Measuring Emotional Awareness in Patients With Schizophrenia and Schizoaffective Disorders

The ability to mentalize (i.e., to form representations of mental states and processes of oneself and others) is often impaired in people with schizophrenia spectrum disorders. Emotional awareness (EA) represents one aspect of affective mentalizing and can be assessed with the Levels of Emotional Awareness Scale (LEAS), but findings regarding individuals with schizophrenia spectrum disorders are inconsistent. The present study aimed at examining the usability and convergent validity of the LEAS in a sample of N = 130 stabilized outpatients with schizophrenia or schizoaffective disorders. An adequacy rating was added to the conventional LEAS rating to account for distortions of content due to, for example, delusional thinking. Scores of the patient group were compared with those of a matched healthy control sample. Correlation with symptom clusters, a self-report measure of EA, a measure of synthetic metacognition (MAS-A-G), and an expert rating capturing EA from the psychodynamic perspective of psychic structure (OPD-LSIA) were examined. Regarding self-related emotional awareness, patients did not score lower than controls neither in terms of conventional LEAS nor in terms of adequacy. Regarding other-related emotional awareness, however, patients showed a reduced level of adequacy compared to controls whereas no such difference was found for conventional LEAS scores. Higher conventional LEAS scores were associated with fewer negative symptoms, and higher structural integration of self-perceptions measured by the OPD-LSIA. Higher adequacy of responses correlated with fewer symptoms of disorganization as well as excitement, higher scores of self-reflection on the MAS-A-G as well as self- and object-perception and internal and external communication as measured by the subscales of the OPD-LSIA. Findings suggest that the LEAS might not be sensitive enough to detect differences between mildly symptomatic patients with schizophrenia or schizoaffective disorders and healthy controls. However, LEAS ratings are still suitable to track intraindividual changes in EA over time. Observing the adequacy of patients’ responses when using the LEAS may be a promising way to increase diagnostical utility and to identify patterns of formal and content-related alterations of mentalizing in this patient group. Methodological indications for future studies are discussed.

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A Randomized Clinical Trial of Oxytocin or Galantamine in Schizophrenia: Assessing the Impact on Behavioral, Lexical, and Self-Report Indicators of Social Affiliation

Schizophrenia Bulletin Open ◽

10.1093/schizbullopen/sgaa001 ◽

2020 ◽

Vol 1 (1) ◽

Author(s):

Kristen R Dwyer ◽

Alexandra M Andrea ◽

Christina L G Savage ◽

Ryan D Orth ◽

LeeAnn Shan ◽

...

Keyword(s):

Negative Symptoms ◽

Controlled Trial ◽

Self Report ◽

Schizophrenia Spectrum Disorders ◽

Social Affiliation ◽

Subjective Responses ◽

Randomized Controlled ◽

Schizophrenia Spectrum ◽

Spectrum Disorders ◽

The Impact

Abstract Prior studies examining the impact of oxytocin on negative symptoms in schizophrenia have yielded mixed results. The current study explored whether oxytocin can improve more proximal indicators of social affiliation as indicated by changes in behavior, language and subjective indices of social affiliation among individuals with schizophrenia spectrum disorders during a role-play designed to elicit affiliative responses. We tested the hypothesis that daily intranasal oxytocin administered for 6 weeks would improve social affiliation as manifested by increased social skill ratings, use of positive, affiliative, and social words, and subjective responses from a previously published randomized controlled trial. Forty outpatients with schizophrenia or schizoaffective disorder were randomized to the oxytocin, galantamine, or placebo group and completed affiliative role-plays and self-report questionnaires of affect, reactions to the affiliative confederate, and willingness to interact at baseline and post-treatment. Results demonstrated that oxytocin was not effective at improving behavioral or subjective indicators of social affiliation. This study adds to a growing literature that the prosocial effects of oxytocin in schizophrenia are limited or null.

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Ten-year course of cognition in first-episode non-affective psychosis patients: PAFIP cohort

Psychological Medicine ◽

10.1017/s0033291720002408 ◽

2020 ◽

pp. 1-10

Author(s):

José Manuel Rodríguez-Sánchez ◽

Esther Setién-Suero ◽

Paula Suárez-Pinilla ◽

Jaqueline Mayoral Van Son ◽

Javier Vázquez-Bourgon ◽

...

Keyword(s):

Cognitive Functions ◽

Large Body ◽

Control Sample ◽

First Episode ◽

Control Group ◽

Entire Group ◽

Schizophrenia Spectrum Disorders ◽

Schizophrenia Spectrum ◽

Spectrum Disorders ◽

Concomitant Factors

Abstract Background A large body of research states that cognitive impairment in schizophrenia is static. Nevertheless, most previous studies lack a control group or have small study samples or short follow-up periods. Method We aimed to address these limitations by studying a large epidemiological cohort of patients with first-episode schizophrenia spectrum disorders and a comparable control sample for a 10-year period. Results Our results support the generalized stability of cognitive functions in schizophrenia spectrum disorders considering the entire group. However, the existence of a subgroup of patients characterized by deteriorating cognition and worse long-term clinical outcomes must be noted. Nevertheless, it was not possible to identify concomitant factors or predictors of deterioration (all Ps > 0.05). Conclusions Cognitive functions in schizophrenia spectrum disorder are stable; however, a subgroup of subjects that deteriorate can be characterized.

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Schizotypy and brain structure: a voxel-based morphometry study

Psychological Medicine ◽

10.1017/s0033291709991875 ◽

2009 ◽

Vol 40 (9) ◽

pp. 1423-1431 ◽

Cited By ~ 54

Author(s):

G. Modinos ◽

A. Mechelli ◽

J. Ormel ◽

N. A. Groenewold ◽

A. Aleman ◽

...

Keyword(s):

Gray Matter Volume ◽

Chronic Schizophrenia ◽

Posterior Cingulate Cortex ◽

Self Report ◽

Schizophrenia Spectrum Disorders ◽

Voxel Based Morphometry ◽

Schizotypal Personality ◽

Psychosis Proneness ◽

Schizophrenia Spectrum ◽

Spectrum Disorders

BackgroundSchizotypy is conceptualized as a subclinical manifestation of the same underlying biological factors that give rise to schizophrenia and other schizophrenia spectrum disorders. Individuals with psychometric schizotypy (PS) experience subthreshold psychotic signs and can be psychometrically identified among the general population. Previous research using magnetic resonance imaging (MRI) has shown gray-matter volume (GMV) abnormalities in chronic schizophrenia, in subjects with an at-risk mental state (ARMS) and in individuals with schizotypal personality disorder (SPD). However, to date, no studies have investigated the neuroanatomical correlates of PS.MethodSix hundred first- and second-year university students completed the Community Assessment of Psychic Experiences (CAPE), a self-report instrument on psychosis proneness measuring attenuated positive psychotic experiences. A total of 38 subjects with high and low PS were identified and subsequently scanned with MRI. Voxel-based morphometry (VBM) was applied to examine GMV differences between subjects with high and low positive PS.ResultsSubjects with high positive PS showed larger global volumes compared to subjects with low PS, and larger regional volumes in the medial posterior cingulate cortex (PCC) and the precuneus. There were no regions where GMV was greater in low than in high positive PS subjects.ConclusionsThese regions, the PCC and precuneus, have also been sites of volumetric differences in MRI studies of ARMS subjects and schizophrenia, suggesting that psychotic or psychotic-like experiences may have common neuroanatomical correlates across schizophrenia spectrum disorders.

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A transdiagnostic investigation of ‘theory of mind’ and ‘jumping to conclusions’ in patients with persecutory delusions

Psychological Medicine ◽

10.1017/s0033291707002152 ◽

2007 ◽

Vol 38 (11) ◽

pp. 1577-1583 ◽

Cited By ~ 40

Author(s):

R. Corcoran ◽

G. Rowse ◽

R. Moore ◽

N. Blackwood ◽

P. Kinderman ◽

...

Keyword(s):

Theory Of Mind ◽

Probabilistic Reasoning ◽

Diagnostic Category ◽

Mental States ◽

Psychotic Depression ◽

Cognitive Effects ◽

Schizophrenia Spectrum Disorders ◽

Persecutory Delusions ◽

Schizophrenia Spectrum ◽

Spectrum Disorders

BackgroundA tendency to make hasty decisions on probabilistic reasoning tasks and a difficulty attributing mental states to others are key cognitive features of persecutory delusions (PDs) in the context of schizophrenia. This study examines whether these same psychological anomalies characterize PDs when they present in the context of psychotic depression.MethodPerformance on measures of probabilistic reasoning and theory of mind (ToM) was examined in five subgroups differing in diagnostic category and current illness status.ResultsThe tendency to draw hasty decisions in probabilistic settings and poor ToM tested using story format feature in PDs irrespective of diagnosis. Furthermore, performance on the ToM story task correlated with the degree of distress caused by and preoccupation with the current PDs in the currently deluded groups. By contrast, performance on the non-verbal ToM task appears to be more sensitive to diagnosis, as patients with schizophrenia spectrum disorders perform worse on this task than those with depression irrespective of the presence of PDs.ConclusionsThe psychological anomalies associated with PDs examined here are transdiagnostic but different measures of ToM may be more or less sensitive to indices of severity of the PDs, diagnosis and trait- or state-related cognitive effects.

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Qualitative Differences in Attribution of Mental States to Other People in Autism and Schizophrenia: What are the Tools for Differential Diagnosis?

Journal of Autism and Developmental Disorders ◽

10.1007/s10803-021-05035-3 ◽

2021 ◽

Author(s):

Monica Mazza ◽

Maria Chiara Pino ◽

Roberto Keller ◽

Roberto Vagnetti ◽

Margherita Attanasio ◽

...

Keyword(s):

Differential Diagnosis ◽

Mental States ◽

Autism Spectrum ◽

Typically Developing ◽

Interesting Aspect ◽

Schizophrenia Spectrum Disorders ◽

Schizophrenia Spectrum ◽

Advanced Theory Of Mind ◽

Spectrum Disorders ◽

Important Clinical Question

AbstractThe differential diagnosis between schizophrenia spectrum disorders (SSD) and autism spectrum disorders (ASD) remains an important clinical question, because they have overlap in clinical diagnosis. This study explored the differences between ASD (n = 44) and SSD patients (n = 59), compared to typically developing peers (n = 63), in completing an advanced Theory of Mind (ToM) task. The outcome found several differences between groups. The SSD patients showed greater difficulty in understanding social scenarios, while ASD individuals understood the stories, but did not correctly identify the protagonist’s intention. The interesting aspect of the results is that some ToM stories are more informative about the mentalistic reasoning of the two clinical groups, namely, the stories that investigate pretend, persuasion, double bluff and ironic joke constructs.

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Development of the Thought Disorder Measure for the Hierarchical Taxonomy of Psychopathology

10.31219/osf.io/f9yha ◽

2021 ◽

Author(s):

David C Cicero ◽

Katherine Jonas ◽

Michael Chmielewski ◽

Elizabeth A Martin ◽

Anna Docherty ◽

...

Keyword(s):

Negative Symptoms ◽

Thought Disorder ◽

Self Report ◽

Schizophrenia Spectrum Disorders ◽

Schizophrenia Spectrum ◽

Item Level ◽

Scale Scores ◽

Spectrum Disorders ◽

Report Measure ◽

Positive And Negative Symptoms

The Hierarchical Taxonomy of Psychopathology consortium aims to develop a comprehensive self-report measure to assess psychopathology dimensionally. The current research describes the initial conceptualization, development, and item selection for the thought disorder spectrum and related constructs from other spectra. The thought disorder spectrum is defined primarily by the positive and disorganized traits and symptoms of schizophrenia-spectrum disorders. The Thought Disorder Sub-Workgroup identified and defined 16 relevant constructs and wrote 10-15 items per each construct. These items were administered, along with detachment and mania items, to undergraduates and people with serious mental illness. Three hundred sixty-five items across 25 scales were administered. An exploratory factor analysis of the scale scores suggested a two-factor structure corresponding to positive and negative symptoms for both samples. The mania scales loaded with the positive factor, while the detachment scales loaded with the negative factor. Item-level analyses resulted in 19 preliminary scales, including 224 items that cover the range of thought disorder pathology, and will be carried forward for the next phase of data collection/analysis.

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