Metacognitive beliefs mediate the effect of emotional abuse on depressive and psychotic symptoms in severe mental disorders

2017 ◽  
Vol 47 (13) ◽  
pp. 2323-2333 ◽  
Author(s):  
T. Østefjells ◽  
J. U. Lystad ◽  
A. O. Berg ◽  
R. Hagen ◽  
R. Loewy ◽  
...  
Keyword(s):  
Emotional Abuse ◽  
Psychotic Disorders ◽  
Bipolar Disorders ◽  
Ordinary Least Squares ◽  
Psychotic Symptoms ◽  
Positive Symptoms ◽  
Moderate Amount ◽  
Metacognitive Beliefs ◽  
Early Trauma ◽  
The Relationship

BackgroundEarly trauma is linked to higher symptom levels in bipolar and psychotic disorders, but the translating mechanisms are not well understood. This study examines whether the relationship between early emotional abuse and depressive symptoms is mediated by metacognitive beliefs about thoughts being uncontrollable/dangerous, and whether this pathway extends to influence positive symptoms.MethodPatients (N= 261) with psychotic or bipolar disorders were assessed for early trauma experiences, metacognitive beliefs, and current depression/anxiety and positive symptoms. Mediation path analyses using ordinary least-squares regressions tested if the effect of early emotional abuse on depression/anxiety was mediated by metacognitive beliefs, and if the effect of early emotional abuse on positive symptoms was mediated by metacognitive beliefs and depression/anxiety.ResultsMetacognitive beliefs about thoughts being uncontrollable/dangerous significantly mediated the relationship between early emotional abuse and depression/anxiety. Metacognitive beliefs and depression/anxiety significantly mediated the relationship between early emotional abuse and positive symptoms. The models explained a moderate amount of the variance in symptoms (R2= 0.21–0.29).ConclusionOur results indicate that early emotional abuse is relevant to depression/anxiety and positive symptoms in bipolar and psychotic disorders, and suggest that metacognitive beliefs could play a role in an affective pathway to psychosis. Metacognitive beliefs could be relevant treatment targets with regards to depression/anxiety and positive symptoms in bipolar and psychotic disorders.

Evaluation of positive and negative symptoms in schizophrenia

1986 ◽  
Vol 1 (2) ◽  
pp. 108-122 ◽  
Author(s):  
Nancy C. Andreasen ◽  
William M. Grove
Keyword(s):  
Negative Symptoms ◽  
The United States ◽  
Psychotic Symptoms ◽  
Positive Symptoms ◽  
University Of Iowa ◽  
Normal Functions ◽  
Subsequent Investigation ◽  
The University ◽  
The Relationship ◽  
Positive And Negative Symptoms

SummaryMost investigators concur that schizophrenia is probably a heterogeneous group of disorders that share the common features of psychotic symptoms, partial response to neuroleptics, and a relatively poor outcome. The subdivision of schizophrenia into two subtypes, positive versus negative, has achieved wide acceptance throughout the world during recent years. This distinction has heuristic and theoretical appeal because it unites phenomenology, pathophysiology, and etiology into a single comprehensive hypothesis.In spite of its wide appeal, the distinction has a number of problems. These include the failure to distinguish between symptom syndromes and diseases; failure to deal with the mixed patient; failure to take longitudinal course into account; and failure to address conceptually and methodologically the distinction between positive and negative symptoms.This paper focuses primarily on the conceptual basis for two instruments designed to measure positive and negative symptoms, the Scale for the Assessment of Negative Symptoms (SANS) and the Scale for the Assessment of Positive Symptoms (SAPS), originally described in 1982. Since their description, these scales have been used in a variety of other centers. These scales are based on the hypothesis that negative symptoms represent a deficit or diminution in normal psychological functions wliile positive symptoms represent an excess or distortion of normal functions. Reliability data are now available from Italy, Spain, and Japan which suggest that these scales can be used reliably in cultural settings outside the United States. The results of these studies are summarized in this paper. In addition, a replication study involving a new sample of 117 schizophrenics collected at the University of Iowa is described. In this second study of the SANS and SAPS, internal consistency is found to be quite high in the SANS. Thus negative symptoms appear to be more internally correlated with one another than are positive symptoms. The implications of this result are discussed. A principal components analysis is used to explore the relationship between positive and negative symptoms. While the study reported in 1982 suggested that positive and negative symptoms are negatively correlated, in the present study they appear to be uncorrelated. Overall, the results suggest that the SANS and SAPS are useful comprehensive instruments for the evaluation of positive and negative symptoms. The relationship between these symptoms and external validators such as cognitive functioning or CT scan abnormalities will be reported in a subsequent investigation.

scholarly journals Cognitive impairment as a risk factor for psychosis

2005 ◽  
Vol 7 (1) ◽  
pp. 31-38 ◽  
Keyword(s):  
Risk Factor ◽  
Cognitive Impairment ◽  
Cognitive Functioning ◽  
Brain Function ◽  
Negative Symptoms ◽  
Psychotic Disorders ◽  
Epidemiological Studies ◽  
Psychotic Symptoms ◽  
Future Research ◽  
The Relationship

Since the time of Kraepelin and Bleuler, it has been recognized that schizophrenia is associated with a profound and persistent cognitive impairment. This paper reviews the major clinical and epidemiological studies of cognitive functioning in schizophrenia and other psychotic disorders, and presents several possible models to explain the association between cognitive impairment and psychosis. Cognitive impairment is present in the majority of patients with schizophrenia, and, in some, it is already evident in the premorbid stages of the disorder. This cognitive impairment is not secondary to psychotic symptoms, negative symptoms, or socioeconomic status. Cognitive impairment can also be observed in nonpsychotic family members of psychotic patients. On the basis of this evidence, it has been proposed that abnormal cognitive functioning can be considered as a possible causal risk factor for psychosis. Recent studies assessing the relationship between genetic background, cognition, brain function, and schizophrenia are presented here as an outline for future research.

scholarly journals Negative and disorganized symptoms mediate the relationship between verbal learning and global functioning in adolescents with early-onset psychosis

2020 ◽  
Vol 29 (12) ◽  
pp. 1693-1703 ◽  
Author(s):  
Runar Elle Smelror ◽  
Bjørn Rishovd Rund ◽  
Vera Lonning ◽  
Kjetil Nordbø Jørgensen ◽  
Kirsten Wedervang-Resell ◽  
...  
Keyword(s):  
Early Onset ◽  
Psychotic Disorders ◽  
Five Factor Model ◽  
Verbal Learning ◽  
Psychotic Symptoms ◽  
Point Estimate ◽  
Neurocognitive Deficits ◽  
Global Functioning ◽  
Mediation Effects ◽  
The Relationship

Abstract Neurocognitive deficits are associated with impaired global functioning and psychotic symptoms. However, whether symptoms can mediate the relationship between neurocognition and global functioning in adolescent psychosis is unclear. Here, we investigated if symptoms assessed with the Positive And Negative Syndrome Scale (PANSS), mediated the relationship between neurocognitive performance and global functioning in adolescents with non-affective early-onset psychotic disorders (EOP). Sixty-one adolescent EOP patients (age 12–18 years) from 2 Norwegian clinical cohorts were included. Linear regression models were applied to investigate associations between neurocognitive domains from the MATRICS Consensus Cognitive Battery (MCCB) and global functioning. PANSS symptoms were analyzed using the Wallwork/Fortgang five-factor model. Using the INDIRECT macro for SPSS, mediation effects were tested using bootstrapping with 95% bias corrected confidence intervals. Verbal learning was positively associated with global functioning (P < 0.001) and negatively associated with the disorganized symptom factor (P = 0.002), controlling for age, sex and cohort. Testing of indirect effects, controlling for age, sex and cohort, showed that the Negative (point estimate = 1.56, 95% CI 0.22, 3.47) and Disorganized (point estimate = 1.24, 95% CI 0.05, 3.69) symptom factors significantly mediated the relationship between verbal learning and global functioning. We found that verbal learning, negative and disorganized symptoms influenced global functioning in adolescents with EOP, while reality-distorted positive symptoms did not. These results suggest that assessing these domains in EOP is helpful for planning treatment and rehabilitation programs focusing on functional outcome.

scholarly journals From Speech Illusions to Onset of Psychotic Disorder: Applying Network Analysis to an Experimental Measure of Aberrant Experiences

2020 ◽  
Vol 1 (1) ◽  
Author(s):  
Lindy-Lou Boyette ◽  
Adela-Maria Isvoranu ◽  
Frederike Schirmbeck ◽  
Eva Velthorst ◽  
Claudia J P Simons ◽  
...  
Keyword(s):  
Psychotic Disorder ◽  
Psychotic Disorders ◽  
Psychotic Symptoms ◽  
Positive Symptoms ◽  
Clinical High Risk ◽  
Cross Sectional ◽  
Affective Symptoms ◽  
The Eu

Abstract Aberrant perceptional experiences are a potential early marker of psychosis development. Earlier studies have found experimentally assessed speech illusions to be associated with positive symptoms in patients with psychotic disorders, but findings for attenuated symptoms in individuals without psychotic disorders have been inconsistent. Also, the role of affect is unclear. The aim of this study was to use the network approach to investigate how speech illusions relate to individual symptoms and onset of a psychotic disorder. We estimated a network model based on data from 289 Clinical High-Risk (CHR) subjects, participating in the EU-GEI project. The network structure depicts statistical associations between (affective and all) speech illusions, cross-sectional individual attenuated positive and affective symptoms, and transition to psychotic disorder after conditioning on all other variables in the network. Speech illusions were assessed with the White Noise Task, symptoms with the BPRS and transition during 24-month follow-up with the CAARMS. Affective, not all, speech illusions were found to be directly, albeit weakly, associated with hallucinatory experiences. Hallucinatory experiences, in turn, were associated with delusional ideation. Bizarre behavior was the only symptom in the network steadily predictive of transition. Affective symptoms were highly interrelated, with depression showing the highest overall strength of connections to and predictability by other symptoms. Both speech illusions and transition showed low overall predictability by symptoms. Our findings suggest that experimentally assessed speech illusions are not a mere consequence of psychotic symptoms or disorder, but that their single assessment is likely not useful for assessing transition risk.

Is change over time in psychotic symptoms related to social functioning?

2021 ◽  
pp. 002076402110392
Author(s):  
Sascha Kwakernaak ◽  
Wiepke Cahn ◽  
Richard Janssen ◽  
Keyword(s):  
Quality Of Life ◽  
Social Functioning ◽  
Repeated Measures ◽  
Psychotic Disorders ◽  
Medication Use ◽  
Psychotic Symptoms ◽  
Positive Symptoms ◽  
Needs For Care ◽  
Over Time

Objective: In psychosis, treatment often focuses on symptom reduction whereas social functioning is also essential. In this study, we investigate positive psychotic symptoms and medication use in relation to social functioning over a 3-year time-period in 531 patients diagnosed with psychosis. Furthermore, relations of positive symptoms with needs for care and quality of life were also investigated. Method: Using repeated measures analysis, changes were measured over time. Hereafter, mixed model analyses were performed to determine the associations of social functioning, needs for care, and quality of life with psychotic symptoms and patient characteristics. Finally, we assessed differences in symptoms and medication dose between those with an increase and those with a decrease in social functioning. Results: Patients significantly improved in social functioning, while psychotic symptoms increased. Improvement in social functioning was associated with younger age, higher IQ, and lower social functioning at T1, but not with positive symptoms. Also, improvement in social functioning was found to be related to a decrease in the dose of clozapine. Improvement in social functioning occurs despite worsening of positive symptoms. Conclusions: The findings suggest the need to further explore the relation between symptomatology, social functioning, and medication use. In the treatment of psychotic disorders, one should reconsider the strong focus on reducing psychotic symptoms. The current focus needs to shift much more toward improving functional outcome, especially when the patient expresses a desire for change in this respect.

Meditation-induced psychosis: a narrative review and individual patient data analysis

2019 ◽  
pp. 1-7 ◽  
Author(s):  
Pawan Sharma ◽  
Ananya Mahapatra ◽  
Rishab Gupta
Keyword(s):  
English Language ◽  
Psychotic Disorders ◽  
Case Reports ◽  
Psychotic Symptoms ◽  
Clinical Settings ◽  
Equal Distribution ◽  
Meditative Practice ◽  
History Of ◽  
Age Range ◽  
The Relationship

Background: Meditation is associated with health benefits; however, there are reports that it may trigger or exacerbate psychotic states. In this review, we aim to collate case reports of psychotic disorders occurring in association with meditative practice and to discuss the relationship between psychosis and meditation. Methodology: We performed case-based analysis of all the existing studies published in English language using PubMed, PsycINFO, Cochrane, Scopus, EMBASE, CINAHL and Google Scholar with the search terms; ‘Psychosis’ OR ‘Psychotic Symptoms’ OR ‘Schizophrenia’ AND ‘Meditation.’ Results: A total of 19 studies and 28 cases were included in the review. The patients described had an age range of 18–57 years; there was equal distribution of males and females. The diagnoses included acute psychosis in 14 cases, schizophrenia in 7 cases, mania with psychotic symptoms in 3 cases, and schizoaffective disorder in 1 case. The types of meditation described were Transcendent, Mindfulness, Buddhist Meditation like Qigong, Zen, and Theraveda, and others like Bikram yoga, Pranic Healing, and Hindustan Type meditation. Of the 28 cases reported, 14 patients had certain precipitating factors like insomnia, lack of food intake, history of mental illness, stress, and psychoactive substance use. Conclusion: There are case reports of psychotic disorder arising in association with meditative practice; however, it is difficult to attribute a causal relationship between the two. At the same time, there is a body of research describing the beneficial effect of meditative practice in clinical settings for patients with psychotic disorders. Appropriately designed studies are needed to further investigate the relationship between meditative practice and psychosis.

Duration of untreated psychosis: a critical examination of the concept and its importance

2001 ◽  
Vol 31 (3) ◽  
pp. 381-400 ◽  
Author(s):  
ROSS M. G. NORMAN ◽  
ASHOK K. MALLA
Keyword(s):  
Treatment Outcome ◽  
Negative Symptoms ◽  
Psychotic Disorders ◽  
Psychotic Symptoms ◽  
First Episode ◽  
Critical Examination ◽  
Duration Of Untreated Psychosis ◽  
Relationship Of ◽  
The Relationship

Background. The concept of duration of untreated psychosis (DUP) has recently attracted much interest because of its possible relationship to treatment outcome and implications for preventive efforts with reference to psychotic disorders, especially schizophrenia. In this paper we review critically the literature concerning the concept and its importance.Methods. Articles concerned with measuring DUP and those that have been suggested to provide indirect or direct evidence of the effect of DUP on treatment outcome are reviewed.Results. Evidence thus far suggests that DUP may be related to ease of reducing psychotic symptoms once treatment begins for first episode patients, but there is no evidence of a relationship to likelihood of relapse. There has been little investigation of the relationship of DUP to other long-term outcomes such as negative symptoms and cognitive functioning neither have the possible confounds of DUP been widely investigated or controlled.Conclusions. It is important that there should be more thorough investigations of DUP, its correlates, and the extent to which it does mediate any advantages of earlier intervention.

scholarly journals Efficacy of Cannabidiol for Δ-9-Tetrahydrocannabinol-Induced Psychotic Symptoms, Schizophrenia, and Cannabis Use Disorders: A Narrative Review

2021 ◽  
Vol 10 (6) ◽  
pp. 1303
Author(s):  
Francesco Bartoli ◽  
Ilaria Riboldi ◽  
Bianca Bachi ◽  
Angela Calabrese ◽  
Federico Moretti ◽  
...  
Keyword(s):  
Clinical Studies ◽  
Psychotic Disorders ◽  
Cannabis Use ◽  
Cochrane Library ◽  
Psychotic Symptoms ◽  
Positive Symptoms ◽  
Therapeutic Properties ◽  
Cannabis Use Disorders ◽  
Insight Into

Although cannabis’ major psychoactive component, Δ-9-tetrahydrocannabinol (THC), has been linked to both earlier onset and poorer outcomes of psychotic disorders, Cannabidiol (CBD) seems to have different pharmacological mechanisms and potential therapeutic properties. However, no clinical study has investigated CBD for the treatment of co-occurring psychotic and cannabis use disorders so far, even though its utility seems grounded in a plausible biological basis. The aim of this work is thus to provide an overview of available clinical studies evaluating the efficacy of CBD for psychotic symptoms induced by THC, schizophrenia, and cannabis use disorders. After searching for relevant studies in PubMed, Cochrane Library, and ClinicalTrials.gov, we included 10 clinical studies. Available evidence suggests that CBD may attenuate both psychotic-like symptoms induced by THC in healthy volunteers and positive symptoms in individuals with schizophrenia. In addition, preliminary data on the efficacy of CBD for cannabis use disorders show mixed findings. Evidence from ongoing clinical studies will provide insight into the possible role of CBD for treating psychotic and cannabis use disorders.

scholarly journals Aberrant uncertainty processing is linked to psychotic-like experiences, autistic traits and reflected in pupil dilation

2020 ◽  
Author(s):  
Isabel Kreis ◽  
Lei Zhang ◽  
Matthias Mittner ◽  
Leonard Syla ◽  
Claus Lamm ◽  
...  
Keyword(s):  
Psychotic Disorders ◽  
Computational Modelling ◽  
Autistic Traits ◽  
Learning Task ◽  
Pupil Dilation ◽  
Psychotic Symptoms ◽  
Belief Updating ◽  
The World ◽  
Healthy Sample ◽  
The Relationship

Misestimation of uncertainty and an increased perception of the world as volatile (i.e. unstable) have been linked to aberrant belief updating in autism and psychotic disorders. Pupil dilation tracks belief updating and volatility, but studies linking pupillometric data to autistic- or psychotic-like symptoms are scarce. Here we investigated the relationship between behavioral and pupillometric markers of subjective volatility (i.e. experience of the world as unstable), psychotic-like experiences, and autistic traits in a healthy sample with a probabilistic reversal learning task. Computational modelling revealed that participants with high psychotic-like experience scores overestimated volatility in low-volatile task periods and showed a decreased pupil response to stimuli that urged belief updating. For autistic-like traits, behavioral results indicated a reduced ability to differentiate between high- and low-risk trials. These findings provide new insights into the relationship between misestimation of uncertainties and autistic and psychotic symptoms.

scholarly journals Sleep disturbance mediates the link between childhood trauma and clinical outcome in severe mental disorders

2020 ◽  
pp. 1-10
Author(s):  
Jannicke Fjæra Laskemoen ◽  
Monica Aas ◽  
Anja Vaskinn ◽  
Akiah Ottesen Berg ◽  
Synve Hoffart Lunding ◽  
...  
Keyword(s):  
Mental Disorders ◽  
Childhood Trauma ◽  
Emotional Abuse ◽  
Sleep Disturbances ◽  
Clinical Symptoms ◽  
Ordinary Least Squares ◽  
Least Squares Regression ◽  
Severe Mental Disorders ◽  
The Relationship ◽  
Insomnia Symptoms

Abstract Background The experience of childhood trauma is linked to more severe symptoms and poorer functioning in severe mental disorders; however, the mechanisms behind this are poorly understood. We investigate the relationship between childhood trauma and sleep disturbances in severe mental disorders including the role of sleep disturbances in mediating the relationship between childhood trauma and the severity of clinical symptoms and poorer functioning. Methods In total, 766 participants with schizophrenia-spectrum (n = 418) or bipolar disorders (n = 348) were assessed with the Childhood Trauma Questionnaire. Sleep disturbances were assessed through the sleep items in the self-reported Inventory of Depressive Symptoms. Clinical symptoms and functioning were assessed with The Positive and Negative Syndrome Scale and the Global Assessment of Functioning Scale. Mediation analyses using ordinary least squares regression were conducted to test if sleep disturbances mediated the relationship between childhood trauma and the severity of clinical symptoms and poorer functioning. Results Symptoms of insomnia, but not hypersomnia or delayed sleep phase, were significantly more frequent in participants with childhood trauma experiences compared to those without. Physical abuse, emotional abuse, and emotional neglect were significantly associated with insomnia symptoms. Insomnia symptoms partly mediate the relationship between childhood trauma and the severity of positive and depressive/anxiety symptoms, in addition to poorer functioning. Conclusion We found frequent co-occurrence of childhood trauma history and current insomnia in severe mental disorders. Insomnia partly mediated the relationship between childhood trauma and the severity of clinical symptoms and functional impairment.

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