Personality traits, interpersonal problems and therapeutic alliance in early schizophrenia spectrum disorders

High levels of linguistic referential failures are associated with liability to develop schizophrenia-spectrum disorders, and it has been shown that these failures can differentiate healthy subjects, high-schizotypal and schizophrenics groups. Nevertheless, few investigations have focused on whether or not schizotypal traits in nonclinical populations can also impact linguistic reference. In Brazilian Portuguese, only one previous study (acceptability judgements task) had been conducted, and its results suggest association between schizotypal traits and a more rigid preference for assignment of specific readings to definite singular DPs. Here, we present another experimental study in Brazilian Portuguese, a comprehension task designed to examine possible effects of schizotypal personality traits on the interpretation of definite singular DPs. The findings, in line with the previous results, support the conclusion that schizotypy does affect the interpretation of definite singular DPs in Brazilian Portuguese. Together, these two experiments suggest that schizotypal personality traits impact the integration of linguistic contextual information into the semantic meaning of definite DPs. This is consistent with the general hypothesis that schizotypy, similarly to schizophrenia, is associated with pragmatic difficulties. Yet, our results emphasize that the impact of schizotypal traits on pragmatics can be observed even in healthy (nonclinical) speakers.

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A meta-analysis of client-therapist perspectives on the therapeutic alliance: Examining the moderating role of type of measurement and diagnosis

European Psychiatry ◽

10.1192/j.eurpsy.2020.67 ◽

2020 ◽

Vol 63 (1) ◽

Author(s):

Libby Igra ◽

Michal Lavidor ◽

Dana Atzil-Slonim ◽

Nitzan Arnon-Ribenfeld ◽

Steven de Jong ◽

...

Keyword(s):

Therapeutic Alliance ◽

Meta Analysis ◽

Schizophrenia Spectrum Disorders ◽

Schizophrenia Spectrum ◽

Spectrum Disorders ◽

Mean Differences ◽

Therapist Perspectives ◽

Therapist Perspective ◽

Moderating Role

Abstract Background: Clients and therapists often have different perspectives on their therapeutic alliance (TA), affecting the process and outcome of therapy. The aim of the present meta-analysis was to assess the mean differences between clients’ and therapists’ estimations of TA among clients with severe disturbances, while focusing on two potential moderators: client diagnosis and alliance instrument. Method: We conducted a systematic literature search of studies examining both client perspective and therapist perspective on TA in psychotherapy among people with schizophrenia spectrum disorders, personality disorders, and substance misuse disorders. We then analyzed the data using a random-effects meta-analytic model with Cohen’s d standardized mean effect size. Results: Heterogeneity analyses (k = 22, Cohen’s d = −.46, 95% confidence interval = .31–1.1) produced a significant Q-statistic (Q = 94.96) and indicated high heterogeneity, suggesting that moderator analyses were appropriate. Conclusions: Our findings show that the type of TA instrument moderates the agreement on TA between client and therapist, but there was no indication of the client’s diagnosis moderating the effect. The agreement between client and therapist estimations seems to be dependent on the instrument that is used to assess TA. Specific setting-related instruments seem to result in higher agreement between clients’ and therapists’ estimations than do more general instruments that are applied to assess TA.

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The influence of baseline symptoms and insight on the therapeutic alliance early in the treatment of schizophrenia

European Psychiatry ◽

10.1016/j.eurpsy.2008.12.015 ◽

2009 ◽

Vol 24 (4) ◽

pp. 259-267 ◽

Cited By ~ 55

Author(s):

Andreas Wittorf ◽

Ute Jakobi ◽

Andreas Bechdolf ◽

Bernhard Müller ◽

Gudrun Sartory ◽

...

Keyword(s):

Therapeutic Alliance ◽

Negative Symptoms ◽

Schizophrenia Spectrum Disorders ◽

Alliance Formation ◽

Treatment Patient ◽

Schizophrenia Spectrum ◽

Spectrum Disorders ◽

Positive And Negative Symptoms

AbstractBackgroundThe consistent association between therapeutic alliance and outcome underlines the importance of identifying factors which predict the development of a positive alliance. However, only few studies have examined the association between pretreatment characteristics and alliance formation in patients with schizophrenia.ObjectiveThe study examined whether symptoms and insight would predict the therapeutic alliance in psychotherapy of schizophrenia. Further, the associations and differences between patient and therapist alliance ratings were studied.MethodsEighty patients with schizophrenia spectrum disorders received manual-based psychotherapy. Assessment of symptoms and insight was conducted at baseline, and questionnaire-based alliance ratings were obtained three weeks into treatment. Patient and therapist alliance ratings were examined separately.ResultsPatient and therapist alliance ratings were not significantly correlated (r = 0.17). Patient ratings of the alliance were significantly higher than the ratings of their therapists (d = 0.73). More insight in psychosis significantly predicted higher patient ratings of the alliance. Less positive and negative symptoms were significant predictors of higher therapist alliance ratings.ConclusionThe findings indicate that symptoms and insight have an influence on the therapeutic alliance in the treatment of schizophrenia spectrum disorders. Patients' and therapists' perceptions of the alliance do not seem to demonstrate much convergence.

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Understanding the Influence of Personality Traits on Risk of Suicidal Behaviour in Schizophrenia Spectrum Disorders: A Systematic Review

Journal of Clinical Medicine ◽

10.3390/jcm10194604 ◽

2021 ◽

Vol 10 (19) ◽

pp. 4604

Author(s):

Manuel Canal-Rivero ◽

Rosa Ayesa-Arriola ◽

Esther Setién-Suero ◽

Benedicto Crespo-Facorro ◽

Celso Arango ◽

...

Keyword(s):

Systematic Review ◽

Personality Traits ◽

Suicidal Behaviour ◽

Selection Criteria ◽

Schizophrenia Spectrum Disorders ◽

Related Factors ◽

Schizotypal Personality ◽

Premature Deaths ◽

Schizophrenia Spectrum ◽

Spectrum Disorders

Risk of suicidal behaviour (SB) in schizophrenia spectrum disorders (SSD) is a major concern, particularly in early stages of the illness, when suicide accounts for a high number of premature deaths. Although some risk factors for SB in SSD are well understood, the extent to which personality traits may affect this risk remains unclear, which may have implications for prevention. We conducted a systematic review of previous studies indexed in MEDLINE, PsycINFO and Embase examining the relationship between personality traits and SB in samples of patients with SSD. Seven studies fulfilled predetermined selection criteria. Harm avoidance, passive-dependent, schizoid and schizotypal personality traits increased the risk of SB, while self-directedness, cooperativeness, excluding persistence and self-transcendence acted as protective factors. Although only seven studies were retrieved from three major databases after applying predetermined selection criteria, we found some evidence to support that personality issues may contribute to SB in patients with SSD. Personality traits may therefore become part of routine suicide risk assessment and interventions targeting these personality-related factors may contribute to prevention of SB in SSD.

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Schizophrenia–schizoaffective–bipolar spectra: an epistemological perspective

CNS Spectrums ◽

10.1017/s1092852919001408 ◽

2019 ◽

pp. 1-5

Author(s):

João Gama Marques ◽

Sílvia Ouakinin

Keyword(s):

Personality Traits ◽

Schizophrenia Spectrum Disorders ◽

Epistemological Perspective ◽

Schizophrenia Spectrum ◽

Spectrum Disorders ◽

Different Levels

AbstractFor decades clinicians and researchers have been thinking and writing about the spectrum of schizophrenia disorders. Indeed both Kraepelin and Bleuler believed in schizophrenia as a spectrum, both in a clinical (individual) and hereditary (family) continuum, from just some exquisite personality traits to unquestionable chronic and debilitating psychosis. Other authors would put the schizophrenia spectrum disorders on different levels of continuum: developmental, psychofunctional, existential, and genetic. Here, we would like to present an historical chronology for the schizophrenia–schizoaffective–bipolar spectra plus a tridimensional model for these spectra: the first axis for categories (affective versus nonaffective psychoses), the second axis for dimensions (personality versus full blown psychosis), and a third axis for biomarkers (remission versus relapse). We believe that without the schizophrenia–schizoaffective–bipolar spectra concept in our minds all our efforts will keep failing one the hardest quest: searching for biomarkers in schizophrenia and related disorders.

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