The Reality Distortion and Thought Disorganisation Dimensions

2018 ◽  
pp. 127-158
Author(s):  
Lorenzo Tarsitani ◽  
Annalisa Maraone
Keyword(s):  
Reality Distortion

scholarly journals The effect of the environment on symptom dimensions in the first episode of psychosis: a multilevel study

2014 ◽  
Vol 44 (11) ◽  
pp. 2419-2430 ◽  
Author(s):  
F. J. Oher ◽  
A. Demjaha ◽  
D. Jackson ◽  
C. Morgan ◽  
P. Dazzan ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Population Density ◽  
Negative Symptoms ◽  
Psychotic Disorders ◽  
Urban Environments ◽  
Psychotic Symptoms ◽  
First Episode ◽  
Multilevel Regression ◽  
Symptom Dimensions ◽  
Reality Distortion

BackgroundThe extent to which different symptom dimensions vary according to epidemiological factors associated with categorical definitions of first-episode psychosis (FEP) is unknown. We hypothesized that positive psychotic symptoms, including paranoid delusions and depressive symptoms, would be more prominent in more urban environments.MethodWe collected clinical and epidemiological data on 469 people with FEP (ICD-10 F10–F33) in two centres of the Aetiology and Ethnicity in Schizophrenia and Other Psychoses (AESOP) study: Southeast London and Nottinghamshire. We used multilevel regression models to examine neighbourhood-level and between-centre differences in five symptom dimensions (reality distortion, negative symptoms, manic symptoms, depressive symptoms and disorganization) underpinning Schedules for Clinical Assessment in Neuropsychiatry (SCAN) Item Group Checklist (IGC) symptoms. Delusions of persecution and reference, along with other individual IGC symptoms, were inspected for area-level variation.ResultsReality distortion [estimated effect size (EES) 0.15, 95% confidence interval (CI) 0.06–0.24] and depressive symptoms (EES 0.21, 95% CI 0.07–0.34) were elevated in people with FEP living in more urban Southeast London but disorganized symptomatology was lower (EES –0.06, 95% CI –0.10 to –0.02), after controlling for confounders. Delusions of persecution were not associated with increased neighbourhood population density [adjusted odds ratio (aOR) 1.01, 95% CI 0.83–1.23], although an effect was observed for delusions of reference (aOR 1.41, 95% CI 1.12–1.77). Hallucinatory symptoms showed consistent elevation in more densely populated neighbourhoods (aOR 1.32, 95% CI 1.09–1.61).ConclusionsIn people experiencing FEP, elevated levels of reality distortion and depressive symptoms were observed in more urban, densely populated neighbourhoods. No clear association was observed for paranoid delusions; hallucinations were consistently associated with increased population density. These results suggest that urban environments may affect the syndromal presentation of psychotic disorders.

The Symptoms of Chronic Schizophrenia

1987 ◽  
Vol 151 (2) ◽  
pp. 145-151 ◽  
Author(s):  
Peter F. Liddle
Keyword(s):  
Self Care ◽  
Chronic Schizophrenia ◽  
Personal Relationships ◽  
Spontaneous Movement ◽  
Schizophrenic Patients ◽  
Reality Distortion

The relationships between symptoms in 40 schizophrenic patients, selected for persistence of symptoms, were examined. The symptoms segregated into three syndromes: psychomotor poverty (poverty of speech, lack of spontaneous movement and various aspects of blunting of affect): disorganisation (inappropriate affect, poverty of content of speech, and disturbances of the form of thought): and reality distortion (particular types of delusions and hallucinations). Both the psychomotor poverty and disorganisation syndromes were associated with social and occupational impairment; in particular, the psychomotor poverty syndrome was associated with impairment of personal relationships, and the disorganisation syndrome with poor self-care and impersistence at work.

Neuropsychological correlates of syndromes in schizophrenia

1997 ◽  
Vol 170 (2) ◽  
pp. 134-139 ◽  
Author(s):  
Ross M. G. Norman ◽  
A. K. Malla ◽  
S. L. Morrison-Stewart ◽  
E. Helmes ◽  
P. C. Williamson ◽  
...  
Keyword(s):  
Prefrontal Cortex ◽  
Temporal Lobe ◽  
Neuropsychological Tests ◽  
Dorsolateral Prefrontal Cortex ◽  
Neuropsychological Performance ◽  
Left Temporal Lobe ◽  
Impaired Performance ◽  
Dorsolateral Prefrontal ◽  
Reality Distortion ◽  
The Brain

BackgroundOn the basis of Liddle's three-syndrome model of schizophrenia, it was predicted that: (1) symptoms of psychomotor poverty would be particularly correlated with impaired performance on neuropsychological tests likely to reflect functioning of the dorsolateral prefrontal cortex; (2) disorganisation would be particularly correlated with impaired performance on tests sensitive to medio-basal prefrontal functioning; and (3) reality distortion would be particularly correlated with measures sensitive to temporal lobe functioning.MethodThe above hypotheses were tested on 87 subjects with a confirmed diagnosis of schizophrenia. Patients' symptoms were scored for each of the three syndromes. Patients completed six neuropsychological tests designed to measure impairment in specific areas of the brain.ResultsThere was no support for the first two hypotheses. There was, however, evidence of a specific relationship between reality distortion and neuropsychological performance usually considered to be related to left temporal lobe functioning.ConclusionsAlthough not directly supporting the first two hypotheses; the results are, in general, consistent with there being different cortical-subcortical circuits associated with each of psychomotor poverty and disorganisation. Temporal lobe functioning appears to have particular significance for the reality distortion syndrome.

Source memory biases associated with reality distortion in schizophrenia

2003 ◽  
Vol 60 (1) ◽  
pp. 186-187 ◽  
Author(s):  
T. Woodward ◽  
J.C. Whitman ◽  
C.C. Cuttler ◽  
S. Moritz
Keyword(s):  
Source Memory ◽  
Memory Biases ◽  
Reality Distortion

Syndromes of Chronic Schizophrenia

1990 ◽  
Vol 157 (4) ◽  
pp. 558-561 ◽  
Author(s):  
Peter F. Liddle ◽  
Thomas R. E. Barnes
Keyword(s):  
Chronic Schizophrenia ◽  
Spontaneous Movement ◽  
Reality Distortion

Confirmation is reported of an earlier finding that the symptoms of patients with chronic schizophrenia segregate into three syndromes: psychomotor poverty (poverty of speech, flatness of affect, decreased spontaneous movement); disorganisation (disorders of the form of thought, inappropriate affect); and reality distortion (delusions and hallucinations).

scholarly journals The Psychomotor Disorders: Disorders of the Supervisory Mental Processes

1993 ◽  
Vol 6 (1) ◽  
pp. 5-14 ◽  
Author(s):  
P. F. Liddle
Keyword(s):  
Clinical Evidence ◽  
Specific Pattern ◽  
Mental Activity ◽  
Association Cortex ◽  
Mental Processes ◽  
Psychomotor Disorders ◽  
Subcortical Nuclei ◽  
Psychiatric Conditions ◽  
Differential Involvement ◽  
Reality Distortion

Clinical evidence suggests that three major patterns of disturbance of the supervisory mental processes that regulate self-generated mental activity can occur, either alone or together, in a variety of neurological and psychiatric conditions. Psychomotor poverty involves a diminished ability to initiate activity. Psychomotor disorganization reflects impaired ability to select between activities. Reality distortion, which is manifest as delusions and hallucinations, appears to reflect an abnormality of internal monitoring of mental activity. Each of these three syndromes is associated with a specific pattern of disordered function in multimodal association cortex and related subcortical nuclei. The evidence suggests that the neurotransmitter dopamine plays a major role in modulating the supervisory mental processes, though serotonin and noradrenaline are also implicated. While a particular neurotransmitter might have conflicting influences on different syndromes, the differential involvement of different anatomic sites and different neuroreceptor types offers the possibility of successful treatment even when different syndromes co-exist.

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