 12/02/2022]
Abstract
Research on negative symptoms of schizophrenia has received renewed interest since the 1980s. A scientometric analysis that objectively maps scientific knowledge, with changes in recent trends, is currently lacking. We searched the Web of Science Core Collection (WOSCC) on December 17, 2021 using relevant keywords. R-bibliometrix and CiteSpace were used to perform the analysis. We retrieved 27,568 references published between 1966 and 2022. An exponential rise in scientific interest was observed, with an average annual growth rate in publications of 16.56% from 1990 to 2010. The co-cited reference network that was retrieved presented 24 different clusters with a well-structured network (Q=0.7921; S=0.9016). Two distinct major research trends were identified: research on the conceptualization and treatment of negative symptoms. The latest trends in research on negative symptoms include evidence synthesis, nonpharmacological treatments, and computational psychiatry. Scientometric analyses provide a useful summary of changes in negative symptom research across time by identifying intellectual turning point papers and emerging trends. These results will be informative for systematic reviews, meta-analyses, and generating novel hypotheses.
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Affiliation(s)
- Michel Sabe
- Division of Adult Psychiatry, Department of Psychiatry, Geneva University Hospitals, Switzerland.
| | - Chaomei Chen
- College of Computing & Informatics, Drexel University, Philadelphia, PA, USA
| | - Natacha Perez
- Division of Adult Psychiatry, Department of Psychiatry, Geneva University Hospitals, Switzerland
| | - Marco Solmi
- Department of Psychiatry, University of Ottawa, Ontario, Canada; Department of Mental Health, The Ottawa Hospital, Ontario, Canada; Ottawa Hospital Research Institute (OHRI) Clinical Epidemiology Program University of Ottawa, Ontario, Ottawa; School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada; Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany
| | - Armida Mucci
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Silvana Galderisi
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | | | - Stefan Kaiser
- Division of Adult Psychiatry, Department of Psychiatry, Geneva University Hospitals, Switzerland
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11
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James SH, Berglund A, Chang WC, Strauss GP. Discrepancies between ideal and actual affect in schizophrenia: Implications for understanding negative symptoms. J Psychiatr Res 2022; 155:313-319. [PMID: 36174366 DOI: 10.1016/j.jpsychires.2022.09.024] [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: 06/08/2022] [Revised: 08/29/2022] [Accepted: 09/16/2022] [Indexed: 11/26/2022]
Abstract
Anhedonia is a core symptom of schizophrenia (SZ). However, psychological mechanisms underlying anhedonia are unclear, making it difficult to develop personalized psychosocial treatments. The current study explored the novel hypothesis that anhedonia is driven by discrepancies between ideal and actual affect (i.e., how positive or negative someone wants to feel compared to how they do feel), which impact the frequency of recreational, goal-directed, and social behaviors. Participants included 32 outpatients with SZ and 29 healthy controls (CN) who completed the Affect Valuation Index and measures of negative symptom severity. Results indicated that individuals with SZ displayed greater positive and negative emotion discrepancy scores than CN, suggesting that they strongly desire to feel more positive and less negative in the future than they actually do. Additionally, greater ideal relative to actual positive and negative affect was associated with greater severity of anhedonia, avolition, and asociality. The discrepancy between ideal and actual affective states may be demotivating, leading individuals with SZ to develop dysfunctional beliefs after repeated experiences of failing to achieve their desired emotional goal state. These findings suggest that ideal affect may be a novel psychological mechanism underlying negative symptoms that could be targeted in psychosocial treatments.
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Affiliation(s)
- Sydney H James
- Department of Psychology, University of Georgia, Athens, GA, USA
| | - Alysia Berglund
- Department of Psychology, University of Georgia, Athens, GA, USA
| | - Wing Chung Chang
- Department of Psychiatry, University of Hong Kong, Pok Fu Lam, Hong Kong; State Key Laboratory of Brain and Cognitive Sciences, University of Hong Kong, Pok Fu Lam, Hong Kong
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12
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Talking about Health: A Topic Analysis of Narratives from Individuals with Schizophrenia and Other Serious Mental Illnesses. Behav Sci (Basel) 2022; 12:bs12080286. [PMID: 36004857 PMCID: PMC9405157 DOI: 10.3390/bs12080286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 07/31/2022] [Accepted: 08/08/2022] [Indexed: 11/23/2022] Open
Abstract
Individuals with schizophrenia have higher mortality and shorter lifespans. There are a multitude of factors which create these conditions, but one aspect is worse physical health, particularly cardiovascular and metabolic health. Many interventions to improve the health of individuals with schizophrenia have been created, but on the whole, there has been limited effectiveness in improving quality of life or lifespan. One potential new avenue for inquiry involves a more patient-centric perspective; understanding aspects of physical health most important, and potentially most amenable to change, for individuals based on their life narratives. This study used topic modeling, a type of Natural Language Processing (NLP) on unstructured speech samples from individuals (n = 366) with serious mental illness, primarily schizophrenia, in order to extract topics. Speech samples were drawn from three studies collected over a decade in two geographically distinct regions of the United States. Several health-related topics emerged, primarily centered around food, living situation, and lifestyle (e.g., routine, hobbies). The implications of these findings for how individuals with serious mental illness and schizophrenia think about their health, and what may be most effective for future health promotion policies and interventions, are discussed.
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13
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Collins DE, Luther L, Raugh IM, Condray R, Allen DN, Strauss GP. The Role of Disability Benefits as an Environmental Factor Contributing to Negative Symptoms. Schizophr Bull 2022; 49:1-4. [PMID: 35808961 PMCID: PMC9810000 DOI: 10.1093/schbul/sbac077] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
| | - Lauren Luther
- Department of Psychology, University of Georgia, Athens, GA, USA
| | - Ian M Raugh
- Department of Psychology, University of Georgia, Athens, GA, USA
| | - Ruth Condray
- Biometrics Research Program, VA Pittsburgh Healthcare System, Pittsburgh, PA, USA
| | - Daniel N Allen
- Department of Psychology, University of Nevada, Las Vegas, Las Vegas, NV, USA
| | - Gregory P Strauss
- To whom correspondence should be addressed; Department of Psychology, University of Georgia, 125 Baldwin St., Athens, GA 30602; tel: +1-706-542-0307, fax: +1-706-542-3275,
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14
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Everything is connected: Inference and attractors in delusions. Schizophr Res 2022; 245:5-22. [PMID: 34384664 PMCID: PMC9241990 DOI: 10.1016/j.schres.2021.07.032] [Citation(s) in RCA: 19] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 07/21/2021] [Accepted: 07/23/2021] [Indexed: 02/06/2023]
Abstract
Delusions are, by popular definition, false beliefs that are held with certainty and resistant to contradictory evidence. They seem at odds with the notion that the brain at least approximates Bayesian inference. This is especially the case in schizophrenia, a disorder thought to relate to decreased - rather than increased - certainty in the brain's model of the world. We use an active inference Markov decision process model (a Bayes-optimal decision-making agent) to perform a simple task involving social and non-social inferences. We show that even moderate changes in some model parameters - decreasing confidence in sensory input and increasing confidence in states implied by its own (especially habitual) actions - can lead to delusions as defined above. Incorporating affect in the model increases delusions, specifically in the social domain. The model also reproduces some classic psychological effects, including choice-induced preference change, and an optimism bias in inferences about oneself. A key observation is that no change in a single parameter is both necessary and sufficient for delusions; rather, delusions arise due to conditional dependencies that create 'basins of attraction' which trap Bayesian beliefs. Simulating the effects of antidopaminergic antipsychotics - by reducing the model's confidence in its actions - demonstrates that the model can escape from these attractors, through this synthetic pharmacotherapy.
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15
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Oh H, Nagendra A, Besecker M, Smith L, Koyanagi A, Wang JSH. Economic strain, parental education and psychotic experiences among college students in the United States: Findings from the Healthy Minds Study 2020. Early Interv Psychiatry 2022; 16:770-781. [PMID: 34469041 DOI: 10.1111/eip.13221] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2021] [Revised: 07/28/2021] [Accepted: 08/15/2021] [Indexed: 01/14/2023]
Abstract
AIM Socioeconomic status (SES) is linked to psychosis, and much can be learned by examining how various indicators of SES-specifically economic strain and intergenerational transfer of resources-are related to sub-threshold psychotic experiences among college students. METHODS Using data from the Healthy Minds Survey (September 2020-December 2020), we used multivariable logistic regression models to examine the associations between five SES indicators and 12-month psychotic experiences, adjusting for age, gender and race/ethnicity. We also examined the count of predictors and psychotic experiences. RESULTS Each indicator of economic strain was associated with greater odds of psychotic experiences. In particular, increasing levels of financial stress (current, childhood and pandemic-related) were associated with greater odds of psychotic experiences in a dose-response fashion. Food insecurity was associated with double the odds of psychotic experiences. In terms of intergenerational transfer of resources, having either one or no parents who attended college was associated with significantly greater odds of having psychotic experiences, when compared with having both parents who attended college. Examining all predictors in the same model, only childhood and current financial stress and food insecurity were significantly associated with psychotic experiences. The count of predictors was significantly associated with greater odds of having psychotic experiences in a dose-dependent fashion. CONCLUSIONS Among college students, economic strain and intergenerational transfer of resources were associated with recent psychotic experiences, highlighting the importance of economic interventions targeting young adults to influence risk for psychosis.
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Affiliation(s)
- Hans Oh
- Suzanne Dworak Peck School of Social Work, University of Southern California, Los Angeles, California, USA
| | - Arundati Nagendra
- Department of Psychiatry, Massachusetts General Hospital/Harvard Medical School, Boston, Massachusetts, USA
| | - Megan Besecker
- Suzanne Dworak Peck School of Social Work, University of Southern California, Los Angeles, California, USA
| | - Lee Smith
- The Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge, UK
| | - Ai Koyanagi
- Parc Sanitari Sant Joan de Deu/CIBERSAM, Universitat de Barcelona, Fundació Sant Joan de Déu, Barcelona, Spain.,Institució Catalana de Recerca i Estudis Avançats (ICREA), Pg. Lluis Companys, Barcelona, Spain
| | - Julia Shu-Huah Wang
- Department of Social Work and Social Administration, The University of Hong Kong, Pok Fu Lam Road, Hong Kong
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16
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The impact of the COVID-19 pandemic on negative symptoms in individuals at clinical high-risk for psychosis and outpatients with chronic schizophrenia. Eur Arch Psychiatry Clin Neurosci 2022; 272:17-27. [PMID: 33881621 PMCID: PMC8057945 DOI: 10.1007/s00406-021-01260-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Accepted: 03/30/2021] [Indexed: 12/14/2022]
Abstract
Negative symptoms are core features of schizophrenia-spectrum disorders that are frequently observed across all phases of illness. By their nature, COVID-19 social isolation, physical distancing, and health precautions induce behavioural aspects of negative symptoms. However, it is unclear whether these prevention measures also lead to increases in experiential negative symptoms, whether such effects are equivalent across individual negative symptom domains, and if exacerbations occur equivalently across phases of illness. The current study compared negative symptom severity scores obtained during the pandemic to pre-pandemic assessments in two samples: (1) outpatients with chronic schizophrenia (SZ: n = 32) and matched healthy controls (CN: n = 31) and (2) individuals at clinical high risk for psychosis (CHR: n = 25) and matched CN (n = 30). Pre-pandemic ratings of negative symptoms were clinically elevated in SZ and CHR groups, which did not differ from each other in severity. In SZ, ratings obtained during the pandemic were significantly higher than pre-pandemic ratings for all 5 domains (alogia, blunted affect, anhedonia, avolition, and asociality) and item-level analyses indicated that exacerbations occurred on both experiential and behavioral symptoms of anhedonia, avolition, and asociality. In contrast, CHR only exhibited increases in anhedonia and avolition items during the pandemic compared to pre-ratings. Findings suggest that negative symptoms should be a critical treatment target during and after the pandemic in the schizophrenia spectrum given that they are worsening and critically related to risk for conversion, functional outcome, and recovery.
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Saleh Y, Jarratt-Barnham I, Fernandez-Egea E, Husain M. Mechanisms Underlying Motivational Dysfunction in Schizophrenia. Front Behav Neurosci 2021; 15:709753. [PMID: 34566594 PMCID: PMC8460905 DOI: 10.3389/fnbeh.2021.709753] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2021] [Accepted: 08/20/2021] [Indexed: 12/24/2022] Open
Abstract
Negative symptoms are a debilitating feature of schizophrenia which are often resistant to pharmacological intervention. The mechanisms underlying them remain poorly understood, and diagnostic methods rely on phenotyping through validated questionnaires. Deeper endo-phenotyping is likely to be necessary in order to improve current understanding. In the last decade, valuable behavioural insights have been gained through the use of effort-based decision making (EBDM) tasks. These have highlighted impairments in reward-related processing in schizophrenia, particularly associated with negative symptom severity. Neuroimaging investigations have related these changes to dysfunction within specific brain networks including the ventral striatum (VS) and frontal brain regions. Here, we review the behavioural and neural evidence associated with negative symptoms, shedding light on potential underlying mechanisms and future therapeutic possibilities. Findings in the literature suggest that schizophrenia is characterised by impaired reward based learning and action selection, despite preserved hedonic responses. Associations between amotivation and reward-processing deficits have not always been clear, and may be mediated by factors including cognitive dysfunction or dysfunctional or self-defeatist beliefs. Successful endo-phenotyping of negative symptoms as a function of objective behavioural and neural measurements is crucial in advancing our understanding of this complex syndrome. Additionally, transdiagnostic research–leveraging findings from other brain disorders, including neurological ones–can shed valuable light on the possible common origins of motivation disorders across diseases and has important implications for future treatment development.
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Affiliation(s)
- Youssuf Saleh
- Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom
| | - Isaac Jarratt-Barnham
- Department of Psychiatry, Herchel Smith Building for Brain & Mind Sciences, University of Cambridge, Cambridge, United Kingdom.,Cambridge Psychosis Centre, Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, United Kingdom
| | - Emilio Fernandez-Egea
- Department of Psychiatry, Herchel Smith Building for Brain & Mind Sciences, University of Cambridge, Cambridge, United Kingdom.,Cambridge Psychosis Centre, Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, United Kingdom
| | - Masud Husain
- Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, University of Oxford, Oxford, United Kingdom
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