scholarly journals Systematic review and meta-analysis of the calibration of confidence judgments in individuals with schizophrenia spectrum disorders

2020 ◽  
Author(s):  
Martin Rouy ◽  
Pauline Saliou ◽  
Ladislas Nalborczyk ◽  
Michael Pereira ◽  
Paul Roux ◽  
...  
Keyword(s):  
Cognitive Task ◽  
Meta Analysis ◽  
Clinical Severity ◽  
Schizophrenia Spectrum Disorders ◽  
Cognitive Domains ◽  
First Order ◽  
Confidence Judgments ◽  
Schizophrenia Spectrum ◽  
Experimental Protocols ◽  
Spectrum Disorders

AbstractBackgroundMetacognitive deficits are well documented in schizophrenia spectrum disorders as a decreased capacity to adjust confidence to first-order performance in a cognitive task. Because metacognitive ability directly depends on first-order performance, observed metacognitive deficits might be driven by lower first-order performance. We aimed to determine the extent to which individuals with schizophrenia experience specific deficits when producing confidence judgments and examined whether studies controlling for first-order performance found metacognitive deficits of smaller magnitude.MethodElectronic databases were searched for studies published until April 24th 2020. We conducted a Bayesian meta-analysis of 43 studies comparing the calibration of confidence in 1458 individuals with schizophrenia compared to 1337 matched controls. Group analyses and meta-regressions quantified how metacognitive deficits depended on task performance, cognitive domains, clinical severity, and antipsychotic dosage.OutcomesWe found a global metacognitive deficit in schizophrenia (g = -0.57, 95% CrI [-0.71, -0.43]), which was driven by studies which did not equate first-order performance between groups (g = -0.64, 95% CrI [-0.77, -0.51]), and inconclusive among controlled-studies (g = -0.28, 95% CrI [-0.63, 0.07], BF01 = 1.3). Plus, the metacognitive deficit in non-controlled studies was correlated with first-order performance. No correlation was found between metacognitive deficit and clinical features of schizophrenia.InterpretationWe provide evidence for the existence of a deficit in the calibration of confidence judgments in schizophrenia, which is inflated due to non-equated first-order performance. Thus, efforts should be made to develop experimental protocols accounting for lower first-order performance in schizophrenia.

scholarly journals Empathy and perceived burden in caregivers of patients with schizophrenia spectrum disorders

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Rosaria Di Lorenzo ◽  
Anna Girone ◽  
Nunzio Panzera ◽  
Gianluca Fiore ◽  
Margherita Pinelli ◽  
...  
Keyword(s):  
Local Community ◽  
Mental Health Center ◽  
Clinical Severity ◽  
Schizophrenia Spectrum Disorders ◽  
Cronbach’S Alpha ◽  
Emotional Empathy ◽  
Cronbach's Alpha ◽  
Schizophrenia Spectrum ◽  
Spectrum Disorders ◽  
Spearman Test

Abstract Background Caregivers of patients load different kinds of burdens, including emotional distress. Aims of this study were to evaluate both burden and empathy of caregivers who assist patients with schizophrenia spectrum disorders. Methods We selected a sample of 60 caregivers (34 women and 26 men), who assisted patients with schizophrenia spectrum disorders treated in our local Community Mental Health Center for a 1-year minimum period. We administered two scales to our sample, Zarit Burden Interview (ZBI) and Balanced Emotional Empathy Scale (BEES), and collected data of caregivers and their assisted patients in a 3-month period. Data were statistically analyzed. Results We reported a mean ZBI score of 49.68 (±15.03 SD) and a mean BEES score of 14.35 (±9.05 SD), indicating the perception of moderate-severe burden and low level of empathy, respectively. The analysis of internal consistency confirmed the good reliability of both ZBI (Cronbach’s alpha = 0.90) and BEES (Cronbach’s alpha = 0.77). The correlation between the two scales was not statistically significant at Spearman test. At our multiple linear regression, many variables of both caregiver and patient showed a significant correlation with the ZBI score. In particular, not living with the assisted patient and female gender of caregiver potentially decreased the burden, whereas clinical severity of assisted patient and two caregiver conditions, middle school education and spouse relationship with patient, could worsen the burden. We highlighted two positive statistically significant correlations between the total score of BEES and caregiver characteristics: being spouse and not living with assisted patient. Conclusions Our study highlights that the caregiver burden of patients with severe psychiatric disorders is high and is associated with low emotional empathy experienced by caregivers, probably due to a defensive psychological mechanism. The conditions of spouse and cohabitation can concomitantly increase both empathy and burden in caregivers.

scholarly journals Cytokines in cerebrospinal fluid of patients with schizophrenia spectrum disorders: New data and an updated meta-analysis

2018 ◽  
Vol 202 ◽  
pp. 64-71 ◽  
Author(s):  
Juan A. Gallego ◽  
Emily A. Blanco ◽  
Sehba Husain-Krautter ◽  
E. Madeline Fagen ◽  
Paula Moreno-Merino ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Meta Analysis ◽  
Schizophrenia Spectrum Disorders ◽  
Schizophrenia Spectrum ◽  
Spectrum Disorders

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

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.

Depressive psychopathology in first-episode schizophrenia spectrum disorders: a systematic review, meta-analysis and meta-regression

2019 ◽  
Vol 49 (15) ◽  
pp. 2463-2474 ◽  
Author(s):  
Sarah E. Herniman ◽  
Kelly Allott ◽  
Lisa J. Phillips ◽  
Stephen J. Wood ◽  
Jacqueline Uren ◽  
...  
Keyword(s):  
Systematic Review ◽  
Depressive Disorder ◽  
Meta Analysis ◽  
First Episode ◽  
Schizophrenia Spectrum Disorders ◽  
Schizophrenia Spectrum ◽  
Pooled Prevalence ◽  
Meta Regression ◽  
Spectrum Disorders ◽  
First Episode Schizophrenia

AbstractBackgroundDespite knowing for many decades that depressive psychopathology is common in first-episode schizophrenia spectrum disorders (FES), there is limited knowledge regarding the extent and nature of such psychopathology (degree of comorbidity, caseness, severity) and its demographic, clinical, functional and treatment correlates. This study aimed to determine the pooled prevalence of depressive disorder and caseness, and the pooled mean severity of depressive symptoms, as well as the demographic, illness, functional and treatment correlates of depressive psychopathology in FES.MethodsThis systematic review, meta-analysis and meta-regression was prospectively registered (CRD42018084856) and conducted in accordance with PRISMA and MOOSE guidelines.ResultsForty studies comprising 4041 participants were included. The pooled prevalence of depressive disorder and caseness was 26.0% (seven samples, N = 855, 95% CI 22.1–30.3) and 43.9% (11 samples, N = 1312, 95% CI 30.3–58.4), respectively. The pooled mean percentage of maximum depressive symptom severity was 25.1 (38 samples, N = 3180, 95% CI 21.49–28.68). Correlates of depressive psychopathology were also found.ConclusionsAt least one-quarter of individuals with FES will experience, and therefore require treatment for, a full-threshold depressive disorder. Nearly half will experience levels of depressive symptoms that are severe enough to warrant diagnostic investigation and therefore clinical intervention – regardless of whether they actually fulfil diagnostic criteria for a depressive disorder. Depressive psychopathology is prominent in FES, manifesting not only as superimposed comorbidity, but also as an inextricable symptom domain.

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