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Chirica MG, Zhu Y, Mu W, Zhou H, Gong J, Chan RCK, Kwapil TR, Berenbaum H. Exploring phenotypic overlap across schizotypy and autism spectrum conditions in American and Chinese young adults. Schizophr Res 2024; 267:359-366. [PMID: 38626663 DOI: 10.1016/j.schres.2024.03.050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/30/2023] [Revised: 03/25/2024] [Accepted: 03/31/2024] [Indexed: 04/18/2024]
Abstract
Competing theories have been proposed to explain the considerable overlap in social-cognitive features and risk factors across schizotypy and autism spectrum conditions (ASCs). Six previous factor analyses have been reported in the literature, yet all have major limitations; evidence for the clear superiority of any of the competing theories is insufficient and warrants further investigation. The primary aim of the present research was to identify dimensions that cut across schizotypy and ASCs while addressing limitations of past research. Data were collected from three independent samples (n = 1006, 544, and 2469) in the U.S. and China using the Autism-Spectrum Quotient, the Schizotypal Personality Questionnaire, and the Wisconsin Schizotypy Scales. Exploratory factor analyses in Sample 1 identified an interpretable three-factor structure, which was replicated in Samples 2 and 3 using confirmatory factor analyses. We found consistent evidence for three dimensions (Aberrant Salience, Asociality, and Concrete Thinking) underlying schizotypy and ASCs. This three-dimension model is consistent with a common vulnerability model of schizotypy and ASCs. Implications of these findings for the schizotypy and ASCs literature are discussed.
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Affiliation(s)
- Marianne G Chirica
- Department of Psychological and Brain Sciences, Indiana University Bloomington, Bloomington, IN, United States of America
| | - Yiqin Zhu
- Department of Psychological and Brain Sciences, Washington University in St Louis, St Louis, MO, United States of America
| | - Wenting Mu
- Department of Psychology, Tsinghua University, Beijing, China.
| | - Hanyu Zhou
- School of Psychology and Cognitive Science, East China Normal University, Shanghai, China
| | - Jingbo Gong
- Shanghai Changning Mental Health Center, Shanghai, China
| | - Raymond C K Chan
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China; Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Thomas R Kwapil
- Department of Psychology, University of Illinois at Urbana Champaign, Champaign, IL, United States of America
| | - Howard Berenbaum
- Department of Psychology, University of Illinois at Urbana Champaign, Champaign, IL, United States of America
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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 DOI: 10.3390/bs14050363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [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
| | - Madisen T Russell
- Department of Psychology, Indiana University Indianapolis, Indianapolis, IN 46202, USA
| | - Danielle B Abel
- Department of Psychology, Indiana University Indianapolis, Indianapolis, IN 46202, USA
| | - 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
| | - Evan J Myers
- Department of Psychology, Indiana University Indianapolis, Indianapolis, IN 46202, USA
| | - Megan M Hricovec
- Department of Psychology, University of North Texas, Denton, TX 76201, USA
| | - David C Cicero
- Department of Psychology, University of North Texas, Denton, TX 76201, USA
| | - J Wolny
- Department of Psychological and Brain Sciences, Indiana University, Bloomington, IN 47405, USA
| | - William P Hetrick
- Department of Psychological and Brain Sciences, Indiana University, Bloomington, IN 47405, USA
| | - 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
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Mas-Bermejo P, Papiol S, Via M, Rovira P, Torrecilla P, Kwapil TR, Barrantes-Vidal N, Rosa A. Schizophrenia polygenic risk score in psychosis proneness. Eur Arch Psychiatry Clin Neurosci 2023; 273:1665-1675. [PMID: 37301774 PMCID: PMC10713704 DOI: 10.1007/s00406-023-01633-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2023] [Accepted: 05/29/2023] [Indexed: 06/12/2023]
Abstract
Schizophrenia (SZ) is a complex disorder with a highly polygenic inheritance. It can be conceived as the extreme expression of a continuum of traits that are present in the general population often broadly referred to as schizotypy. However, it is still poorly understood how these traits overlap genetically with the disorder. We investigated whether polygenic risk for SZ is associated with these disorder-related phenotypes (schizotypy, psychotic-like experiences, and subclinical psychopathology) in a sample of 253 non-clinically identified participants. Polygenic risk scores (PRSs) were constructed based on the latest SZ genome-wide association study using the PRS-CS method. Their association with self-report and interview measures of SZ-related traits was tested. No association with either schizotypy or psychotic-like experiences was found. However, we identified a significant association with the Motor Change subscale of the Comprehensive Assessment of At-Risk Mental States (CAARMS) interview. Our results indicate that the genetic overlap of SZ with schizotypy and psychotic-like experiences is less robust than previously hypothesized. The relationship between high PRS for SZ and motor abnormalities could reflect neurodevelopmental processes associated with psychosis proneness and SZ.
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Affiliation(s)
- Patricia Mas-Bermejo
- Secció de Zoologia i Antropologia Biològica. Departament de Biologia Evolutiva, Ecologia i Ciències Ambientals. Facultat de Biologia, Universitat de Barcelona, Avda. Diagonal 643, 08028, Barcelona, Spain
- Institut de Biomedicina de la Universitat de Barcelona, Barcelona, Spain
| | - Sergi Papiol
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, 80336, Munich, Germany
- Max Planck Institute of Psychiatry, Munich, Germany
- CIBER de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
| | - Marc Via
- Brainlab, Cognitive Neuroscience Research Group, Department of Clinical Psychology and Psychobiology, Universitat de Barcelona, Barcelona, Spain
- Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain
- Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain
| | - Paula Rovira
- Vicerectorat de Recerca, Investigadora Postdoctoral Margarita Salas, Universitat de Barcelona, Barcelona, Spain
- Instituto de Neurociencias, Centro de Investigación Biomédica (CIBM), Universidad de Granada, Granada, Spain
- Departamento de Psiquiatría, Facultad de Medicina, Universidad de Granada, Granada, Spain
- Instituto de Investigación Biosanitaria Ibs.Granada, Granada, Spain
| | - Pilar Torrecilla
- Department of Clinical and Health Psychology, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Thomas R Kwapil
- Department of Psychology, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Neus Barrantes-Vidal
- CIBER de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
- Department of Clinical and Health Psychology, Universitat Autònoma de Barcelona, Barcelona, Spain
- Sant Pere Claver-Fundació Sanitària, Barcelona, Spain
| | - Araceli Rosa
- Secció de Zoologia i Antropologia Biològica. Departament de Biologia Evolutiva, Ecologia i Ciències Ambientals. Facultat de Biologia, Universitat de Barcelona, Avda. Diagonal 643, 08028, Barcelona, Spain.
- Institut de Biomedicina de la Universitat de Barcelona, Barcelona, Spain.
- CIBER de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain.
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Nonweiler J, Torrecilla P, Kwapil TR, Ballespí S, Barrantes-Vidal N. I don't understand how I feel: mediating role of impaired self-mentalizing in the relationship between childhood adversity and psychosis spectrum experiences. Front Psychiatry 2023; 14:1268247. [PMID: 38098634 PMCID: PMC10719857 DOI: 10.3389/fpsyt.2023.1268247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Accepted: 11/13/2023] [Indexed: 12/17/2023] Open
Abstract
Introduction Childhood adversity is associated with the severity of multiple dimensions of psychosis, but the mechanisms underpinning the close link between the two constructs is unclear. Mentalization may underlie this relationship, as impaired mentalizing is found in various stages of the psychosis continuum. Nonetheless, the differential roles of self- and other-mentalizing in psychosis are not well understood. Methods Parallel multiple mediation was conducted for the relationship between a diverse range of childhood adversity types, including intentional and nonintentional harm, and schizotypy (positive, negative, disorganized), psychotic-like experiences (PLE) and paranoia via self-mentalizing (attention to emotions and emotional clarity) and other-mentalizing in n = 1,156 nonclinically ascertained young adults. Results Significant parallel multiple mediation models were found for all psychotic outcomes except negative schizotypy. The associations between intentionally harmful childhood adversity and psychotic outcomes were significantly mediated by increased attention to emotions for most models and decreased emotional clarity for some models. No significant mediation was found for parental loss. Paternal abuse was only mediated by attention to emotions whereas the effects of maternal abuse were mediated by attention to emotions and emotional clarity. Other-mentalizing only showed mediating effects on one of thirty models tested. Conclusion Results highlight the mediating role of impaired self-mentalizing in the association between childhood adversity and psychosis. This is consistent with disturbances of self-concept and self-boundary characterizing, in particular, the positive dimension of psychosis. Maternal versus paternal figures may contribute differentially to the development of mentalizing. These results could inform future preventative interventions, focusing on the development and maintenance of self-mentalizing.
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Affiliation(s)
- Jacqueline Nonweiler
- Departament de Psicologia Clínica i de la Salut, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Pilar Torrecilla
- Departament de Psicologia Clínica i de la Salut, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Thomas R. Kwapil
- Department of Psychology, University of Illinois at Urbana-Champaign, Champaign, IL, United States
| | - Sergi Ballespí
- Departament de Psicologia Clínica i de la Salut, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Neus Barrantes-Vidal
- Departament de Psicologia Clínica i de la Salut, Universitat Autònoma de Barcelona, Barcelona, Spain
- CIBER de Salud Mental, Instituto de Salud Carlos III, Madrid, Spain
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Sahakyan L, Wahlheim CN, Kwapil TR. Mnemonic discrimination deficits in multidimensional schizotypy. Hippocampus 2023; 33:1139-1153. [PMID: 37345675 DOI: 10.1002/hipo.23566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 04/29/2023] [Accepted: 06/02/2023] [Indexed: 06/23/2023]
Abstract
Current developmental psychopathology models indicate that schizophrenia can be understood as the most extreme expression of a multidimensional continuum of symptoms and impairment referred to as schizotypy. In nondisordered adults, schizotypy predicts risk for developing schizophrenia-spectrum psychopathology. Schizophrenia is associated with disruptions in detecting subtle differences between objects, which is linked to hippocampal dysfunction. These disruptions have been shown in the Mnemonic Similarity Task (MST) when patients are less likely to reject lures that are similar but not identical to studied objects, and instead mistake them for studied items. This pattern of errors may be a behavioral manifestation of impaired pattern separation, a key episodic memory ability associated with hippocampal integrity and overreliance on pattern completion. We examined whether multidimensional schizotypy is associated with such deficits in nondisordered young adults. Participants (n = 230) were assessed for positive, negative, and disorganized schizotypy and completed the MST and a perceptual discrimination task. MST performance showed that a combination of elevated negative and disorganized schizotypy was associated with decreased rejections of similar lures because they were mistakenly identified as studied items. These deficits were not observed in traditional recognition measures within the same task, nor in perceptual discrimination, suggesting that mnemonic discrimination deficits assessed by MST were selective and did not reflect generalized deficits. These findings extend the results obtained in schizophrenia patients and support a multidimensional model of schizophrenia-spectrum psychopathology.
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Affiliation(s)
- Lili Sahakyan
- Department of Psychology, University of Illinois at Urbana-Champaign, Champaign, Illinois, USA
- Beckman Institute for Advanced Science and Technology, Urbana, Illinois, USA
| | - Christopher N Wahlheim
- Department of Psychology, University of North Carolina at Greensboro, Greensboro, North Carolina, USA
| | - Thomas R Kwapil
- Department of Psychology, University of Illinois at Urbana-Champaign, Champaign, Illinois, USA
- Department of Psychology, University of North Carolina at Greensboro, Greensboro, North Carolina, USA
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Hernández LM, Kemp KC, Barrantes-Vidal N, Kwapil TR. Replication of the associations of positive, negative, and disorganized schizotypy with interview-assessed symptoms and impairment: Convergence with previous studies. Personal Disord 2023; 14:527-533. [PMID: 36595437 DOI: 10.1037/per0000611] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Schizophrenia-spectrum psychopathology appears best understood as being expressed across a continuum of clinical and subclinical symptoms and impairment referred to as schizotypy. This brief report describes a comprehensive replication study examining the associations of positive, negative, and disorganized schizotypy with interview ratings of impairment, psychopathology, and personality pathology in a sample of 161 young adults. Consistent with past studies, positive, negative, and disorganized schizotypy had distinct and hypothesized associations with symptoms and impairment. Positive schizotypy was associated with prodromal symptoms and schizotypal, paranoid, and borderline personality traits. Negative schizotypy was associated with impaired functioning, negative symptoms, and schizoid, schizotypal, and paranoid traits, as well as any broad personality disorder diagnosis; it was also associated with never having dated. Disorganized schizotypy was associated with impaired functioning, disorganized schizotypic experiences, attentional deficits, and schizotypal, paranoid, borderline, and avoidant personality traits, as well as depression. Overall, we successfully replicated findings from five previous schizotypy interview studies, supporting the construct validity of the multidimensional model of schizotypy and the Multidimensional Schizotypy Scale. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Affiliation(s)
- Laura M Hernández
- Department of Psychology, University of Illinois at Urbana-Champaign
| | - Kathryn C Kemp
- Department of Psychology, University of Illinois at Urbana-Champaign
| | - Neus Barrantes-Vidal
- Departament de Psicologia Clinica i de la Salut, Universitat Autonoma de Barcelona
| | - Thomas R Kwapil
- Department of Psychology, University of Illinois at Urbana-Champaign
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Pfarr JK, Meller T, Evermann U, Sahakyan L, Kwapil TR, Nenadić I. Trait schizotypy and the psychosis prodrome: Current standard assessment of extended psychosis spectrum phenotypes. Schizophr Res 2023; 254:208-217. [PMID: 36933416 DOI: 10.1016/j.schres.2023.03.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2022] [Revised: 01/10/2023] [Accepted: 03/03/2023] [Indexed: 03/20/2023]
Abstract
Schizotypy has become an increasingly important construct for elaborating psychotic disorders that vary along the schizophrenic spectrum. However, different schizotypy inventories vary in conceptual approach and measurement. In addition, commonly used schizotypy scales have been seen as qualitatively different from screening instruments for prodromal schizophrenia like the Prodromal Questionnaire-16 (PQ-16). Our study investigated the psychometric properties of three schizotypy questionnaires (the Schizotypal Personality Questionnaire-Brief, Oxford-Liverpool Inventory of Feelings and Experiences, and the Multidimensional Schizotypy Scale) as well as the PQ-16 in a cohort of 383 non-clinical subjects. We initially evaluated their factor structure using Principal Component Analysis (PCA) and used Confirmatory Factor Analysis (CFA) to test a newly proposed composition of factors. PCA results support a three-factor structure of schizotypy that accounts for 71 % of the total variance, but also shows cross-loadings of some schizotypy subscales. CFA of the newly composed schizotypy factors (together with an added neuroticism factor) shows good fit. Analyses including the PQ-16 indicate considerable overlap with measures of trait schizotypy, suggesting that the PQ-16 might not be quantitatively or qualitatively different from schizotypy measurements. Taken together, results indicate that there is good support for a three-factor structure of schizotypy but also that different schizotypy measurements grasp facets of schizotypy differently. This points towards the need for an integrative approach for assessing the construct of schizotypy.
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Affiliation(s)
- Julia-Katharina Pfarr
- Department of Psychiatry and Psychotherapy, University of Marburg, Germany; Center for Mind, Brain and Behavior, University of Marburg, Germany.
| | - Tina Meller
- Department of Psychiatry and Psychotherapy, University of Marburg, Germany; Center for Mind, Brain and Behavior, University of Marburg, Germany
| | - Ulrika Evermann
- Department of Psychiatry and Psychotherapy, University of Marburg, Germany; Center for Mind, Brain and Behavior, University of Marburg, Germany
| | - Lili Sahakyan
- Department of Psychology, University of Illinois at Urbana-Champaign, United States of America; Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, United States of America
| | - Thomas R Kwapil
- Department of Psychology, University of Illinois at Urbana-Champaign, United States of America; Department of Psychology, University of North Carolina at Greensboro, United States of America
| | - Igor Nenadić
- Department of Psychiatry and Psychotherapy, University of Marburg, Germany; Center for Mind, Brain and Behavior, University of Marburg, Germany
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Monsonet M, Amedy A, Kwapil TR, Barrantes-Vidal N. A psychosocial pathway to paranoia: The interplay between social connectedness and self-esteem. Schizophr Res 2023; 254:199-207. [PMID: 36931182 DOI: 10.1016/j.schres.2023.03.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/26/2022] [Revised: 01/11/2023] [Accepted: 03/03/2023] [Indexed: 03/19/2023]
Abstract
The quantity and quality of social contacts have been related to self-esteem, and both social relationships and self-esteem have been implicated in the pathways to paranoia. However, how social relationships interplay with self-esteem to trigger paranoia is not well understood. This study aims to investigate whether different measures of social connectedness (social support, loneliness, and desired friendship), as well as the frequency of social contact, impact paranoia and other positive and negative psychotic-like experiences (PLE) through the indirect effect of self-esteem. Data from a sample of 169 nonclinically ascertained participants oversampled for schizotypy scores were analyzed using two different approaches: retrospective trait-like and ecological momentary measures of social connectedness. Results showed that self-esteem mediates the pathways from poor social support and social longing, but not from loneliness, to paranoia and other cognitive PLE. In contrast, pathways from social connectedness to perceptual PLE and negative PLE were not mediated by self-esteem. Results were consistent across trait-like and momentary measures. Finally, self-esteem was not implicated in the pathways from the frequency of social contact and paranoia or other forms of PLE. These results provide a comprehensive picture of how social connectedness drives specific symptoms of psychosis through self-esteem. Findings underscore the need to explore separately the quality and quantity of social relationships and suggest that the subjective experience of meaningful social bonds is key social determinants of mental health. Therefore, addressing inadequacies of social connectedness could substantially improve symptomatic and functional outcomes of psychosis.
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Affiliation(s)
- Manel Monsonet
- Departament de Psicologia Clínica i de la Salut, Universitat Autònoma de Barcelona, Bellaterra, Barcelona, Spain; Department of Psychology, University of Illinois at Urbana-Champaign, United States of America
| | - Amad Amedy
- Department of Psychology, Vanderbilt University, United States of America
| | - Thomas R Kwapil
- Department of Psychology, University of Illinois at Urbana-Champaign, United States of America
| | - Neus Barrantes-Vidal
- Departament de Psicologia Clínica i de la Salut, Universitat Autònoma de Barcelona, Bellaterra, Barcelona, Spain; CIBER de Salud Mental, Instituto de Salud Carlos III, Spain.
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Gizdic A, Sheinbaum T, Kwapil TR, Barrantes-Vidal N. Empirically-derived dimensions of childhood adversity and cumulative risk: associations with measures of depression, anxiety, and psychosis-spectrum psychopathology. Eur J Psychotraumatol 2023; 14:2222614. [PMID: 37377079 DOI: 10.1080/20008066.2023.2222614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 04/30/2023] [Accepted: 05/25/2023] [Indexed: 06/29/2023] Open
Abstract
Background: Investigating different approaches to operationalizing childhood adversity and how they relate to transdiagnostic psychopathology is relevant to advance research on mechanistic processes and to inform intervention efforts. To our knowledge, previous studies have not used questionnaire and interview measures of childhood adversity to examine factor-analytic and cumulative-risk approaches in a complementary manner.Objective: The first aim of this study was to identify the dimensions underlying multiple subscales from three well-established childhood adversity measures (the Childhood Trauma Questionnaire, the Childhood Experience of Care and Abuse Interview, and the Interview for Traumatic Events in Childhood) and to create a cumulative risk index based on the resulting dimensions. The second aim of the study was to examine the childhood adversity dimensions and the cumulative risk index as predictors of measures of depression, anxiety, and psychosis-spectrum psychopathology.Method: Participants were 214 nonclinically ascertained young adults who were administered questionnaire and interview measures of depression, anxiety, psychosis-spectrum phenomena, and childhood adversity.Results: Four childhood adversity dimensions were identified that captured experiences in the domains of Intrafamilial Adversity, Deprivation, Threat, and Sexual Abuse. As hypothesized, the adversity dimensions demonstrated some specificity in their associations with psychopathology symptoms. Deprivation was uniquely associated with the negative symptom dimension of psychosis (negative schizotypy and schizoid symptoms), Intrafamilial Adversity with schizotypal symptoms, and Threat with depression, anxiety, and psychosis-spectrum symptoms. No associations were found with the Sexual Abuse dimension. Finally, the cumulative risk index was associated with all the outcome measures.Conclusions: The findings support the use of both the empirically-derived adversity dimensions and the cumulative risk index and suggest that these approaches may facilitate different research objectives. This study contributes to our understanding of the complexity of childhood adversity and its links to different expressions of psychopathology.
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Affiliation(s)
- Alena Gizdic
- Departament de Psicología Clínica i de la Salut, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Tamara Sheinbaum
- Dirección de Investigaciones Epidemiológicas y Psicosociales, Instituto Nacional de Psiquiatría Ramón de la Fuente Muñiz, Mexico City, Mexico
| | - Thomas R Kwapil
- Department of Psychology, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Neus Barrantes-Vidal
- Departament de Psicología Clínica i de la Salut, Universitat Autònoma de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, Instituto de Salud Carlos III, Barcelona, Spain
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Kemp KC, Sperry SH, Hernández L, Barrantes-Vidal N, Kwapil TR. Affective dynamics in daily life are differentially expressed in positive, negative, and disorganized schizotypy. J Psychopathol Clin Sci 2023; 132:110-121. [PMID: 36548077 DOI: 10.1037/abn0000799] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
Schizotypy and schizophrenia are associated with disruptions in the experience of affect. Temporal patterns of affect, or affective dynamics, offer unique information about the expression of multidimensional schizophrenia-spectrum psychopathology. The present study employed experience sampling methodology to examine affective intensity, inertia, variability, reactivity, and instability in positive, negative, and disorganized schizotypy in nonclinically ascertained young adults (n = 275). As hypothesized, disorganized schizotypy demonstrated the most robust associations with affective dynamics and was characterized by elevated intensity, reactivity, and variability of negative affect. Disorganized schizotypy was also associated with instability of negative affect, but this relation was better accounted for by mean negative affect, which was elevated in disorganized schizotypy. Negative schizotypy was characterized by diminished intensity and variability of positive affect as expected, but was unassociated with affective inertia. Finally, as hypothesized, positive schizotypy was associated with elevated intensity and variability of negative affect at the bivariate level, but was unassociated with affective dynamics when including disorganized schizotypy in the model. These findings indicate that the schizotypy dimensions are differentiated by both mean levels and dynamics of affect, and that affective dynamics convey unique information about multidimensional schizotypy beyond mean levels of affect. The findings provide further support for the multidimensional model of schizotypy. (PsycInfo Database Record (c) 2023 APA, all rights reserved).
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Welhaf MS, Meier ME, Smeekens BA, Silvia PJ, Kwapil TR, Kane MJ. A "Goldilocks zone" for mind-wandering reports? A secondary data analysis of how few thought probes are enough for reliable and valid measurement. Behav Res Methods 2023; 55:327-347. [PMID: 35381956 DOI: 10.3758/s13428-021-01766-4] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/03/2021] [Indexed: 11/08/2022]
Abstract
Mind-wandering assessment relies heavily on the thought probe technique as a reliable and valid method to assess momentary task-unrelated thought (TUT), but there is little guidance available to help researchers decide how many probes to include within a task. Too few probes may lead to unreliable measurement, but too many probes might artificially disrupt normal thought flow and produce reactive effects. Is there a "Goldilocks zone" for how few thought probes can be used to reliably and validly assess individual differences in mind-wandering propensity? We address this question by reanalyzing two published datasets (Study 1, n = 541; Study 2, ns ≈ 260 per condition) in which thought probes were presented in multiple tasks. Our primary analyses randomly sampled probes in increments of two for each subject in each task. A series of confirmatory factor analyses for each probe "bin" size tested whether the latent correlations between TUT rate and theoretically relevant constructs like working memory capacity, attention-control ability, disorganized schizotypy, and retrospective self-reported mind wandering changed as more probes assessed the TUT rate. TUT rates were remarkably similar across increasing probe-bin sizes and zero-order correlations within and between tasks stabilized at 8-10 probes; moreover, TUT-rate correlations with other latent variables stabilized at about 8 thought probes. Our provisional recommendation (with caveats) is that researchers may use as few as 8 thought probes in prototypical cognitive tasks to gain reliable and valid information about individual differences in TUT rate.
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Affiliation(s)
- Matthew S Welhaf
- University of North Carolina at Greensboro, Greensboro, NC, 27412, USA.
| | | | | | - Paul J Silvia
- University of North Carolina at Greensboro, Greensboro, NC, 27412, USA
| | - Thomas R Kwapil
- University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Michael J Kane
- University of North Carolina at Greensboro, Greensboro, NC, 27412, USA.
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12
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Kemp KC, Kaczorowski JA, Burgin CJ, Raulin ML, Lynam DR, Sleep C, Miller JD, Barrantes-Vidal N, Kwapil TR. Association of Multidimensional Schizotypy with PID-5 Domains and Facets. J Pers Disord 2022; 36:680-700. [PMID: 36454161 DOI: 10.1521/pedi.2022.36.6.680] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/05/2022]
Abstract
The underlying vulnerability for schizophrenia-spectrum disorders is expressed across a continuum of clinical and subclinical symptoms referred to as schizotypy. Schizotypy is a multidimensional construct with positive, negative, and disorganized dimensions. The present study examined associations of positive, negative, and disorganized schizotypy with pathological personality traits and facets assessed by the Personality Inventory for DSM-5 (PID-5) in 1,342 young adults. As hypothesized, positive schizotypy was associated with the PID-5 psychoticism domain and facets, negative schizotypy was associated with the detachment domain and facets and the restricted affectivity facet, and disorganized schizotypy's strongest associations were with the distractibility and eccentricity facets and the negative affect domain. The PID-5 facets accounted for upwards of two thirds of the variance in each schizotypy dimension. The authors conclude by providing regression-based algorithms for computing positive, negative, and disorganized schizotypy scores based on the PID-5 facets.
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Affiliation(s)
- Kathryn C Kemp
- University of Illinois at Urbana-Champaign, Champaign, Illinois
| | | | | | | | | | | | | | | | - Thomas R Kwapil
- University of Illinois at Urbana-Champaign, Champaign, Illinois.,University of North Carolina at Greensboro, Greensboro, North Carolina
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13
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Kwapil TR, Edmundson MS, Hernández LM, Kemp KC, Rbeiz KS, Clark HE, Bathery AJ, Raulin ML, Barrantes-Vidal N. Schizotypal ambivalence is associated with schizophrenia-spectrum and borderline personality traits in young adults: Converging results from three interview studies. Journal of Research in Personality 2022. [DOI: 10.1016/j.jrp.2022.104312] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
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14
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Monsonet M, Rockwood NJ, Kwapil TR, Barrantes-Vidal N. Psychological Pathways to Paranoia and Psychotic-Like Experiences in Daily-Life: The Mediating Role of Distinct Affective Disturbances. Schizophr Bull 2022; 48:1053-1065. [PMID: 35759215 PMCID: PMC9434429 DOI: 10.1093/schbul/sbac071] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND AND HYPOTHESIS Influential models of psychosis indicate that the impact of putative causal factors on positive symptoms might be explained partly through affective disturbances. We aimed to investigate whether pathways from stress and self-esteem to positive symptoms, as well as reversal pathways from symptoms to stress and self-esteem, were mediated through specific affective disturbances across the extended psychosis phenotype. STUDY DESIGN Using experience sampling methodology, 178 participants (65 high-schizotypy, 74 at-risk mental state, and 39 first-episode psychosis) were assessed on levels of momentary stress, self-esteem, anxiety, sadness, psychotic-like experiences (PLE), and paranoia. Multilevel mediation models were fit to examine indirect effects of each of these pathways. Considering evidence of mediation, each indirect pathway will be combined in a single model to explore their relative contributions. STUDY RESULTS Anxiety, sadness, and self-esteem mediated the pathways from stress to PLE and paranoia in daily-life. In the pathway to paranoia, sadness, and self-esteem showed larger contributions than anxiety. Pathways from self-esteem to PLE and paranoia were mediated by anxiety and sadness, the later showing a larger contribution. Pathways from symptoms to stress, but not from symptoms to self-esteem, were differently explained by emotional states; sadness lost its mediating effect and anxiety was the most important mediator. Few differences across groups were found. CONCLUSIONS This study lends support to psychological models of psychosis that highlight the relevance of affective disturbances in the risk and expression of psychosis. Furthermore, specific influences of different negative emotional states were identified, which could enhance psychological treatments.
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Affiliation(s)
- Manel Monsonet
- Departament de Psicologia Clínica i de la Salut, Universitat Autònoma de Barcelona, Barcelona, Spain
| | | | - Thomas R Kwapil
- Department of Psychology, University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Neus Barrantes-Vidal
- To whom correspondence should be addressed; Departament de Psicologia Clínica i de la Salut, Facultat de Psicologia, Edifici B, Universitat Autònoma de Barcelona, 08193 Bellaterra (Cerdanyola del Vallès), Barcelona, Spain; tel: 34-93-581-38-64, fax: 34-93-581-21-25, e-mail:
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15
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Berson TR, Sperry SH, Walsh MA, Kwapil TR. A critical examination of multidimensionality within the Hypomanic Personality Scale. Compr Psychiatry 2022; 115:152306. [PMID: 35315343 DOI: 10.1016/j.comppsych.2022.152306] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 02/22/2022] [Accepted: 02/24/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND The Hypomanic Personality Scale (HPS) assesses bipolar spectrum psychopathology and risk for bipolar disorders. Despite the developers' intent to create a scale that provides a unitary score, several studies have examined whether the HPS has a multidimensional structure. These models have been unable to identify a replicable multidimensional structure, with models varying from fairly similar to entirely dissimilar, and have suffered from theoretical and methodological concerns. PROCEDURES We therefore examined the multidimensional structure of the HPS in a large undergraduate and adult sample (n = 5002). MAIN FINDINGS We failed to reproduce factors with equal congruence to those of previously published models. PRINCIPLE CONCLUSIONS We concluded that the HPS lacks factorial validity in previous research as a multidimensional measure of bipolar spectrum psychopathology. We further recommend the creation of a novel multidimensional assessment of bipolar spectrum psychopathology developed from a theoretically driven, comprehensive model, rather than examining a multidimensional model of a pre-existing measure, such as the HPS.
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Affiliation(s)
- Talia R Berson
- University of Illinois at Urbana-Champaign, United States of America.
| | - Sarah H Sperry
- University of Illinois at Urbana-Champaign, United States of America
| | - Molly A Walsh
- University of Illinois at Urbana-Champaign, United States of America
| | - Thomas R Kwapil
- University of Illinois at Urbana-Champaign, United States of America.
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16
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Rbeiz KS, Clark HE, Kemp KC, Bathery AJ, Monette MA, Barrantes-Vidal N, Kwapil TR. The association of multidimensional schizotypy with symptoms and impairment across racial groups. Personal Ment Health 2022; 16:79-89. [PMID: 34528403 DOI: 10.1002/pmh.1528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2021] [Revised: 08/23/2021] [Accepted: 09/01/2021] [Indexed: 11/12/2022]
Abstract
The assessment of schizotypy and schizophrenia-spectrum psychopathology has historically been adversely impacted by multiple forms of measurement bias, including racial bias. The Multidimensional Schizotypy Scale (MSS) was developed using modern scale construction methods to minimize measurement bias in the assessment of schizotypic traits. However, studies have not examined the validity of the measurement across different racial groups. The present study examined whether the associations of MSS positive, negative, and disorganized schizotypy subscales with interview-assessed ratings of functioning, schizophrenia-spectrum personality traits, and depressive disorders were generally comparable across nonclinically ascertained samples of Black (n = 46), Asian (n = 87), and White (n = 116) young adults. Consistent with previous findings, all three schizotypy subscales were associated with impairment and schizotypal and paranoid traits. Negative schizotypy was associated with schizoid traits, and disorganized schizotypy was associated with depressive disorders. These associations were comparable across the racial groups, supporting the use of the MSS in these groups. Culturally and empirically valid assessments are essential for providing accurate assessments across racial/ethnic groups and reducing the risk of overpathologizing people of color. The present findings support the cross-cultural validity of the MSS; however, future studies should expand upon these findings by including more diverse samples and longitudinal designs.
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Affiliation(s)
- Katrina S Rbeiz
- Department of Psychology, University of Illinois at Urbana-Champaign, Champaign, Illinois, USA
| | - Haley E Clark
- Department of Psychology, University of Illinois at Urbana-Champaign, Champaign, Illinois, USA
| | - Kathryn C Kemp
- Department of Psychology, University of Illinois at Urbana-Champaign, Champaign, Illinois, USA
| | - Alyssa J Bathery
- Department of Psychology, University of Illinois at Urbana-Champaign, Champaign, Illinois, USA
| | - Mahogany A Monette
- Department of Psychology, University of Illinois at Urbana-Champaign, Champaign, Illinois, USA
| | - Neus Barrantes-Vidal
- Departament de Psicologia Clínica i de la Salut, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Thomas R Kwapil
- Department of Psychology, University of Illinois at Urbana-Champaign, Champaign, Illinois, USA.,Department of Psychology, University of North Carolina at Greensboro, Greensboro, North Carolina, USA
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17
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Abstract
INTRODUCTION Although sleep disturbances are well documented in bipolar spectrum disorders (BSDs), significantly less research has examined whether these disturbances are present in those at risk for developing BSDs or with subsyndromal symptoms. The present study examined associations between risk for BSDs, as measured by the Hypomanic Personality Scale (HPS), and sleep assessed using experience sampling. We assessed whether intraindividual variability in sleep was associated with affect, cognition, and behavior in daily life and potential directionality of these relationships. METHODS 233 young adults oversampled for high scores on the HPS completed 14 days of experience sampling assessing total sleep time (TST), bed/rise time, sleep quality, affect (negative and positive affect), cognition (difficulty concentrating, racing thoughts), and behavior (impulsivity) in daily life. We used Dynamic Structural Equation Modeling (DSEM) to assess within-person links between sleep and bipolar spectrum psychopathology. RESULTS HPS scores were associated with less TST, later bedtime, and more variable TST and bedtime. Variability in TST was associated with negative affect, difficulty concentrating/racing thoughts, and impulsivity. Within-person decreases in sleep were associated with next day increases in negative affect, stress, difficulty concentrating, and racing thoughts. LIMITATIONS Measurement of sleep was limited. Future studies should examine both objective measures of sleep (e.g., actigraphy) and fragmentation in sleep. CONCLUSIONS Risk for BSD was associated with similar patterns of sleep disruptions as seen in BSDs. Important dynamic links between sleep and bipolar spectrum psychopathology emerged indicating that sleep is an important target for improving symptoms of BSDs in daily life.
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Affiliation(s)
- Sarah H Sperry
- Department of Psychology, University of Illinois at Urbana-Champaign, Champaign, Illinois.,Vanderbilt University Medical Center
| | - Thomas R Kwapil
- Department of Psychology, University of Illinois at Urbana-Champaign, Champaign, Illinois.,Department of Psychology, University of North Carolina at Greensboro, Greensboro, North Carolina
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18
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Tognin S, Richter A, Kempton MJ, Modinos G, Antoniades M, Azis M, Allen P, Bossong MG, Perez J, Pantelis C, Nelson B, Amminger P, Riecher-Rössler A, Barrantes-Vidal N, Krebs MO, Glenthøj B, Ruhrmann S, Sachs G, Rutten BPF, de Haan L, van der Gaag M, Valmaggia LR, McGuire P, Antoniades M, Pisani S, Modinos G, de Haan L, van der Gaag M, Velthorst E, Kraan TC, van Dam DS, Burger N, Nelson B, McGorry P, Amminger GP, Pantelis C, Politis A, Goodall J, Riecher-Rössler A, Borgwardt S, Studerus E, Bressan R, Gadelha A, Brietzke E, Asevedo G, Asevedo E, Zugman A, Barrantes-Vidal N, Domínguez-Martínez T, Racciopi A, Kwapil TR, Monsonet M, Hinojosa L, Kazes M, Daban C, Bourgin J, Gay O, Mam-Lam-Fook C, Krebs MO, Nordholm D, Randers L, Krakauer K, Glenthøj L, Glenthøj B, Nordentoft M, Ruhrmann S, Gebhard D, Arnhold J, Klosterkötter J, Sachs G, Lasser I, Winklbaur B, Aschauer H, Delespaul PA, Rutten BP, van Os J, Valmaggia LR, McGuire P. The Relationship Between Grey Matter Volume and Clinical and Functional Outcomes in People at Clinical High Risk for Psychosis. Schizophr Bull Open 2022; 3:sgac040. [PMID: 35903803 PMCID: PMC9309497 DOI: 10.1093/schizbullopen/sgac040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Objective To examine the association between baseline alterations in grey matter volume (GMV) and clinical and functional outcomes in people at clinical high risk (CHR) for psychosis. Methods 265 CHR individuals and 92 healthy controls were recruited as part of a prospective multi-center study. After a baseline assessment using magnetic resonance imaging (MRI), participants were followed for at least two years to determine clinical and functional outcomes, including transition to psychosis (according to the Comprehensive Assessment of an At Risk Mental State, CAARMS), level of functioning (according to the Global Assessment of Functioning), and symptomatic remission (according to the CAARMS). GMV was measured in selected cortical and subcortical regions of interest (ROI) based on previous studies (ie orbitofrontal gyrus, cingulate gyrus, gyrus rectus, inferior temporal gyrus, parahippocampal gyrus, striatum, and hippocampus). Using voxel-based morphometry, we analysed the relationship between GMV and clinical and functional outcomes. Results Within the CHR sample, a poor functional outcome (GAF < 65) was associated with relatively lower GMV in the right striatum at baseline (P < .047 after Family Wise Error correction). There were no significant associations between baseline GMV and either subsequent remission or transition to psychosis. Conclusions In CHR individuals, lower striatal GMV was associated with a poor level of overall functioning at follow-up. This finding was not related to effects of antipsychotic or antidepressant medication. The failure to replicate previous associations between GMV and later psychosis onset, despite studying a relatively large sample, is consistent with the findings of recent large-scale multi-center studies.
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Affiliation(s)
- Stefania Tognin
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Anja Richter
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Matthew J Kempton
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Gemma Modinos
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Mathilde Antoniades
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Matilda Azis
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Paul Allen
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Matthijs G Bossong
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Jesus Perez
- CAMEO Early Intervention in Psychosis Services, Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
| | - Christos Pantelis
- Department of Psychiatry, Melbourne Neuropsychiatry Centre, University of Melbourne & Melbourne Health, Carlton South, Victoria, Australia
| | | | | | | | - Neus Barrantes-Vidal
- Departament de Psicologia Clínica i de la Salut (Universitat Autònoma de Barcelona), Fundació Sanitària Sant Pere Claver (Spain), Center for Biomedical Research in Mental Health (CIBERSAM), Madrid, Spain
| | - Marie-Odile Krebs
- University of Paris, GHU-Paris, Sainte-Anne, C'JAAD, Hospitalo-Universitaire department SHU, Inserm U1266, Institut de Psychiatrie (CNRS 3557), Paris, France
| | - Birte Glenthøj
- Center for Neuropsychiatric Schizophrenia Research, CNSR, and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, Mental Health Services Capital Region of Denmark, Mental Health Center Glostrup, Glostrup, Denmark
| | - Stephan Ruhrmann
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital University of Cologne, Cologne, Germany
| | - Gabriele Sachs
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Bart P F Rutten
- Department of Psychiatry and Neuropsychology, Faculty of Health, Medicine and Life Sciences, School for Mental Health and Neuroscience (MHeNS), Maastricht University, Maastricht, The Netherlands
| | - Lieuwe de Haan
- Early Psychosis Department, Amsterdam UMC, Amsterdam, The Netherlands
| | - Mark van der Gaag
- Department of Clinical Psychology and Amsterdam Public Mental Health Research Institute, Faculty of Behavioural and Movement Sciences, VU University, Amsterdam, The Netherlands
| | | | - Lucia R Valmaggia
- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Philip McGuire
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
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- Department of Psychology, Institute of Psychiatry, Psychology & Neuroscience, King’s College London , UK
| | - Philip McGuire
- Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King’s College London , UK
- National Institute for Health Research (NIHR) Biomedical Research Centre (BRC) , UK
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19
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Kemp KC, Raulin ML, Burgin CJ, Barrantes-Vidal N, Kwapil TR. Associations of Multiple Measures of Openness to Experience with a Brief Questionnaire of Positive, Negative, and Disorganized Schizotypy. Journal of Individual Differences 2022. [DOI: 10.1027/1614-0001/a000348] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Abstract. The vulnerability for schizophrenia-spectrum disorders is expressed across a continuum of clinical and subclinical symptoms and impairment known as schizotypy. Schizotypy is a multidimensional construct with positive, negative, and disorganized dimensions. Openness to experience offers a useful personality domain for exploring multidimensional schizotypy. This study examined the factor structure of openness and its relation to schizotypy using the Multidimensional Schizotypy Scale-Brief (MSS-B) in a sample of 2,236 adults. Positive schizotypy was broadly associated with elevated openness and negative schizotypy was generally associated with diminished openness. Principal components analysis of 15 openness facets replicated the four-factor structure of openness including Fantasy/Feelings, Eccentricity, Nontraditionalism, and Ideas factors. All three schizotypy dimensions were associated with Eccentricity. Positive schizotypy was associated with Fantasy/Feelings, whereas negative schizotypy was inversely associated with Fantasy/Feelings. Results support the construct validity of the MSS-B, use of alternative openness measures in examining schizotypy, and the multidimensional structures of schizotypy and openness.
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Affiliation(s)
- Kathryn C. Kemp
- Department of Psychology, University of Illinois at Urbana-Champaign, IL, USA
| | | | - Chris J. Burgin
- Department of Counseling & Psychology, Tennessee Tech University, Cookeville, TN, USA
| | - Neus Barrantes-Vidal
- Departament de Psicologia Clínica i de la Salut, Universitat Autònoma de Barcelona, Spain
| | - Thomas R. Kwapil
- Department of Psychology, University of Illinois at Urbana-Champaign, IL, USA
- Department of Psychology, University of North Carolina at Greensboro, NC, USA
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20
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Monsonet M, Kwapil TR, Barrantes-Vidal N. A time-lagged study of predictors of paranoia and psychotic-like experiences in daily life across the schizotypy continuum. J Abnorm Psychol 2021; 131:98-108. [PMID: 34914404 DOI: 10.1037/abn0000726] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Leading theoretical models of psychosis implicate a wide range of psychological factors in the development of positive symptoms. Ambulatory assessment allows us to repeatedly assess people's mental experiences within and across days to explore putative moment-to-moment prospective relationships that impact the onset and exacerbation of positive symptoms. This study used experience sampling methodology to examine the putative temporal associations of both risk and protective factors (negative emotional states, stress, self-esteem, and social appraisals) with the experience of paranoia and other positive psychotic-like experiences (PLE) in daily-life. A combined sample of 178 participants including 65 high-schizotypy, 74 at-risk mental states for psychosis, and 39 first-episode psychosis individuals was assessed repeatedly over seven consecutive days. Sadness, anxiety, stress, and negative social appraisals predicted higher levels of subsequent paranoia and PLE. In contrast, self-esteem and subjective appraisals of social support and social closeness predicted lower levels of paranoia and PLE. Most findings did not vary across subclinical, at-risk, and clinical levels of psychosis expression. Results support psychological models of psychosis and provide new evidence to disentangle psychological factors involved in the mechanistic pathways to positive symptoms. The findings can help the design of ecological momentary interventions delivered in real-time aimed at buffering psychological mechanisms that promote psychotic symptoms and strengthening causal mechanisms that protect from the development of positive symptoms. Finally, findings suggest that highly similar psychological mechanisms are implicated in the development of psychotic experiences across nonclinical, subclinical, and clinical expressions of schizotypy. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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21
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Silvia PJ, Eddington KM, Maloney KH, Lunsford JM, Harper KL, Kwapil TR. Self-Report Measures of Anhedonia and Approach Motivation Weakly Correspond to Anhedonia and Depression Assessed via Clinical Interviews. Pers Individ Dif 2021; 179. [PMID: 33994609 DOI: 10.1016/j.paid.2021.110963] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Self-report scales are popular tools for measuring anhedonic experiences and motivational deficits, but how well do they reflect clinically significant anhedonia? Seventy-eight adults participated in face-to-face structured diagnostic interviews: 22 showed clinically significant anhedonia, and 18 met criteria for depression. Analyses of effect sizes comparing the anhedonia and depression groups to their respective controls found large effects, as expected, for measures of depressive symptoms, but surprisingly weak effect sizes (all less than d=.50) for measures of general, social, or physical anhedonia, behavioral activation, and anticipatory and consummatory pleasure. Measures of Neuroticism and Extraversion distinguished the anhedonic and depressed groups from the controls at least as well as measures of anhedonia and motivation. Taken together, the findings suggest that caution is necessary when extending self-report findings to populations with clinically significant symptoms.
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Affiliation(s)
- Paul J Silvia
- Department of Psychology, University of North Carolina at Greensboro
| | - Kari M Eddington
- Department of Psychology, University of North Carolina at Greensboro
| | | | - Jaimie M Lunsford
- Department of Psychology, University of North Carolina at Greensboro
| | - Kelly L Harper
- National Center for PTSD, Behavioral Science Division, VA Boston Healthcare System
| | - Thomas R Kwapil
- Department of Psychology, University of Illinois at Urbana-Champaign
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22
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Kwapil TR, Clark HE, Rbeiz KS, Bathery AJ, Kemp KC, Barrantes-Vidal N. Association of positive, negative, and disorganized schizotypy with cluster a, borderline, and avoidant personality disorders and traits. Personal Disord 2021; 13:182-191. [PMID: 33856836 DOI: 10.1037/per0000488] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The present study examined the associations of positive, negative, and disorganized schizotypy dimensions assessed by the Multidimensional Schizotypy Scale with 5 interview-rated personality disorder diagnoses and traits in 151 young adults. As hypothesized, all 3 schizotypy dimensions were associated with impaired functioning. Positive schizotypy was associated with schizotypal and borderline personality traits; negative schizotypy was associated with schizotypal, schizoid, paranoid, and avoidant personality traits; and disorganized schizotypy was associated with paranoid, borderline, and avoidant personality disorder traits. Negative schizotypy predicted broad diagnoses of Cluster A personality disorders. Both negative and disorganized schizotypy predicted the broad diagnosis of any of the 5 personality disorders. The study further examined the association of the schizotypy dimensions with the individual personality disorder criteria to better understand the overall associations. Given the common origins and high comorbidity, we examined whether the schizotypy dimensions explained the association of borderline and schizotypal personality disorder traits. Positive and disorganized schizotypy fully mediated the association between borderline and schizotypal traits. In summary, the study replicated and extended previous findings that the schizotypy dimensions are uniquely associated with personality disorders and traits, as well as impaired functioning, in young adults. The study also provided additional support for the construct validity of the Multidimensional Schizotypy Scale and for the use of psychometric assessment of schizotypy. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Hinojosa-Marqués L, Monsonet M, Kwapil TR, Barrantes-Vidal N. The impact of family environment on self-esteem and symptoms in early psychosis. PLoS One 2021; 16:e0249721. [PMID: 33819314 PMCID: PMC8021173 DOI: 10.1371/journal.pone.0249721] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2020] [Accepted: 03/23/2021] [Indexed: 11/18/2022] Open
Abstract
Expressed emotion (EE) and self-esteem (SE) have been implicated in the onset and development of paranoia and positive symptoms of psychosis. However, the impact of EE on patients’ SE and ultimately on symptoms in the early stages of psychosis is still not fully understood. The main objectives of this study were to examine whether: (1) patients’ SE mediated the effect of relatives’ EE on patients’ positive symptoms and paranoia; (2) patients’ perceived EE mediated the effect of relatives’ EE on patients’ SE; (3) patients’ SE mediated between patients’ perceived EE and patients’ symptomatology; and (4) patients’ perceived EE and patients’ SE serially mediated the effect of relatives’ EE on patients’ positive symptoms and paranoia. Incipient psychosis patients (at-risk mental states and first-episode of psychosis) and their respective relatives completed measures of EE, SE, and symptoms. Findings indicated that: (1) patients’ perceived EE mediated the link between relatives’ EE and patients’ negative, but not positive, SE; (2) patients’ negative SE mediated the effect of patients’ perceived EE on positive symptoms and paranoia; (3) the association of relatives’ EE with positive symptoms and paranoia was serially mediated by an increased level of patients’ perceived EE leading to increases in negative SE; (4) high levels of patients’ distress moderated the effect of relatives’ EE on symptoms through patients’ perceived EE and negative SE. Findings emphasize that patients’ SE is relevant for understanding how microsocial environmental factors impact formation and expression of positive symptoms and paranoia in early psychosis. They suggest that broader interventions for patients and their relatives aiming at improving family dynamics might also improve patients’ negative SE and symptoms.
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Affiliation(s)
- Lídia Hinojosa-Marqués
- Departament de Psicologia Clínica i de la Salut, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Manel Monsonet
- Departament de Psicologia Clínica i de la Salut, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Thomas R. Kwapil
- Department of Psychology, University of Illinois at Urbana-Champaign, Champaign, IL, United States of America
| | - Neus Barrantes-Vidal
- Departament de Psicologia Clínica i de la Salut, Universitat Autònoma de Barcelona, Barcelona, Spain
- Sant Pere Claver- Fundació Sanitària, Barcelona, Spain
- Centre for Biomedical Research on Mental Health (CIBERSAM), Madrid, Spain
- * E-mail:
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24
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Silvia PJ, McHone AN, Mironovová Z, Eddington KM, Harper KL, Sperry SH, Kwapil TR. RZ Interval as an Impedance Cardiography Indicator of Effort-Related Cardiac Sympathetic Activity. Appl Psychophysiol Biofeedback 2021; 46:83-90. [PMID: 33170410 PMCID: PMC7880868 DOI: 10.1007/s10484-020-09493-w] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/03/2020] [Indexed: 11/27/2022]
Abstract
Research on effort and motivation commonly assesses how the sympathetic branch of the autonomic nervous system affects the cardiovascular system. The cardiac pre-ejection period (PEP), assessed via impedance cardiography, is a common outcome, but assessing PEP requires identifying subtle points on cardiac waveforms. The present research examined the psychometric value of the RZ interval (RZ), which has recently been proposed as an indicator of sympathetic activity, for effort research. Also known as the initial systolic time interval (ISTI), RZ is the time (in ms) between the ECG R peak and the dZ/dt Z peak. Unlike PEP, RZ involves salient waveform points that are easily and reliably identified. Data from two experiments evaluated the suitability of RZ for effort paradigms and compared it to a popular automated PEP method. In Studies 1 (n = 89) and 2 (n = 71), participants completed a standard appetitive task in which each correct response earned a small amount of cash. As expected, incentives significantly affected PEP and RZ in both experiments. PEP and RZ were highly correlated (all rs ≥ 0.89), and RZ consistently yielded a larger effect size than PEP. In Study 3, a quantitative synthesis of the experiments indicated that the effect size of RZ's response to incentives (Hedges's g = 0.432 [0.310, 0.554]) was roughly 15% larger than PEP's effect size (g = 0.376 [0.256, 0.496]). RZ thus appears promising for future research on sympathetic aspects of effort-related cardiac activity.
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Affiliation(s)
- Paul J Silvia
- Department of Psychology, University of North Carolina at Greensboro, P.O. Box 26170, Greensboro, NC, 27402-6170, USA.
| | - Ashley N McHone
- Department of Psychology, University of North Carolina at Greensboro, P.O. Box 26170, Greensboro, NC, 27402-6170, USA
| | - Zuzana Mironovová
- Department of Psychology, University of North Carolina at Greensboro, P.O. Box 26170, Greensboro, NC, 27402-6170, USA
| | - Kari M Eddington
- Department of Psychology, University of North Carolina at Greensboro, P.O. Box 26170, Greensboro, NC, 27402-6170, USA
| | - Kelly L Harper
- Behavioral Science Division, VA Boston Healthcare System, National Center for PTSD, Boston, USA
| | - Sarah H Sperry
- Department of Psychology, University of Illinois at Urbana-Champaign, Champaign, USA
| | - Thomas R Kwapil
- Department of Psychology, University of Illinois at Urbana-Champaign, Champaign, USA
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25
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Sperry SH, Eckland NS, Kwapil TR. Emotional awareness, affective dysregulation, and bipolar spectrum psychopathology: A path analysis. Psychiatry Res 2021; 297:113739. [PMID: 33513486 DOI: 10.1016/j.psychres.2021.113739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Accepted: 01/15/2021] [Indexed: 10/22/2022]
Abstract
Affective dysregulation is present in those with subsyndromal symptoms of hypomania and mania and prospectively predicts the development of bipolar spectrum disorders. A crucial, understudied area related to the experience and regulation of emotion in this population is emotional awareness - emotional clarity (Clarity) and attention to emotion (Attention). We examined whether scores on the Hypomanic Personality Scale (HPS) were associated with deficits in emotional awareness and whether these deficits were associated with heightened intensity and instability of negative (NA) and positive affect (PA). Young adults (n=233), oversampled for high HPS scores completed self-reports and 14 days of experience sampling assessing high and low arousal NA and PA. HPS scores were associated with low Clarity and unassociated with Attention. High HPS scores were associated with greater high and low arousal NA intensity and instability only for those at low and mean levels of Attention. In contrast, there was a significant indirect association between HPS scores and intensity of high and low arousal NA and PA, as well as instability of high arousal NA, through low Clarity. Results highlighted that individual differences exist in the extent to which facets of emotional awareness differentially link scores on the HPS to emotional outcomes.
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Affiliation(s)
- Sarah H Sperry
- University of Illinois at Urbana-Champaign, Champaign, IL, USA.
| | | | - Thomas R Kwapil
- University of Illinois at Urbana-Champaign, Champaign, IL, USA
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26
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Monsonet M, Kwapil TR, Barrantes-Vidal N. Exploring the Psychometric Properties and the Factor Structure of the Calgary Depression Scale for Schizophrenia Across the Schizotypy Continuum. Assessment 2021; 29:686-699. [PMID: 33522263 DOI: 10.1177/1073191120986622] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
This study evaluated the psychometric properties and factor structure of the Calgary Depression Scale for Schizophrenia (CDSS) across different levels of the schizotypy continuum. A combined sample of high-schizotypy, at-risk mental states, and patients with first-episode psychosis was assessed for depression and other clinical and functional outcomes. Additionally, experience sampling methodology was used to assess depressive and psychotic-like experiences in daily life. The CDSS exhibited solid internal consistency, validity, and discrimination between depressed and nondepressed participants. Confirmatory factor analyses and the associations of the resulting factors with clinical and functional measures supported a two-factor structure that included general depression and guilt factors. Furthermore, both factors of the CDSS were differentially related to positive and negative symptoms of psychosis in daily life. The CDSS appears to have two underlying psychopathological dimensions and to be a reliable and valid measure for assessing depression across the schizotypy continuum.
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Affiliation(s)
- Manel Monsonet
- Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Barcelona, Spain
| | - Thomas R Kwapil
- University of Illinois at Urbana-Champaign, Champaign, IL, USA
| | - Neus Barrantes-Vidal
- Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Barcelona, Spain.,Sant Pere Claver-Fundació Sanitària, Barcelona, Spain.,Instituto de Salud Carlos III, Madrid, Spain
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27
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Silvia PJ, Eddington KM, Harper KL, Burgin CJ, Kwapil TR. Depressive Anhedonia and Creative Self‐concepts, Behaviors, and Achievements. J Creat Behav 2020. [DOI: 10.1002/jocb.482] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Paul J. Silvia
- Department of Psychology University of North Carolina at Greensboro
| | | | - Kelly L. Harper
- National Center for PTSD, Behavioral Science Division VA Boston Healthcare System
| | - Chris J. Burgin
- Department of Counseling and Psychology Tennessee Tech University
| | - Thomas R. Kwapil
- Department of Psychology University of North Carolina at Greensboro
- Department of Psychology University of Illinois at Urbana‐Champaign
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28
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Silvia PJ, Eddington KM, Harper KL, Burgin CJ, Kwapil TR. Appetitive Motivation in Depressive Anhedonia: Effects of Piece-Rate Cash Rewards on Cardiac and Behavioral Outcomes. Motiv Sci 2020; 6:259-265. [PMID: 33778105 PMCID: PMC7989634 DOI: 10.1037/mot0000151] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Deficits in self-regulation and motivation are central to depression. Using motivational intensity theory (Brehm & Self, 1989), the present research examined how depressive anhedonia influences effort during a piece-rate appetitive task. In piece-rate tasks, people can work at their own pace and are rewarded for each correct response, so they can gain rewards more quickly by expending more effort. A sample of community adults (n = 78) was evaluated for depressive anhedonia using a structured clinical interview, yielding depressive anhedonia and control groups. Participants completed a self-paced cognitive task, and each correct response yielded a cash reward (3 cents or 15 cents, manipulated within-person). Using impedance cardiography, effort-related physiological activity was assessed via the cardiac pre-ejection period (PEP). The results indicated lower reward responsiveness in the anhedonia group. Compared to the control group, the depressive anhedonia group showed significantly less baseline-to-task change in PEP, and they performed marginally worse on the task. The experiment supports the predictions made by applying motivational intensity theory to depression and offers a useful paradigm for evaluating anhedonic effects on effort while people are striving for appealing rewards.
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Affiliation(s)
- Paul J Silvia
- Department of Psychology, University of North Carolina at Greensboro
| | - Kari M Eddington
- Department of Psychology, University of North Carolina at Greensboro
| | - Kelly L Harper
- Department of Psychology, University of North Carolina at Greensboro
| | | | - Thomas R Kwapil
- Department of Psychology, University of North Carolina at Greensboro
- Department of Psychology, University of Illinois at Urbana-Champaign
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29
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Monsonet M, Kwapil TR, Barrantes-Vidal N. Deconstructing the relationships between self-esteem and paranoia in early psychosis: an experience sampling study. Br J Clin Psychol 2020; 59:503-523. [PMID: 32862467 PMCID: PMC7693052 DOI: 10.1111/bjc.12263] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 07/21/2020] [Indexed: 12/27/2022]
Abstract
Background No studies have examined the association between self‐esteem and paranoia developmentally across the critical stages of psychosis emergence. The present study fills this gap and extends previous research by examining how different dimensions, measures, and types of self‐esteem relate to daily‐life paranoia across at‐risk mental states for psychosis (ARMS) and first episode of psychosis (FEP) stages. Furthermore, the moderation effects of momentary anxiety and momentary perceived social support on the association between momentary self‐esteem and paranoia were examined. Design This study used a multilevel, cross‐sectional design. Methods One‐hundred and thirteen participants (74 ARMS and 39 FEP) were assessed repeatedly over seven consecutive days on levels of momentary paranoia, self‐esteem, anxiety and perceived social support using experience sampling methodology. Measures of trait and implicit self‐esteem were also collected. Results Global momentary and trait self‐esteem, and their positive and negative dimensions, were related to daily‐life paranoia in both ARMS and FEP groups. Conversely, implicit self‐esteem was not associated with daily‐life paranoia in either group. Anxiety negatively moderated the association between positive self‐esteem and lower paranoia, whereas both feeling close to others and feeling cared for by others strengthened this association. However, only feeling cared for by others moderated the association between negative self‐esteem and higher paranoia. Conclusions Different types, measures and dimensions of self‐esteem are differentially related to paranoia in early psychosis and are influenced by contextual factors in daily‐life. This yields a more complex picture of these associations and offers insights that might aid psychological interventions. Practitioner points Different measures (trait and momentary) and dimensions (positive and negative) of explicit self‐esteem are distinctly related to paranoia across risk and first‐episode stages of psychosis. Explicit, but not implicit, self‐esteem is associated with real‐life paranoia in incipient psychosis. Anxiety boosted the association of poor self‐esteem and paranoia ideation in daily‐life. Social closeness, but feeling cared for by others in particular, interacts with self‐esteem tempering the expression of paranoia in real life.
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Affiliation(s)
- Manel Monsonet
- Departament de Psicologia Clínica i de la Salut, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Thomas R Kwapil
- Department of Psychology, University of Illinois at Urbana-Champaign, USA
| | - Neus Barrantes-Vidal
- Departament de Psicologia Clínica i de la Salut, Universitat Autònoma de Barcelona, Barcelona, Spain.,Sant Pere Claver - Fundació Sanitària, Barcelona, Spain.,Centre for Biomedical Research Network on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Barcelona, Spain
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30
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Kemp KC, Bathery AJ, Barrantes-Vidal N, Kwapil TR. A brief questionnaire measure of multidimensional schizotypy predicts interview-rated symptoms and impairment. PLoS One 2020; 15:e0237614. [PMID: 32776979 PMCID: PMC7416934 DOI: 10.1371/journal.pone.0237614] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2020] [Accepted: 07/29/2020] [Indexed: 11/22/2022] Open
Abstract
The present study employed structured diagnostic interviews to assess the construct validity of the brief version of the Multidimensional Schizotypy Scale (MSS-B), which was developed to assess positive, negative, and disorganized dimensions of schizotypy. It was hypothesized that the MSS-B subscales would be associated with differential patterns of symptoms and impairment, comparable to findings for the full-length MSS. A total of 177 young adults completed structured diagnostic interviews assessing symptoms and impairment. As hypothesized, MSS-B positive schizotypy was significantly associated with interview ratings of positive (psychotic-like) symptoms, as well as schizotypal and paranoid personality disorder traits. MSS-B negative schizotypy was associated with interview ratings of negative symptoms, as well as schizoid, paranoid, and schizotypal traits. Furthermore, negative schizotypy predicted Cluster A personality disorder diagnoses. MSS-B disorganized schizotypy was associated with interview ratings of disorganized symptoms. All three schizotypy dimensions were associated with impaired functioning. This was the first study to evaluate the validity of the MSS-B using interview measures, and the pattern of findings for each MSS-B subscale was closely comparable to the findings for the full-length MSS. Contrary to our hypothesis, cannabis use was largely unassociated with psychotic-like symptoms and did not moderate the expression of the schizotypy dimensions. The MSS-B has good psychometric properties, high concordance with the full-length MSS, and good construct validity. Thus, it appears to be a promising brief alternative to traditional schizotypy measures.
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Affiliation(s)
- Kathryn C. Kemp
- Department of Psychology, University of Illinois at Urbana-Champaign, Champaign, IL, United States of America
| | - Alyssa J. Bathery
- Department of Psychology, University of Illinois at Urbana-Champaign, Champaign, IL, United States of America
| | - Neus Barrantes-Vidal
- Departament de Psicologia Clínica i de la Salut, Universitat Autònoma de Barcelona, Barcelona, Spain
- Sant Pere Claver–Fundació Sanitària, Barcelona, Spain
- CIBERSAM, Instituto de Salud Carlos III, Barcelona, Spain
| | - Thomas R. Kwapil
- Department of Psychology, University of Illinois at Urbana-Champaign, Champaign, IL, United States of America
- Department of Psychology, University of North Carolina at Greensboro, Greensboro, NC, United States of America
- * E-mail:
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31
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Sahakyan L, Meller T, Evermann U, Schmitt S, Pfarr JK, Sommer J, Kwapil TR, Nenadić I. Anterior vs Posterior Hippocampal Subfields in an Extended Psychosis Phenotype of Multidimensional Schizotypy in a Nonclinical Sample. Schizophr Bull 2020; 47:207-218. [PMID: 32691055 PMCID: PMC8208318 DOI: 10.1093/schbul/sbaa099] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Numerous studies have implicated involvement of the hippocampus in the etiology and expression of schizophrenia-spectrum psychopathology, and reduced hippocampal volume is one of the most robust brain abnormalities reported in schizophrenia. Recent studies indicate that early stages of schizophrenia are specifically characterized by reductions in anterior hippocampal volume; however, studies have not examined hippocampal volume reductions in subclinical schizotypy. The present study was the first to examine the associations of positive, negative, and disorganized schizotypy dimensions with hippocampal subfield volumes in a large sample (n = 195) of nonclinically ascertained young adults, phenotyped using the Multidimensional Schizotypy Scale (MSS). Hippocampal subfields were analyzed from high-resolution 3 Tesla structural magnetic resonance imaging scans testing anatomical models, including anterior vs posterior regions and the cornu ammonis (CA), dentate gyrus (DG), and subiculum subfields separately for the left and right hemispheres. We demonstrate differential spatial effects across anterior vs posterior hippocampus segments across different dimensions of the schizotypy risk phenotype. The interaction of negative and disorganized schizotypy robustly predicted left hemisphere volumetric reductions for the anterior and total hippocampus, and anterior CA and DG, and the largest reductions were seen in participants high in negative and disorganized schizotypy. These findings extend previous early psychosis studies and together with behavioral studies of hippocampal-related memory impairments provide the basis for a dimensional neurobiological hippocampal model of schizophrenia risk. Subtle hippocampal subfield volume reductions may be prevalent prior to the onset of detectable prodromal clinical symptoms of psychosis and play a role in the etiology and development of such conditions.
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Affiliation(s)
- Lili Sahakyan
- Department of Psychology and Beckman Institute for Advanced Science and
Technology, University of Illinois, Champaign, IL
| | - Tina Meller
- Cognitive Neuropsychiatry Lab, Department of Psychiatry and Psychotherapy,
Philipps-University Marburg, Marburg, Germany,Center for Mind, Brain, and Behavior (CMBB), Marburg, Germany
| | - Ulrika Evermann
- Cognitive Neuropsychiatry Lab, Department of Psychiatry and Psychotherapy,
Philipps-University Marburg, Marburg, Germany,Center for Mind, Brain, and Behavior (CMBB), Marburg, Germany
| | - Simon Schmitt
- Cognitive Neuropsychiatry Lab, Department of Psychiatry and Psychotherapy,
Philipps-University Marburg, Marburg, Germany,Center for Mind, Brain, and Behavior (CMBB), Marburg, Germany
| | - Julia-Katharina Pfarr
- Cognitive Neuropsychiatry Lab, Department of Psychiatry and Psychotherapy,
Philipps-University Marburg, Marburg, Germany,Center for Mind, Brain, and Behavior (CMBB), Marburg, Germany
| | - Jens Sommer
- Core Facility BrainImaging, School of Medicine, Philipps-University
Marburg, Marburg, Germany
| | - Thomas R Kwapil
- Department of Psychology and Beckman Institute for Advanced Science and
Technology, University of Illinois, Champaign, IL
| | - Igor Nenadić
- Cognitive Neuropsychiatry Lab, Department of Psychiatry and Psychotherapy,
Philipps-University Marburg, Marburg, Germany,Center for Mind, Brain, and Behavior (CMBB), Marburg, Germany,To whom correspondence should be addressed; Department of Psychiatry and
Psychotherapy, Philipps-University Marburg, Rudolf-Bultmann-Str. 8, 35039 Marburg,
Germany; tel: +49-6421-58-65002, fax: +49-6421-58-68939, e-mail:
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32
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Kemp KC, Burgin CJ, Raulin ML, Kwapil TR. Using multiple measures of openness to experience to capture positive, negative, and disorganized dimensions of schizotypy. ACTA ACUST UNITED AC 2020; 11:260-269. [DOI: 10.1037/per0000389] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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33
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Welhaf MS, Smeekens BA, Meier ME, Silvia PJ, Kwapil TR, Kane MJ. The Worst Performance Rule, or the Not-Best Performance Rule? Latent-Variable Analyses of Working Memory Capacity, Mind-Wandering Propensity, and Reaction Time. J Intell 2020; 8:jintelligence8020025. [PMID: 32498311 PMCID: PMC7713012 DOI: 10.3390/jintelligence8020025] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Revised: 05/05/2020] [Accepted: 05/15/2020] [Indexed: 11/16/2022] Open
Abstract
The worst performance rule (WPR) is a robust empirical finding reflecting that people's worst task performance shows numerically stronger correlations with cognitive ability than their average or best performance. However, recent meta-analytic work has proposed this be renamed the "not-best performance" rule because mean and worst performance seem to predict cognitive ability to similar degrees, with both predicting ability better than best performance. We re-analyzed data from a previously published latent-variable study to test for worst vs. not-best performance across a variety of reaction time tasks in relation to two cognitive ability constructs: working memory capacity (WMC) and propensity for task-unrelated thought (TUT). Using two methods of assessing worst performance-ranked-binning and ex-Gaussian-modeling approaches-we found evidence for both the worst and not-best performance rules. WMC followed the not-best performance rule (correlating equivalently with mean and longest response times (RTs)) but TUT propensity followed the worst performance rule (correlating more strongly with longest RTs). Additionally, we created a mini-multiverse following different outlier exclusion rules to test the robustness of our findings; our findings remained stable across the different multiverse iterations. We provisionally conclude that the worst performance rule may only arise in relation to cognitive abilities closely linked to (failures of) sustained attention.
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Affiliation(s)
- Matthew S. Welhaf
- Department of Psychology, University of North Carolina at Greensboro, Greensboro, NC 27402, USA; (M.S.W.); (B.A.S.); (P.J.S.)
| | - Bridget A. Smeekens
- Department of Psychology, University of North Carolina at Greensboro, Greensboro, NC 27402, USA; (M.S.W.); (B.A.S.); (P.J.S.)
| | - Matt E. Meier
- Department of Psychology, Western Carolina University, Cullowhee, NC 28723, USA;
| | - Paul J. Silvia
- Department of Psychology, University of North Carolina at Greensboro, Greensboro, NC 27402, USA; (M.S.W.); (B.A.S.); (P.J.S.)
| | - Thomas R. Kwapil
- Department of Psychology, University of Illinois at Urbana-Champaign, Champaign, IL 61820, USA;
| | - Michael J. Kane
- Department of Psychology, University of North Carolina at Greensboro, Greensboro, NC 27402, USA; (M.S.W.); (B.A.S.); (P.J.S.)
- Correspondence:
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34
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Silvia PJ, Eddington KM, Harper KL, Burgin CJ, Kwapil TR. Reward-Seeking Deficits in Major Depression: Unpacking Appetitive Task Performance with Ex-Gaussian Response Time Variability Analysis. Motiv Sci 2020; 7:219-224. [PMID: 34504900 DOI: 10.1037/mot0000208] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Major depressive disorder (MDD) has extensive ties to motivation, including impaired response time (RT) performance. Average RT, however, conflates response speed and variability, so RT differences can be complex. Because recent studies have shown inconsistent effects of MDD on RT variability, the present research sought to unpack RT performance with several key improvements: (1) a sample of adults (n = 78; 18 MDD, 60 Control) free of antidepressant medication; (2) an unambiguously appetitive task with appealing incentives at stake; and (3) ex-Gaussian RT modeling, which can unconfound speed and variability by estimating parameters for the mean (Mu) and standard deviation (Sigma) of the normal component and the mean of the exponential component (Tau). The groups had comparable Mu and Sigma parameters, but the MDD group had a significantly larger Tau, reflecting greater intraindividual RT variability. The findings suggest that MDD's effect on average RT can stem from greater intraindividual variability, not from overall slowness. Possible mechanisms, such as impaired executive processes in MDD and difficulties maintaining stable mental representations of incentives, are considered.
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Affiliation(s)
- Paul J Silvia
- Department of Psychology, University of North Carolina at Greensboro
| | - Kari M Eddington
- Department of Psychology, University of North Carolina at Greensboro
| | - Kelly L Harper
- National Center for PTSD, Behavioral Science Division, VA Boston Healthcare System
| | - Chris J Burgin
- Department of Counseling and Psychology, Tennessee Tech University
| | - Thomas R Kwapil
- Department of Psychology, University of North Carolina at Greensboro
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35
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Sperry SH, Kwapil TR. Bipolar spectrum psychopathology is associated with altered emotion dynamics across multiple timescales. Emotion 2020; 22:627-640. [DOI: 10.1037/emo0000759] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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36
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Kwapil TR, Kemp KC, Mielock A, Sperry SH, Chun CA, Gross GM, Barrantes-Vidal N. Association of multidimensional schizotypy with psychotic-like experiences, affect, and social functioning in daily life: Comparable findings across samples and schizotypy measures. J Abnorm Psychol 2020; 129:492-504. [PMID: 32250141 DOI: 10.1037/abn0000522] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The present study examined the associations of positive, negative, and disorganized schizotypy with psychotic-like experiences, affect, and social functioning in daily life using experience sampling methodology (ESM) in 2 samples (ns = 165 and 203) that employed different measures of schizotypy. Schizotypy is a useful framework for understanding schizophrenia-spectrum psychopathology, and ESM offers a powerful approach for assessing schizotypy in real-world settings. Participants were signaled 8 times daily for 7 days to complete ESM questionnaires. As hypothesized, positive schizotypy was robustly associated with psychotic-like experiences in daily life, whereas negative schizotypy was associated with negative experiences, diminished positive affect, and social disinterest in both samples. As expected, disorganized schizotypy was associated with disorganization in daily life. Furthermore, it was associated with increased negative affect and diminished positive affect. Thus, positive, negative, and disorganized schizotypy were associated with unique, hypothesized patterns of experiences in daily life, and the findings across the two samples and two schizotypy measures were strikingly consistent. Note that when disorganized schizotypy was not entered as a predictor in the 2 samples, disorganized experiences and negative affect in daily life were associated with positive schizotypy. However, when disorganized schizotypy was included as a predictor, these daily life experiences were associated with disorganized, not positive, schizotypy. This is similar to findings from interview and questionnaire studies that have simultaneously assessed positive, negative, and disorganized schizotypy. The findings support the construct validity of the multidimensional model of schizotypy and the importance of including disorganization in the conceptualization and assessment of schizotypy. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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Affiliation(s)
- Thomas R Kwapil
- Department of Psychology, University of Illinois at Urbana-Champaign
| | - Kathryn C Kemp
- Department of Psychology, University of Illinois at Urbana-Champaign
| | | | - Sarah H Sperry
- Department of Psychology, University of Illinois at Urbana-Champaign
| | | | | | - Neus Barrantes-Vidal
- Departament de Psicologia Clinica i de la Salut, Universitat Autonoma de Barcelona
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Cristóbal-Narváez P, Sheinbaum T, Rosa A, de Castro-Catala M, Domínguez-Martínez T, Kwapil TR, Barrantes-Vidal N. Interaction of both positive and negative daily-life experiences with FKBP5 haplotype on psychosis risk. Eur Psychiatry 2020; 63:e11. [PMID: 32093798 PMCID: PMC7315877 DOI: 10.1192/j.eurpsy.2019.4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023] Open
Abstract
Background. There is limited research on the interaction of both positive and negative daily-life environments with stress-related genetic variants on psychotic experiences (PEs) and negative affect (NA) across the extended psychosis phenotype. This study examined whether the FK506 binding protein 51 (FKBP5) variability moderates the association of positive and negative experiences in the moment with PEs and NA in participants with incipient psychosis and their nonclinical counterparts. Methods. A total of 233 nonclinical and 86 incipient psychosis participants were prompted for a 1-week period to assess their day-to-day experiences. Participants were genotyped for four FKBP5 single nucleotide polymorphisms (rs3800373, rs9296158, rs1360780, and rs9470080). Results. Multilevel analyses indicated that, unlike the risk haplotype, the protective FKBP5 haplotype moderated all the associations of positive experiences with diminished PEs and NA in incipient psychosis compared with nonclinical group. Conclusions. Participants with incipient psychosis showed symptomatic improvement when reporting positive appraisals in the interpersonal domain, which suggests that these act as a powerful coping mechanism. The fact that this occurred in daily-life underscores the clinical significance of this finding and pinpoints the importance of identifying protective mechanisms. In addition, results seem to concur with the vantage sensitivity model of gene–environment interaction, which poses that certain genetic variants may enhance the likelihood of benefiting from positive exposures.
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Affiliation(s)
- Paula Cristóbal-Narváez
- Parc Sanitari Sant Joan de Déu, Institut de Recerca Sant Joan de Déu, Barcelona, Spain.,Centre for Biomedical Research Network on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Tamara Sheinbaum
- Department of Psychology, University of Southern California, Los Angeles, California, USA
| | - Araceli Rosa
- Centre for Biomedical Research Network on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.,Secció de Zoologia i Antropologia, Departament de Biologia Evolutiva, Ecologia i Ciències Ambientals, Facultat de Biologia, Universitat de Barcelona (UB), Barcelona, Spain.,Institut de Biomedicina de la Universitat de Barcelona (IBUB), Barcelona, Spain
| | - Marta de Castro-Catala
- Secció de Zoologia i Antropologia, Departament de Biologia Evolutiva, Ecologia i Ciències Ambientals, Facultat de Biologia, Universitat de Barcelona (UB), Barcelona, Spain.,Institut de Biomedicina de la Universitat de Barcelona (IBUB), Barcelona, Spain
| | - Tecelli Domínguez-Martínez
- Centro de Investigación en Salud Mental Global, Dirección de Investigaciones Epidemiológicas y Psicosociales, Instituto Nacional de Psiquiatría 'Ramon de la Fuente Muñiz', México
| | - Thomas R Kwapil
- Department of Psychology, University of Illinois at Urbana-Champaign , Champaign, Illinois, USA
| | - Neus Barrantes-Vidal
- Centre for Biomedical Research Network on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.,Departament de Psicologia Clínica i de la Salut, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain.,Sant Pere Claver-Fundació Sanitària, Barcelona, Spain
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Kemp KC, Bathery AJ, Barrantes-Vidal N, Kwapil TR. Positive, Negative, and Disorganized Schizotypy Predict Differential Patterns of Interview-Rated Schizophrenia-Spectrum Symptoms and Impairment. Assessment 2020; 28:141-152. [DOI: 10.1177/1073191119900008] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The present study assessed the construct validity of the Multidimensional Schizotypy Scale (MSS). Specifically, it assessed the associations of the MSS positive, negative, and disorganized schizotypy subscales with interview-rated symptoms and impairment in 177 young adults. As hypothesized, the MSS positive schizotypy subscale was associated with interview-rated positive symptoms, and schizotypal and paranoid personality traits. Negative schizotypy was associated with interview-rated negative symptoms, and schizotypal and schizoid traits, and elevated rates of schizophrenia-spectrum personality disorders. Disorganized schizotypy was associated with disorganized symptoms and attentional deficits. All three subscales were associated with impaired functioning. This was the first study to evaluate the validity of the MSS using interview measures. The findings indicate that the schizotypy dimensions are associated with unique patterns of symptoms and impairment, and support the validity of the MSS.
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Affiliation(s)
| | | | - Neus Barrantes-Vidal
- Universitat Autònoma de Barcelona, Spain
- Sant Pere Claver–Fundació Sanitària, Barcelona, Spain
- Instituto de Salud Carlos III, Madrid, Spain
| | - Thomas R. Kwapil
- University of Illinois at Urbana–Champaign, IL, USA
- University of North Carolina at Greensboro, NC, USA
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Sperry SH, Walsh MA, Kwapil TR. Emotion dynamics concurrently and prospectively predict mood psychopathology. J Affect Disord 2020; 261:67-75. [PMID: 31600589 DOI: 10.1016/j.jad.2019.09.076] [Citation(s) in RCA: 35] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2019] [Revised: 09/04/2019] [Accepted: 09/30/2019] [Indexed: 12/22/2022]
Abstract
INTRODUCTION Altered emotion dynamics may represent a transdiagnostic risk factor for mood psychopathology. The present study examined whether altered emotion dynamics were associated with bipolar and depressive psychopathology concurrently and at a three-year follow-up. METHODS At baseline (n = 138), participants completed diagnostic interviews, questionnaires, and seven days of experience sampling assessments. Four emotion dynamics were computed for negative affect (NA) and positive affect (PA) - within-person variance (variability), mean square of successive differences and probability of acute change (instability), and autocorrelation (inertia). At the three-year follow-up, participants (n = 108) were re-assessed via interviews and questionnaires. RESULTS NA variability was associated with bipolar spectrum disorders at baseline and follow-up. NA instability predicted depressive symptoms and hypomanic personality at baseline, and bipolar spectrum disorders at the follow-up. NA inertia did not predict diagnoses or symptoms at either assessment. PA inertia predicted hyperthymic temperament at baseline but not follow-up. Notably, NA variability and instability predicted the development of new bipolar spectrum disorders at the follow-up. LIMITATIONS Consistent with the recruitment strategy and young age of the participants, only 50% had developed diagnosable psychopathology by the time of the follow-up assessment. CONCLUSIONS The present study provided a unique demonstration that altered emotion dynamics differentially predicted bipolar and depressive psychopathology concurrently and prospectively. Emotion dynamics are important to both digital phenotyping and mobile-based interventions as emotional instability offers a measurable risk factor that is identifiable prior to illness onset.
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Affiliation(s)
- Sarah H Sperry
- University of Illinois, Urbana-Champaign, IL, United States.
| | - Molly A Walsh
- University of North Carolina, Greensboro, NC, United States
| | - Thomas R Kwapil
- University of Illinois, Urbana-Champaign, IL, United States; University of North Carolina, Greensboro, NC, United States
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Hinojosa-Marqués L, Domínguez-Martínez T, Sheinbaum T, Cristóbal-Narváez P, Kwapil TR, Barrantes-Vidal N. Relatives' attachment anxiety mediates the association between perceived loss and expressed emotion in early psychosis. PLoS One 2019; 14:e0223425. [PMID: 31589647 PMCID: PMC6779271 DOI: 10.1371/journal.pone.0223425] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Accepted: 09/20/2019] [Indexed: 11/18/2022] Open
Abstract
A common reaction experienced by family members of patients with psychosis is grief for the loss of their healthy relative. Importantly, high levels of perceived loss have been related to the manifestation of high expressed emotion (EE), which includes the negative attitudes expressed by relatives toward an ill family member. However, the mechanisms underlying the relationship between relatives' perceived loss and EE attitudes in the early stages of psychosis are still not fully understood. In this regard, attachment theory has been suggested as a useful framework for understanding this link. The current study aimed to examine: (1) whether relatives' perceived loss was associated with relatives' EE dimensions (i.e., criticism and emotional over-involvement (EOI)), and (2) whether such associations were mediated by relatives' attachment dimensions (i.e., anxiety and avoidance). Seventy-eight relatives of patients with early psychosis completed the Mental Illness Version of the Texas Inventory of Grief for the assessment of loss reactions. Attachment dimensions and EE attitudes were assessed by the Psychosis Attachment Measure and the Family Questionnaire, respectively. Findings indicated that relatives' perceived loss was associated with EE dimensions. Relatives' attachment anxiety, but not avoidance, mediated the relationship of perceived loss with both criticism and EOI. Findings highlight the importance of examining the role of relatives' attachment characteristics for understanding how perceptions of loss might impact the manifestation of EE attitudes in the early stages of psychosis. Family interventions aimed at assisting relatives to improve their management of negative emotional reactions to loss are fundamental to prevent impairing loss reactions and the entrenchment of high-EE attitudes.
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Affiliation(s)
- Lídia Hinojosa-Marqués
- Departament de Psicologia Clínica i de la Salut, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Tecelli Domínguez-Martínez
- Centro de Investigación en Salud Mental Global, Dirección de Investigaciones Epidemiológicas y Psicosociales, Instituto Nacional de Psiquiatría “Ramón de la Fuente Muñiz”, Mexico City, Mexico
| | - Tamara Sheinbaum
- Department of Psychology, University of Southern California, Los Angeles, California, United States of America
| | - Paula Cristóbal-Narváez
- Unitat de Recerca, Docència i Innovació, Parc Sanitari Sant Joan de Déu, San Boi de Llobregat, Barcelona, Spain
| | - Thomas R. Kwapil
- Department of Psychology, University of Illinois at Urbana-Champaign, Champaign, Illinois, United States of America
| | - Neus Barrantes-Vidal
- Departament de Psicologia Clínica i de la Salut, Universitat Autònoma de Barcelona, Barcelona, Spain
- Sant Pere Claver- Fundació Sanitària, Barcelona, Spain
- Centre for Biomedical Research Network on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Barcelona, Spain
- * E-mail:
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Chun CA, Brugger P, Kwapil TR. Aberrant Salience Across Levels of Processing in Positive and Negative Schizotypy. Front Psychol 2019; 10:2073. [PMID: 31620045 PMCID: PMC6759779 DOI: 10.3389/fpsyg.2019.02073] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Accepted: 08/26/2019] [Indexed: 01/07/2023] Open
Abstract
Schizotypy is a multidimensional construct conceptualized as the expression of the underlying vulnerability for schizophrenia. Certain traits of positive schizotypy, such as odd beliefs, unusual perceptual experiences, suspiciousness, and referential thinking show associations with aberrant salience. Positive schizotypy may involve hyper-attribution of salience toward insignificant events, whereas negative schizotypy may involve hypo-attribution of salience, even toward important events. Attribution of salience is thought to involve dopamine-mediated processes, a mechanism that is disrupted in schizotypy; however, little is known about the cognitive processes potentially underlying salience attribution. The present study assessed the relationship between aberrant salience and latent inhibition (LI), as well as their associations with positive and negative schizotypy. Salience was measured at various stages of processing, including visual salience, attributions of salience to contingency illusions, and self-reported experience of salience. Schizotypy traits were differentially associated with self-reported aberrant salience experiences: positive schizotypy showed positive associations (β = 0.67, f2 = 0.82, large effect) and negative schizotypy showed inverse associations (β = -0.20, f2 = 0.07, small effect). However, neither schizotypy dimension was associated with visual salience, contingency illusions, or LI. Salience processing across perceptual, cognitive, and experiential levels likely involves different mechanisms, some of which may not show major disruption in subclinical manifestations of schizotypy.
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Affiliation(s)
- Charlotte A. Chun
- Department of Psychology, University of North Carolina at Greensboro, Greensboro, NC, United States
- Department of Psychology, Temple University, Philadelphia, PA, United States
| | - Peter Brugger
- Neuropsychology Unit, Department of Neurology, University Hospital Zürich, Zurich, Switzerland
| | - Thomas R. Kwapil
- Department of Psychology, University of North Carolina at Greensboro, Greensboro, NC, United States
- Department of Psychology, University of Illinois at Urbana-Champaign, Champaign, IL, United States
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Sahakyan L, Kwapil TR, Lo Y, Jiang L. Examination of relational memory in multidimensional schizotypy. Schizophr Res 2019; 211:36-43. [PMID: 31383512 DOI: 10.1016/j.schres.2019.07.031] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/06/2019] [Revised: 06/15/2019] [Accepted: 07/21/2019] [Indexed: 11/26/2022]
Abstract
We report the first study to examine the association of positive, negative, and disorganized schizotypy with relational memory. Relational memory refers to memory for relations among multiple elements of an experience, and this form of episodic memory is different from memory for individual elements themselves. Using a cornerstone task from the neurocognitive literature that is designed specifically to assess relational memory, we found that negative schizotypy, but not positive or disorganized schizotypy, is associated with impaired relational memory performance. The deficit was observed both in poorer accuracy and slower response time. The results demonstrate the importance of examining schizotypy as a multidimensional construct, and indicate that using a total schizotypy score both obscures the nature of the association with various dimensions of schizotypy and also explains only half of the variance accounted for by taking into consideration the multidimensionality of schizotypy. These results add to previous findings that negative schizotypy is associated with a wide array of episodic memory deficits linked to impairment in retrieval and processing of contextual information.
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Affiliation(s)
- Lili Sahakyan
- Department of Psychology, University of Illinois at Urbana-Champaign, United States of America; Beckman Institute for Advanced Science and Technology, University of Illinois at Urbana-Champaign, United States of America.
| | - Thomas R Kwapil
- Department of Psychology, University of Illinois at Urbana-Champaign, United States of America
| | - Yipei Lo
- Department of Psychology, University of Illinois at Urbana-Champaign, United States of America
| | - Lydia Jiang
- Department of Psychology, University of Illinois at Urbana-Champaign, United States of America
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Sahakyan L, Kwapil TR. Hits and false alarms in recognition memory show differential impairment in positive and negative schizotypy. J Abnorm Psychol 2019; 128:633-643. [PMID: 31318242 DOI: 10.1037/abn0000441] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The present study examined the extent to which positive and negative schizotypy are associated with impairment in recognition memory in 3 large samples of nonclinically ascertained adults (total n = 826). Schizophrenia is associated with a wide array of cognitive deficits, but the study of cognitive impairment in schizophrenia is confounded by generalized performance deficits related to symptoms and consequences of the disorder, and by failure to separately examine positive and negative symptom dimensions. Schizotypy provides a promising framework for examining these deficits relatively unconfounded by symptoms and sequelae of the disorder. The present study obtained recognition memory deficits in positive and negative schizotypy across verbal and figural stimuli in three different samples. Importantly, although discrimination accuracy is impaired across higher scores on both schizotypy dimensions, the mechanism of impairment differs across positive and negative schizotypy. Negative, but not positive, schizotypy was associated with impaired hit rates, whereas the false alarm rates remained unaffected. In contrast, positive, but not negative, schizotypy was associated with increased false alarm rates despite stable hit rates. The results are discussed from the perspective of a signal-detection theoretic model that accounts for negative schizotypy results through reduced signal mechanism, and accounts for positive schizotypy results through increased noise mechanism. These findings further support the utility of multidimensional schizotypy for assessing and understanding episodic memory impairment in the schizophrenia spectrum. (PsycINFO Database Record (c) 2019 APA, all rights reserved).
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Sahakyan L, Kwapil TR, Jiang L. Differential impairment of positive and negative schizotypy in list-method and item-method directed forgetting. J Exp Psychol Gen 2019; 149:368-381. [PMID: 31259599 DOI: 10.1037/xge0000645] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Schizophrenia is characterized by cognitive impairment and this impairment is expected to occur, albeit to a lesser degree, in people putatively at risk for schizophrenia. Two experiments assessed the relationship between directed forgetting (DF) and schizotypy, which is a multidimensional construct that reflects the expression of the underlying vulnerability for schizophrenia. Experiment 1 involved item-method DF and Experiment 2 involves list-method DF study. The schizotypy dimensions exhibited differential patterns of impairment across the 2 methods that suggest different underlying processes. Positive schizotypy showed impairment in item-method DF that was driven by reduced ability to forget forget-cued items, whereas performance on remember-cued items was unaffected in positive schizotypy. Despite the deficit in item-method DF, positive schizotypy participants showed preserved performance in list-method DF. The opposite pattern was found in negative schizotypy participants, who showed impairment in list-method DF, despite preserved performance in item-method DF. Negative schizotypy was previously associated with deficits in context processing and, consistent with context-change account of list-method DF, showed deficits in list-method DF task. Positive schizotypy is characterized by deficits in inhibitory control and, consistent with inhibitory account of item-method DF, showed deficits in item-method DF task. Collectively, these results (a) suggest that different DF methods involve different underlying mechanisms, (b) support the context-account of list-method DF and an inhibitory account of item-method DF, and (c) support the multidimensional model of schizotypy by showing differential impairment in positive and negative schizotypy across the 2 DF tasks. (PsycINFO Database Record (c) 2020 APA, all rights reserved).
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Sperry SH, Kwapil TR. Affective dynamics in bipolar spectrum psychopathology: Modeling inertia, reactivity, variability, and instability in daily life. J Affect Disord 2019; 251:195-204. [PMID: 30927580 DOI: 10.1016/j.jad.2019.01.053] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Revised: 12/18/2018] [Accepted: 01/22/2019] [Indexed: 01/12/2023]
Abstract
BACKGROUND Bipolar psychopathology is characterized by affective dysregulation independent of mood episodes. However, previous research has relied on laboratory-based emotion-eliciting tasks or retrospective questionnaires that do not take into account temporal dynamics of affect. Thus, the present study examined affective dynamics (reactivity, variability, instability, and inertia) of low and high arousal negative affect (NA) and positive affect (PA) in daily life in those at risk for bipolar psychopathology. METHODS Undergraduates (n = 135) completed the Hypomanic Personality Scale and experience sampling surveys assessing affective experiences 8 times daily for 7 days. RESULTS HPS scores were associated with greater reactivity of NA when experiencing negative or stressful events, variability of NA (high and low arousal) and PA (high arousal), and instability of NA and PA (high and low arousal) in daily life. HPS scores were associated with a high probability of acute increases in NA and PA and were unassociated with levels of inertia. LIMITATIONS This study only examined short-term dynamics over 7 days. Future studies should model both short- and long-term dynamics and whether these dynamics predict behavioral outcomes. CONCLUSIONS These results provide evidence that bipolar spectrum psychopathology is characterized by reactivity of NA as well as variability, instability, and acute increases in NA and PA in daily life over-and-above mean levels of affect. Modeling affective dynamics may provide context-relevant information about the course and trajectory of bipolar spectrum psychopathology and should facilitate the use of experience sampling methodology to study and intervene in mood lability in patients with bipolar disorders.
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Affiliation(s)
- Sarah H Sperry
- Department of Psychology, University of Illinois at Urbana-Champaign, Champaign, IL 61820, United States.
| | - Thomas R Kwapil
- Department of Psychology, University of Illinois at Urbana-Champaign, Champaign, IL 61820, United States; University of North Carolina at Greensboro, Greensboro, NC, United States
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Kemp KC, Gross GM, Kwapil TR. Psychometric Properties of the Multidimensional Schizotypy Scale and Multidimensional Schizotypy Scale–Brief: Item and Scale Test–Retest Reliability and Concordance of Original and Brief Forms. J Pers Assess 2019; 102:508-515. [DOI: 10.1080/00223891.2019.1591425] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Kathryn C. Kemp
- Department of Psychology, University of Illinois at Urbana-Champaign
| | - Georgina M. Gross
- VA Connecticut Healthcare System
- Yale University School of Medicine, Yale University
| | - Thomas R. Kwapil
- Department of Psychology, University of Illinois at Urbana-Champaign
- Department of Psychology, University of North Carolina at Greensboro
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Cohen JR, Thomsen KN, Racioppi A, Ballespi S, Sheinbaum T, Kwapil TR, Barrantes-Vidal N. Emerging Adulthood and Prospective Depression: A Simultaneous Test of Cumulative Risk Theories. J Youth Adolesc 2019; 48:1353-1364. [PMID: 30949796 DOI: 10.1007/s10964-019-01017-y] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Accepted: 03/27/2019] [Indexed: 12/30/2022]
Abstract
Past research indicates that a history of depression and exposure to abuse and neglect represent some of the most robust predictors of depression in emerging adults. However, studies rarely test the additive or interactive risk associated with these distinct risk factors. In response, the present study explored how these three risk factors (prior depression, abuse, and neglect) synergistically predicted prospective depressive symptoms in a sample of 214 emerging adults (Mage = 21.4 years; SDage = 2.4; 78% females). Subtypes of maltreatment and lifetime history of depression were assessed through semi-structured interviews, and depressive symptoms were assessed annually for three years via self-report measures. The results indicated that for both males and females, a lifetime history of depression, abuse, and neglect-exposure uniquely conferred risk for elevated depressive symptoms. Furthermore, the interaction between neglect and prior depression forecasted increasing depressive symptoms, and a history of abuse also predicted increasing depressive symptoms, but only in females. These findings are contextualized within extant developmental psychopathology theories, and translational implications for trauma-informed depression prevention efforts are discussed.
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Affiliation(s)
- Joseph R Cohen
- Department of Psychology, University of Illinois at Urbana-Champaign, Urbana, IL, USA.
| | - Kari N Thomsen
- Department of Psychology, University of Illinois at Urbana-Champaign, Urbana, IL, USA.,Department of Psychology, University of Massachusetts-Amherst, Amherst, MA, USA
| | - Anna Racioppi
- Departament de Psicologia Clínica i de la Salut, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Sergi Ballespi
- Departament de Psicologia Clínica i de la Salut, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Tamara Sheinbaum
- Department of Psychology, University of Southern California, Los Angeles, USA
| | - Thomas R Kwapil
- Department of Psychology, University of Illinois at Urbana-Champaign, Urbana, IL, USA.,Department of Psychology, University of North Carolina at Greensboro, Greensboro, USA
| | - Neus Barrantes-Vidal
- Departament de Psicologia Clínica i de la Salut, Universitat Autònoma de Barcelona, Barcelona, Spain.,Sant Pere Claver - Fundació Sanitària, Barcelona, Spain.,CIBERSAM, Instituto de Salud Carlos III, Madrid, Spain
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Christensen AP, Gross GM, Golino HF, Silvia PJ, Kwapil TR. Exploratory Graph Analysis of the Multidimensional Schizotypy Scale. Schizophr Res 2019; 206:43-51. [PMID: 30573405 DOI: 10.1016/j.schres.2018.12.018] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2018] [Revised: 09/06/2018] [Accepted: 12/09/2018] [Indexed: 10/27/2022]
Abstract
The present study examined the dimensional structure underlying the Multidimensional Schizotypy Scale (MSS) and its brief version (MSS-B). We used Exploratory Graph Analysis (EGA) to evaluate their dimensional structure in two large, independent samples (n = 6265 and n = 1000). We then used Confirmatory Factor Analysis (CFA) to compare the fit of the theoretical dimensions with the EGA dimensions. For the MSS, EGA identified four dimensions: positive schizotypy, two dimensions of negative schizotypy (affective and social anhedonia), and disorganized schizotypy. For the MSS-B, EGA identified three dimensions, which corresponded to the theorized positive, negative, and disorganized dimensions. Based on the MSS's EGA dimensions, we also estimated a four-factor model for the MSS-B. The CFA comparison found that the four-factor model fit significantly better than the theoretical three-factor model for both the MSS and MSS-B, providing support for the theoretical model and offering a more nuanced interpretation of the negative schizotypy factor. In addition, EGA also revealed that the positive and negative schizotypy dimensions of the MSS and MSS-B might be mediated by the disorganized dimension. Our findings offer new implications for future research on the MSS and MSS-B dimensions that may provide differential associations with interview and questionnaire measures.
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Affiliation(s)
- Alexander P Christensen
- Department of Psychology, University of North Carolina at Greensboro, Greensboro, NC 27402-6170, USA.
| | - Georgina M Gross
- U.S. Department of Veterans Affairs, VA Connecticut Healthcare System, West Haven, CT 06516, USA; Yale University School of Medicine, New Haven, CT 06150, USA
| | - Hudson F Golino
- Department of Psychology, University of Virginia, Charlottesville, VA 22904-440, USA
| | - Paul J Silvia
- Department of Psychology, University of North Carolina at Greensboro, Greensboro, NC 27402-6170, USA
| | - Thomas R Kwapil
- Department of Psychology, University of North Carolina at Greensboro, Greensboro, NC 27402-6170, USA; Department of Psychology, University of Illinois at Urbana-Champaign, Champaign, IL 61820-6983, USA
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Maillet D, Beaty RE, Jordano ML, Touron DR, Adnan A, Silvia PJ, Kwapil TR, Turner GR, Spreng RN, Kane MJ. Age-related differences in mind-wandering in daily life. Psychol Aging 2019; 33:643-653. [PMID: 29902056 DOI: 10.1037/pag0000260] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
In recent years, several laboratory studies have indicated that healthy older adults exhibit a reduction in mind-wandering frequency compared with young adults. However, it is unclear if these findings extend to daily life settings. In the current study, using experience sampling over the course of a week in the daily life of 31 young and 20 older adults, we assessed age-related differences in: (a) mind-wandering frequency, (b) the relationship between affect and mind-wandering frequency, and (c) content of mind wandering. Older adults mind wandered less than young adults in daily life. Across age groups, negative affect was positively associated with mind-wandering occurrence. Finally, older adults reported that their thoughts were more pleasant, interesting, and clear compared with young adults, who had thoughts that were more dreamlike, novel, strange, and racing. Our results provide the first demonstration using thought sampling that older adults exhibit a reduction in mind-wandering frequency in daily life. Implications for current theories of age-related reductions in mind-wandering frequency are discussed. (PsycINFO Database Record
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Affiliation(s)
| | | | - Megan L Jordano
- Department of Psychology, University of North Carolina at Greensboro
| | - Dayna R Touron
- Department of Psychology, University of North Carolina at Greensboro
| | | | - Paul J Silvia
- Department of Psychology, University of North Carolina at Greensboro
| | - Thomas R Kwapil
- Department of Psychology, University of Illinois at Urbana-Champaign
| | | | | | - Michael J Kane
- Department of Psychology, University of North Carolina at Greensboro
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Chun CA, Ciceron L, Kwapil TR. A meta-analysis of context integration deficits across the schizotypy spectrum using AX-CPT and DPX tasks. J Abnorm Psychol 2019; 127:789-806. [PMID: 30431288 DOI: 10.1037/abn0000383] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Schizotypy and schizophrenia involve disrupted context integration (CI), the ability to assimilate internal and external information into coherent mental representations. Research has primarily examined patients with schizophrenia, with fewer studies assessing CI in schizotypy-spectrum groups. The literature shows overall CI deficits, but mixed results for specific performance patterns and associations with clinical symptoms. Furthermore, conclusions are limited by small samples and heterogeneity across studies. To examine CI deficits across the schizotypy spectrum using AX-Continuous Performance Task (CPT) and Dot Pattern Expectancy task (DPX) performance. Systematic review involved searching 4 databases and 12 journals, examining key references, and contacting 227 researchers for published and unpublished data. Search terms included AX-CPT/DPX/dot pattern expectancy task/CNTRACs/context* integration/context* processing and schizo*/prodromal/high risk/psychosis; context* and ultra high risk. Independent data from studies with diagnostically or psychometrically assessed schizotypy-spectrum groups and AX-CPT/DPX tasks with 10+ trials and 60+% AX trials were included. Articles were independently coded by two authors using predefined coding schemes with good agreement. Meta-analyses pooled outcomes using random-effects models. Forty-one studies met inclusion criteria. CI impairment was present across the schizotypy spectrum. CI deficits in schizophrenia were substantial and associated with disorganized and negative symptoms. Outcomes were comparable between patients with chronic and first-episode schizophrenia. At-risk groups demonstrated moderate CI impairment. Results were robust across task parameters and there was no evidence that reporting biases grossly impacted outcomes. Findings lend support to theories suggesting that CI is a stable vulnerability factor for schizophrenia. (PsycINFO Database Record (c) 2018 APA, all rights reserved).
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Affiliation(s)
- Charlotte A Chun
- Department of Psychology, University of North Carolina at Greensboro
| | | | - Thomas R Kwapil
- Department of Psychology, University of North Carolina at Greensboro
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