scholarly journals Increased face detection responses on the mooney faces test in people at clinical high risk for psychosis

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Steven M. Silverstein ◽  
Judy L. Thompson ◽  
James M. Gold ◽  
Jason Schiffman ◽  
James A. Waltz ◽  
...  
Keyword(s):  
High Risk ◽  
Face Perception ◽  
Self Report ◽  
Clinical State ◽  
Psychotic Episode ◽  
Control Group ◽  
Clinical High Risk ◽  
Number Of Faces ◽  
Clinical Measures ◽  
At Risk Mental State

AbstractIdentifying state-sensitive measures of perceptual and cognitive processes implicated in psychosis may allow for objective, earlier, and better monitoring of changes in mental status that are predictive of an impending psychotic episode, relative to traditional self-report-based clinical measures. To determine whether a measure of visual perception that has demonstrated sensitivity to the clinical state of schizophrenia in multiple prior studies is sensitive to features of the at-risk mental state, we examined differences between young people identified as being at clinical high risk for psychosis (CHR; n = 37) and non-psychiatric matched controls (n = 29) on the Mooney Faces Test (MFT). On each trial of the MFT, participants report whether they perceive a face in a degraded face image. The CHR group reported perceiving a greater number of faces in both upright and inverted MFT stimuli. Consistent with prior work, males reported more faces on the MFT than females in both conditions. However, the finding of greater reported face perception among CHR subjects was robustly observed in the female CHR group relative to the female control group. Among male CHR participants, greater reported face perception was related to increased perceptual abnormalities. These preliminary results are consistent with a small but growing literature suggesting that heightened perceptual sensitivity may characterize individuals at increased clinical risk for psychosis. Further studies are needed to determine the contributions of specific perceptual, cognitive, and motivational mechanisms to the findings.

scholarly journals Lab-Based and Self-Reported Indices of Fitness Show Lowered Fitness and Insight into Fitness in Individuals at Clinical High Risk for Psychosis

2020 ◽  
Author(s):  
Katherine S. F. Damme ◽  
Richard P. Sloan ◽  
Matthew N. Bartels ◽  
Alara Ozsan ◽  
Luz H. Ospina ◽  
...  
Keyword(s):  
High Risk ◽  
Healthy Volunteers ◽  
Negative Symptoms ◽  
Population Characteristics ◽  
Self Report ◽  
Positive Symptoms ◽  
Clinical High Risk ◽  
Laboratory Findings ◽  
Exercise Interventions ◽  
Intensity Of Exercise

AbstractIntroductionExercise is a promising intervention for clinical high-risk for psychosis (CHR) populations, who have attenuated positive symptoms, but evidence suggests that these youth may require tailored exercise interventions. Presently, the scope of the problem is unknown, as these youth may not be reliable reporters on fitness. This issue is compounded by the fact that there have been no investigations that utilized a formal fitness assessment in this critical population. The present study aims to determine the level of fitness in CHR youth with lab-based measures, test how effectively self-report measures characterize objective fitness indices, and explore clinical factors that may be interrupting reliable self-report-an important tool if these interventions are to be taken to scale.MethodsForty CHR individuals completed an exercise survey and lab-based indices of fitness (i.e., VO2max and BMI). Forty healthy volunteers completed lab indices of fitness and a structured clinical interview ruling out the presence of psychiatric illness.ResultsCHR youth showed greater BMI and lower VO2max compared to healthy volunteers. In the CHR group, abstract self-report items (perceived fitness) did not reflect lab indices of fitness, whereas specific exercise behaviors (intensity of exercise) showed stronger correlations with laboratory-based fitness measurements. Exploratory analyses suggested that positive symptoms involving grandiosity, and negative symptoms such as avolition, correlated with discrepancy between self-perception and laboratory findings of fitness.DiscussionResults suggest that CHR individuals are less objectively fit than matched controls, and that it will be important to consider unique population characteristics when weighing self-report data.

Predictors of transition to psychosis in individuals at clinical high-risk for psychosis

2017 ◽  
Vol 41 (S1) ◽  
pp. s838-s838
Author(s):  
M. Skuhareuskaya ◽  
O. Skugarevsky
Keyword(s):  
High Risk ◽  
Visual Memory ◽  
Negative Symptoms ◽  
Cox Regression ◽  
Neuropsychological Test ◽  
Psychotic Episode ◽  
Clinical High Risk ◽  
Basic Symptoms ◽  
Role Function ◽  
Thought Disorders

ObjectiveClinical high risk (CHR) for psychosis state is characterized by presence of potentially prodromal for schizophrenia symptoms. The aim of this study was to assess the predictors of transition to first psychotic episode.MethodsThe study included 123 CHR subjects. All the subjects were characterized by the presence of one of the group of criteria: (1) UHR criteria, (2) basic symptoms criteria and (3) negative symptoms and formal thought disorders (FTD). The presence of FTD in clinical high-risk individuals was assessed with methods of experimental pathopsychology. The mean length of follow-up was 26 months (SD 18). All subjects were males, mean age = 20.2 (SD: 2.1). We examined the subjects’ performance using the Cambridge automated neuropsychological test battery. We applied survival analyses to determine associations between a transition to psychosis and sociodemographic, clinical and neurocognitive parameters. To determine which items are the best predictors, Cox regression analyses were applied.ResultsThe psychosis developed in 39 subjects (31.7%). Global assessment of functioning, positive symptoms, blunted affect, social isolation, impaired role function, disorganizing/stigmatizing behavior, basic symptoms (thought pressure, unstable ideas of reference), neurocognitive parameters (visual memory and new learning, decision making, executive function) significantly influenced the transition to psychosis. A prediction model was developed and included unusual thought content (Wald = 12.386, P < 0.0001, HR = 2.996), perceptual abnormalities (Wald = 4.777, P = 0.029, HR = 1.43) and impaired role function (Wald = 1.425, P < 0.028, HR = 4.157).ConclusionClinical measures are important predictors for transition to psychosis in high-risk individuals.Disclosure of interestThe authors have not supplied their declaration of competing interest.

HIV-risk behaviour and knowledge about HIV/AIDS among patients with schizophrenia

1999 ◽  
Vol 29 (1) ◽  
pp. 171-179 ◽  
Author(s):  
L. GRASSI ◽  
M. PAVANATI ◽  
R. CARDELLI ◽  
S. FERRI ◽  
L. PERON
Keyword(s):  
High Risk ◽  
Hiv Infection ◽  
Sexual Activity ◽  
Hiv Risk ◽  
Psychiatric Patients ◽  
Risk Behaviour ◽  
Unprotected Sex ◽  
Self Report ◽  
Control Group ◽  
Hiv Aids

Background. Recent literature has demonstrated that psychiatric patients, particularly those with a diagnosis of schizophrenia, may be at high risk for HIV infection. In fact, HIV-risk behaviour, such as intravenous drug with sharing needles, promiscuity associated with unprotected sex and high-risk sexual activity after using drugs has been reported by a substantial proportion of mentally ill patients.Methods. In order to examine this problem in Italy, HIV-risk taking behaviour and knowledge about HIV/AIDS was investigated among 91 schizophrenic patients by using two self-report questionnaires (HIV-Risk Behaviour Questionnaire; AIDS-Risk Behaviour Knowledge Test).Results. One-third of the patients reported having been tested for HIV infection and one tested seropositive (prevalence 3·4%). A high proportion of patients reported HIV-risk behaviour, such as injected drugs use (22·4%) and engaging in high risk sexual activity (e.g. multiple partners, 58%; prostitutes, 45%; occasional partners, 37%). Condoms were ‘never used’ by 41% of the patients and ‘almost never used’ by another 25%. In spite of these behaviours, 65% reported no concern of HIV infection. Knowledge about AIDS was lower among psychiatric patients than a healthy control group. Patients with long-lasting illness and numerous psychiatric admissions were less acknowledgeable about HIV infection. Certain misconceptions on HIV transmission were related to HIV risk behaviour.Conclusions. These results indicate the urgent need for HIV educational programmes within mental health community-care settings.

scholarly journals Potentially important periods of change in the development of social and role functioning in youth at clinical high risk for psychosis

2017 ◽  
Vol 30 (1) ◽  
pp. 39-47 ◽  
Author(s):  
Eva Velthorst ◽  
Jamie Zinberg ◽  
Jean Addington ◽  
Kristin S. Cadenhead ◽  
Tyrone D. Cannon ◽  
...  
Keyword(s):  
High Risk ◽  
Mixed Model ◽  
Daily Functioning ◽  
Control Group ◽  
Clinical High Risk ◽  
Role Functioning ◽  
Age Related ◽  
Healthy Control ◽  
Over Time

AbstractThe developmental course of daily functioning prior to first psychosis-onset remains poorly understood. This study explored age-related periods of change in social and role functioning. The longitudinal study included youth (aged 12–23, mean follow-up years = 1.19) at clinical high risk (CHR) for psychosis (converters [CHR-C], n = 83; nonconverters [CHR-NC], n = 275) and a healthy control group (n = 164). Mixed-model analyses were performed to determine age-related differences in social and role functioning. We limited our analyses to functioning before psychosis conversion; thus, data of CHR-C participants gathered after psychosis onset were excluded. In controls, social and role functioning improved over time. From at least age 12, functioning in CHR was poorer than in controls, and this lag persisted over time. Between ages 15 and 18, social functioning in CHR-C stagnated and diverged from that of CHR-NC, who continued to improve (p = .001). Subsequently, CHR-C lagged behind in improvement between ages 21 and 23, further distinguishing them from CHR-NC (p < .001). A similar period of stagnation was apparent for role functioning, but to a lesser extent (p = .007). The results remained consistent when we accounted for the time to conversion. Our findings suggest that CHR-C start lagging behind CHR-NC in social and role functioning in adolescence, followed by a period of further stagnation in adulthood.

scholarly journals S27. EXAMINING DISCREPANCIES BETWEEN SELF-REPORT AND CLINICIAN-RATED ASSESSMENTS OF PSYCHOSIS RISK: DOES INTERNALIZED STIGMA MATTER?

2020 ◽  
Vol 46 (Supplement_1) ◽  
pp. S41-S41
Author(s):  
LeeAnn Shan ◽  
Zachary B Millman ◽  
Joseph DeLuca ◽  
Mallory J Klaunig ◽  
Pamela Rakhshan Rouhakhtar ◽  
...  
Keyword(s):  
Mental Health ◽  
High Risk ◽  
Help Seeking ◽  
Mental Health Problems ◽  
Structured Interview ◽  
Self Report ◽  
Internalized Stigma ◽  
Clinical High Risk ◽  
Negative Stereotypes ◽  
Psychosis Risk

Abstract Background Psychosis is one of the most highly stigmatized mental health conditions (Thornicroft et al., 2009). Compared to those with other mental health concerns, people diagnosed with schizophrenia spectrum disorders are more likely to be perceived by others as dangerous, violent, and unpredictable. As a result, they are often socially marginalized and discriminated against (Crisp et al., 2000; Martin et al., 2007). Individuals at clinical high risk (CHR) for psychosis may be at lower risk for experiencing public stigma, given that their symptoms are often less outwardly visible at this early stage of illness. However, evidence suggests that those at CHR experience high levels of self-stigma, as they may internalize negative stereotypes related to psychosis (Yang et al., 2010; Yang et al., 2015). Internalized stigma can negatively impact help-seeking behavior and has been associated with lower self-esteem and the underreporting of mental health symptoms (Corrigan, 2004; Corrigan, 2007; Saporito, Ryan, & Teachman, 2011; Rüsch, Angermeyer, & Corrigan, 2005). Despite these findings, no studies to-date have examined how internalized stigma may impact reporting of attenuated psychosis symptoms in the CHR population. The current study aims to examine whether discrepancies between self-report and clinician-rated measures of psychosis risk are associated with internalized stigma in a sample of help-seeking adolescents and young adults. We hypothesized that higher levels of self-stigma will predict inconsistencies between self-reported symptom severity and clinician-obtained diagnoses of psychosis risk. Methods Participants will include youth classified as either non-psychosis-related help-seeking controls or at clinical high risk (CHR) for psychosis, as determined by the Structured Interview for Psychosis-Risk Syndromes (SIPS; Miller et al., 2003). The SIPS is administered by trained raters and is currently considered the gold standard tool for diagnosing clinical high-risk syndromes (Thompson et al., 2018). In addition to SIPS diagnoses, psychosis risk will also be assessed using the Prime Screen – Revised (PS-R; Miller et al., 2004), a brief, 12-item self-report questionnaire designed to measure attenuated positive symptoms. Lastly, internalized stigma will be assessed using the Internalized Stigma of Mental Illness Inventory (ISMI; Ritsher, Otilingam, & Grajales, 2003), a 29-item self-report questionnaire designed to measure subjective experiences of stigma in adolescents (e.g., endorsement of negative stereotypes, social withdrawal and feelings of alienation due to mental health problems, etc.). Results Preliminary analyses demonstrate a significant interaction between Prime scores and internalized stigma in predicting SIPS diagnoses. Specifically, higher scores on the Prime were associated with increased odds of being diagnosed as CHR on the SIPS, but only for those participants who endorsed low and mean levels of stigma. For participants who endorsed high levels of stigma, there did not appear to be any relation between Prime scores and SIPS diagnoses. Discussion At the time of submission, participant recruitment is ongoing, and results and discussion will be presented on the final sample. Findings may inform efforts to improve detection and accurate diagnosis of psychosis risk syndromes in individuals at early stages of illness.

Using the Brief Core Schema Scales with Individuals at Clinical High Risk of Psychosis

2009 ◽  
Vol 37 (2) ◽  
pp. 227-231 ◽  
Author(s):  
Jean Addington ◽  
Lisa Tran
Keyword(s):  
High Risk ◽  
Depression Scale ◽  
Self Esteem ◽  
Self Report ◽  
Psychotic Symptoms ◽  
Short Version ◽  
Clinical High Risk ◽  
Prodromal Symptoms ◽  
Young Schema Questionnaire ◽  
Schema Questionnaire

Background: The Brief Core Schema Scales (BCSS) were developed to provide a theoretically coherent self-report assessment of schemata concerning self and others in psychosis. They provide a more useful measure of schemata about self and others than traditional measures of self-esteem. Aims: The aim of this study was to determine if these scales would be useful in a sample of individuals who are at clinical high risk of psychosis to help identify targets for intervention. Method: Thirty-eight individuals who are at high risk for psychosis were administered the Scale of Prodromal Symptoms, the Calgary Depression Scale, the Brief Core Schema Scales and the Young Schema Questionnaire–short version. Results: Results suggested that these scales are appropriate for this population and that negative evaluations of the self and others were significantly associated with attenuated psychotic symptoms and, in particular, suspiciousness.

scholarly journals The relationship of social function to depressive and negative symptoms in individuals at clinical high risk for psychosis

2010 ◽  
Vol 41 (2) ◽  
pp. 251-261 ◽  
Author(s):  
C. M. Corcoran ◽  
D. Kimhy ◽  
M. A. Parrilla-Escobar ◽  
V. L. Cressman ◽  
A. D. Stanford ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
High Risk ◽  
Negative Symptoms ◽  
Skills Training ◽  
Social Function ◽  
Self Report ◽  
Clinical High Risk ◽  
Social Dysfunction ◽  
Relationship Of ◽  
The Relationship

BackgroundSocial dysfunction is a hallmark symptom of schizophrenia which commonly precedes the onset of psychosis. It is unclear if social symptoms in clinical high-risk patients reflect depressive symptoms or are a manifestation of negative symptoms.MethodWe compared social function scores on the Social Adjustment Scale-Self Report between 56 young people (aged 13–27 years) at clinical high risk for psychosis and 22 healthy controls. The cases were also assessed for depressive and ‘prodromal’ symptoms (subthreshold positive, negative, disorganized and general symptoms).ResultsPoor social function was related to both depressive and negative symptoms, as well as to disorganized and general symptoms. The symptoms were highly intercorrelated but linear regression analysis demonstrated that poor social function was primarily explained by negative symptoms within this cohort, particularly in ethnic minority patients.ConclusionsAlthough this study demonstrated a relationship between social dysfunction and depressive symptoms in clinical high-risk cases, this association was primarily explained by the relationship of each of these to negative symptoms. In individuals at heightened risk for psychosis, affective changes may be related to a progressive decrease in social interaction and loss of reinforcement of social behaviors. These findings have relevance for potential treatment strategies for social dysfunction in schizophrenia and its risk states and predict that antidepressant drugs, cognitive behavioral therapy and/or social skills training may be effective.

scholarly journals Delusion formation and reasoning biases in those at clinical high risk for psychosis

2007 ◽  
Vol 191 (S51) ◽  
pp. s38-s42 ◽  
Author(s):  
M. R. Broome ◽  
L. C. Johns ◽  
I. Valli ◽  
J. B. Woolley ◽  
P. Tabraham ◽  
...  
Keyword(s):  
At Risk ◽  
Working Memory ◽  
High Risk ◽  
Mental State ◽  
Risk Group ◽  
Data Gathering ◽  
Intolerance Of Uncertainty ◽  
Control Group ◽  
Jumping To Conclusions ◽  
At Risk Mental State

BackgroundCognitive models propose that faulty appraisal of anomalous experiences is critical in developing psychosis, particularly delusions. A data gathering bias may be fundamental to abnormal appraisalAimsTo examine whether there is a data gathering bias in people at high risk of developing psychosisMethodIndividuals with an at-risk mental state (n=35) were compared with a matched group of healthy volunteers (n=23). Participants were tested using a modified version of the ‘beads’ reasoning task with different levels of task difficultyResultsWhen task demands were high, the at-risk group made judgements on the basis of less information than the control group (P < 0.05). Within both groups, jumping to conclusions was directly correlated with the severity of abnormal beliefs and intolerance of uncertainty (P<0.05). In the at-risk group it was also associated with impaired working memory (P<0.05), whereas in the control group poor working memory was associated with a more conservative response style (P<0.05)ConclusionsPeople with an at-risk mental state display a jumping to conclusions reasoning style, associated with impaired working memory and intolerance of uncertainty. This may underlie a tendency to develop abnormal beliefs and a vulnerability to psychosis

scholarly journals Duration of basic and attenuated-psychotic symptoms in individuals at clinical high risk for psychosis: pattern of symptom onset and effects of duration on functioning and cognition

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Lorna Staines ◽  
Ruchika Gajwani ◽  
Joachim Gross ◽  
Andrew I. Gumley ◽  
Stephen M. Lawrie ◽  
...  
Keyword(s):  
High Risk ◽  
Cognitive Deficits ◽  
Psychotic Symptoms ◽  
Healthy Controls ◽  
Clinical High Risk ◽  
Basic Symptoms ◽  
Secondary Objective ◽  
Secondary Phenomenon ◽  
The Relationship ◽  
At Risk Mental State

Abstract Introduction Duration of risk symptoms (DUR) in people at clinical high risk for psychosis (CHR-P) has been related to poorer clinical outcomes, such as reduced functioning, but it is currently unclear how different symptoms emerge as well as their link with cognitive deficits. To address these questions, we examined the duration of basic symptoms (BS) and attenuated psychotic symptoms (APS) in a sample of CHR-P participants to test the hypothesis that BS precede the manifestation of APS. As a secondary objective, we investigated the relationship between DUR, functioning and neuropsychological deficits. Methods Data from 134 CHR-P participants were assessed with the Comprehensive Assessment of At-Risk Mental State and the Schizophrenia Proneness Interview, Adult Version. Global, role and social functioning and neurocognition were assessed and compared to a sample of healthy controls (n = 57). Results In CHR-P participants who reported both APS and BS, onset of BS and APS was not significantly related. When divided into short and long BS duration (</> 8 years), CHR-P participants with a longer duration of BS showed evidence for an onset of BS preceding APS (n = 8, p = 0.003). However, in the short BS duration group, APS showed evidence of preceding BS (n = 56, p = 0.020). Finally, there were no significant effects of DUR on cognition or functioning measures. Conclusion The present findings do not support the view that APS constitute a secondary phenomenon to BS. Moreover, our data could also not confirm that DUR has a significant effect on functioning and cognitive deficits. These findings are discussed in the context of current theories regarding emerging psychosis and the importance of DUR.

scholarly journals Acute Physiological and Psychological Stress Response in Youth at Clinical High-Risk for Psychosis

2021 ◽  
Vol 12 ◽  
Author(s):  
Emily E. Carol ◽  
Robert L. Spencer ◽  
Vijay A. Mittal
Keyword(s):  
Stress Response ◽  
High Risk ◽  
Stress Test ◽  
Recovery Period ◽  
Trier Social Stress Test ◽  
Alpha Amylase ◽  
Control Group ◽  
Clinical High Risk ◽  
Subjective Stress ◽  
Cortisol Levels

Deficits in stress-response systems are a characteristic of schizophrenia and psychosis spectrum illnesses, and recent evidence suggests that this impairment may be evident in those at clinical high-risk (CHR) for the development of a psychotic disorder. However, there is limited research specifically investigating biological and subjective stress reactivity in CHR individuals. In the present study, 38 CHR individuals and group of 38 control individuals participated in the Trier Social Stress Test (TSST), an experimentally induced psychosocial stressor. Changes in salivary cortisol and alpha amylase, as well as self-reported units of distress (SUDS), were evaluated. Interestingly, the TSST did not induce a change in cortisol levels in either group, though the CHR group did show higher overall cortisol levels throughout the TSST (pre-anticipation period through recovery period). However, indicative of an effective task manipulation, the TSST did illicit an increase in alpha amylase in both groups. CHR participants exhibited higher levels of subjective stress prior to the stressor compared to the control group and CHR SUDs did not significantly increase in response to the stressor. In contrast, the control group showed an increase in SUDS in response to the stressor. Notably, SUDS for the control group post task mirrored the levels CHR youth endorsed prior to the stressor. Taken together, these findings suggest that there may be a functional relationship between persistently elevated cortisol and chronic high levels of subjective distress in CHR individuals.

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