The impact of lifetime interpersonal and intentional trauma on cognition and vulnerability to psychosis in bipolar disorder

Background Studies have shown that over half of individuals with bipolar disorder experience early-life trauma, which may influence clinical outcomes, including suicidality and presence of psychotic features. However, studies report inconsistent findings regarding the effect of trauma on cognitive outcomes in bipolar disorder. Aims Our study explores the effect of lifetime trauma on the level of vulnerability to psychosis and cognitive performance in participants with bipolar disorder. Method We evaluated lifetime trauma history in 236 participants with a diagnosis of bipolar disorder type 1 or 2, using the Structured Clinical Interview for DSM-IV and the Childhood Trauma Questionnaire. We classified trauma types based on the Substance Abuse and Mental Health Services Administration's concept of trauma, which characterises the type of experienced trauma (e.g. interpersonal and intentional, accidental or naturally occurring). Our primary outcome measures of interest were vulnerability to psychosis (Schizotypal Personality Questionnaire), cognitive performance (MATRICS Consensus Cognitive Battery) and social functioning (Social Adjustment Scale Self-Report). Results Multivariate analysis of covariance showed a significant effect of trauma type on the Schizotypal Personality Questionnaire cognitive–perceptual domain (F(3) = 6.7, P < 0.001). The no-trauma group had lower cognitive–perceptual schizotypal features compared with the accidental and intentional trauma (P < 0.001) and interpersonal and intentional trauma (P = 0.01) groups. Conclusions Our results highlight the need for careful trauma inquiry in patients with bipolar disorder, and consideration of how trauma-focused or -informed treatments may be an integral part of treatment planning to improve outcomes in bipolar disorder.

SHANK3 Genotype Mediates Speech and Language Phenotypes in a Nonclinical Population

Mutations affecting the synaptic-scaffold gene SHANK3 represent the most common genetic causes of autism with intellectual disability, accounting for about 1-2% of cases. Rare variants of this gene have also been associated with schizophrenia, and its deletion results in the autistic condition known as Phelan–McDermid syndrome. Despite the importance of SHANK3 as a paradigmatic gene mediating neurodevelopmental disorders, its psychological effects in nonclinical populations have yet to be studied. We genotyped the nonsynonymous, functional SHANK3 SNP rs9616915 in a large population of typical individuals scored for autism spectrum traits (the Autism Quotient, AQ) and schizotypy spectrum traits (the Schizotypal Personality Questionnaire, SPQ-BR). Males, but not females, showed significant genotypic effects for the SPQ-BR subscale associated with speech and language: Odd Speech. These findings, in conjunction with animal model studies showing vocalization and auditory effects of SHANK3 mutations, and studies indicating severe language alterations and speech-associated white matter tract abnormalities in Phelan–McDermid syndrome, suggest that SHANK3 differentially affects the development and expression of human language and speech. Imaging genetic and speech-language studies of typical individuals carrying different genotypes of rs9616915 should provide novel insights into the neurological and psychological bases of speech and language alterations among individuals with SHANK3 mutations and Phelan–McDermid syndrome.

Exploring Identity Disturbance and Psychotic Spectrum Symptoms as Predictors of Borderline and Schizotypal Personality Disorders

<b><i>Introduction:</i></b> Borderline personality disorder (BPD) and schizotypal personality disorder (SPD) were introduced in DSM-III and retained in DSM-5 Section II. They often co-occur and some aspects of the clinical differentiation between the 2 diagnoses remain unclear (e.g., psychotic-like features and identity disturbance). <b><i>Methods:</i></b> The present study explored if self-reported identity disturbance and psychosis proneness could discriminate between the BPD and SPD DSM-5 diagnoses. All patients were interviewed with the Schedules for Clinical Assessment in Neuropsychiatry and the Structured Clinical Interview for DSM-5 Personality Disorders, and administered the Inventory of Personality Organization, Self-Concept and Identity Measure, Schizotypal Personality Questionnaire, Perceptual Aberration Scale, and the Magical Ideation Scale. <b><i>Results:</i></b> A total of 105 patients were initially assessed, 26 were excluded, and the final sample (<i>N =</i> 79) was composed of 34 BPD patients, 25 SPD patients, and 20 patients with co-occurring SPD and BPD. The BPD group (<i>n</i> = 34) was first compared with the pure SPD group (<i>n</i> = 25), and secondly with the total group of patients diagnosed with SPD (<i>n</i> = 25 + 20). Logistic regression analyses indicated that primitive defenses and disorganization best differentiated the BPD and the pure SPD group, while primitive defenses and interpersonal factor along with perceptual aberrations best differentiated the BPD and the total SPD group. <b><i>Conclusion:</i></b> Identity disturbance did not predict the diagnostic groups, but BPD patients were characterized by primitive defenses, which are closely related to identity disturbance. Pure SPD was characterized by oddness/eccentricity, while the lack of specificity for cognitive-perceptual symptoms suggests that the positive symptoms do not differentiate BPD from SPD.

Beyond the interpersonal core of Schizotypal Personality and Autism: Associations between autism and schizotypal traits are not merely due to Social Anxiety.

Several lines of research have established overlap between autistic and schizotypal traits but there have been limited attempts to identify variables that might explain this overlap. As both sets of traits are individually associated with social anxiety, we investigated whether social anxiety traits could explain the overlap between them. To this end, the Autism Quotient (AQ), Schizotypal Personality Questionnaire Brief-Revised (SPQ-BR) and Liebowitz Social Anxiety Scale-Self Report (LSAS-SR) were administered to a non-clinical population of 345 adults. Correlational analyses revealed strong, positive correlations between autistic, schizotypal, and social anxiety traits. After controlling for social anxiety, the association between total AQ and SPQ-BR scores remained modest and significant, suggesting that their association is not simply due to a shared association with social anxiety.

A médiaeszközök világába való belemerülés: adaptív és nem adaptív következmények

Elméleti háttér: A médiaeszközök számos típusa ismert. A személyes képességeken és a technikai lehetőségeken múlik azonban, hogy az információt fogadó fél a lehetőségek közül melyeket részesíti előnyben és milyen mértékben merül el a médiaeszközökön keresztül közvetített valóságban. A humán technológia álláspontja szerint a médiával való elmélyült foglakozás során a személy természetes környezetére irányuló figyelme háttérbe szorul, a befogadó sokszor a média által teremtett világ rabjává válik. A médiahasználat köti le az alkalmazó figyelmét, együtt mozog vele, mintha az maga a valóság lenne. A média valóságélményt kiváltó hatásában több személyes jellemző játszik szerepet. Cél: A tanulmány bemutatja a média személyes használatakor megjelenő belemerülési képesség egyik kérdőíves mérési lehetőségét, a Belemerülési Tendencia Kérdőívet, továbbá megvizsgálja a személyes prediszpozíciók egy csoportját, amelyek kapcsolatban lehetnek a hagyományos szórakoztató, valamint digitális kommunikációs eszközök használata során átélt belemerülés mértékének mutatóival. Módszerek: A keresztmetszeti, kérdőíves, hozzáférhetőségi mintavételi eljárást alkalmazó vizsgálatban 781 közép- és felsőfokú iskolai végzettséggel rendelkező személy vett részt [192 férfi, átlagéletkor: 28,6 (SD = 11,4) év és 589 nő, átlagéletkor: 28,4 (SD = 11,03) év]. A résztvevők budapesti, pécsi és kaposvári egyetemeken tanuló, illetve szakmai továbbképzéseken megjelenő személyek közül kerültek ki. Mérőeszközök: Belemerülési Tendencia Kérdőív (ITQ), Tellegen Abszorpciós Skála, Lelki Egészség Kontinuum Rövid Változat, Énkép Egyértelműség Skála, Szkizotípiás Személyiség Kérdőív Rövid Változata, Bergeni Facebook Addikciós Skála, valamint a Problémás Internet Használat Kérdőív. Eredmények: Az adatok megerősítették azt a korábbi elképzelést, miszerint az ITQ személyes részvétel skálája maladaptív funkciókhoz kapcsolódik, mint amilyen az abszorpciós képesség (r = 0,47; p = 0,003) és a szkizotípia (r = 0,36; p = 0,004). A számítógépes játék skála szintén pozitív irányú együttjárást mutat a maladaptív jellegű vonásokkal (abszorpciós képesség skála: r = 0,28; p = 0,002; szkizotípia: r = 0,19; p = 0,004). Ezzel szemben az ITQ figyelem fókusz skálája az adaptív funkciókat szolgáló vonásokhoz kapcsolódik (szelf-koherencia: r = 0,27; p = 0,003; lelki egészség: r = 0,43; p = 0,011). Továbbá rámutattunk arra, hogy számítógépes játékokra fordított idő növekedésével párhuzamosan a kognitív zavarok (β = 0,10; p = 0,012) és a mindennapi viselkedésben mutatkozó furcsa megnyilvánulások (β = 0,10; p = 0,016) száma is növekszik. Következtetések : Az ITQ skálái adaptáció és maladaptáció tekintetében eltérő módon mérik a médiaeszközök által közvetített valósághoz való viszonyt, ugyanakkor jól jellemzik a befogadó személy digitális környezethez való hozzáállásának ellentmon dásait.Theoretical background: A lot of the types of a media devices are commonly used. However, the application of these tools depends on personal capabilities, availability of adequate technical conditions, and individual preference to immersion into a mediated environment. The literature of human technology highlighted that when a person dealt with the contents of a digital massage his/her attention got withdrawn from his/her current environment. In same cases, the receiver of the mediated information becomes addicted to the easily controlled digital environment as if it would be a real physical environment. The manifestation of the filing of this type of virtual reality depends on personal capabilities and attitudes. Aims: We presented an assessment method repertoire of sense of immersion for social media and computer gaming and, applications involving the Immersive Tendency Questionnaire. Furthermore, we analyzed the personal pre-dispositions that play a role in the degree of immersion while a person is concerned with the mediated environment. Methods: In the study participated 781 graduated and post-graduated persons (192 male, mean age 28.5 [SD 11.4] years, and 589 females, mean age 28.4 [SD 11.03] years). Participants were recruited via a large university cohort (Budapest, Kaposvár, and Pécs). Used questionnaires: Immersion Tendency Questionnaire (ITQ), Tellegen Absorption Scale, Mental Health Continuum, Self-concept Clarity, Schizotypal Personality Questionnaire, Bergen Facebook Addiction Scale, and Problematic Internet Using Questionnaire. Results: Our data supported the earlier findings that the Involvement scale of the ITQ across the absorption capability (r = 0.47, p = 0.003) and schizotypy (r = 0.36, p = 0.004) associated with maladaptive personality functions. The rate of the computer gaming activity showed a similar maladaptive effect with absorption capability (r = 0.28, p = 0.002) and schizotypy (r = 0.19, p = 0.004). However, the Attentional focus scale of ITQ linked to adaptive personality function such as self-coherence (r = 0.27, p = 0.003) and mental health (r = 0.43, p = 0.011). Furthermore, data revealed that the frequent computer gaming can be associated with cognitive (β = 0.10, p = 0.012) and disorganized (β = 0.10, p = 0.016) factors of schizotypal personality questionnaire. Conclusion: The factor structure of ITQ is dual-faced so the scales measure the immersion into the mediated world in a different way. These results exactly describe the user’s contradictory relationship with the mediated environment.

Cannabis’s Link to Schizotypy: Phenomenon, Measurement Bias, or Delusion?

Links between cannabis use and psychosis continue to generate research and media attention. Cannabis users have outscored non-users on the Schizotypal Personality Questionnaire-Brief (SPQ-B) by a small amount in multiple studies, but previous work on biased items suggests that the groups do not differ if these items are removed. The present study examined links between schizotypal personality, as measured by the SPQ-B, and cannabis use in a large sample recruited from Amazon’s MTurk platform. Over 500 participants (72.5%) reported lifetime cannabis exposure, 259 participants (36.7%) reported current cannabis use, and on average, used 3.5 days per week. Users and non-users failed to differ significantly on total SPQ-B scores or any of the three established subscales, with effect sizes all lower than d = .20. The null results inspired a re-examination of the SPQ-B’s factor structure, which identified a novel 3-factor solution (difficulty opening up to others, hyperawareness, and odd or unusual behavior). Only the “odd or unusual behavior” factor showed cannabis-related differences (g = .234), but a differential item functioning test revealed that one item on that subscale showed potential bias against users. Removing this item dropped the group differences to a non-significant g = 0.149. These results suggest that links between schizotypy and cannabis require cautious interpretation with careful attention to potential measurement bias. In addition, the Schizotypal Personality Questionnaire-Brief might have an alternative factor structure that could help answer important questions in psychopathology.

A Study of Oddity in a Russian Clinical Sample

Background. At the beginning of 20th century, the phenomenon of oddity began to be studied. It was de!ned as a set of characteristics responsible for an individual giving the impression of being unusual, odd, and peculiar. Later, psychiatrists integrated oddity into the concept of schizotypy. Yet, while considered a part of the schizotypy construct, oddity has remained singular and maintained its status as an independent dimension. Objective. "e present article discusses oddity as a set of particular clinical traits that can be evaluated both by self-report measures and clinical assessment. We set out to investigate the oddity phenomena as manifested in a clinical sample, in order to delineate key features that constitute this concept. Design. Seventy-one patients were selected according to a speci!c set of criteria and subjected to a set of self-report measures (the Schizotypal Personality Questionnaire and the Adult Personality Traits Questionnaire), a clinical interview, and a pathopsychological experiment. A number of cognitive, behavioral, and emotional characteristics were analyzed. An intra-group comparison was carried out in order to clarify the potential di#erences between the self-reported and clinically assessed phenomenon of oddity. Results. "e study’s !rst !nding was that the SPQ-74 does not identify odd personalities in the general population, as re$ected in the fact that the sample’s average scores proved to be low. Secondly, restricted emotionality and a de!cit in social interactions proved to be the prevalent characteristics of the sample of “odd” individuals. Furthermore, a set of certain speech peculiarities (word coinage, bizarrerie, etc.) and thinking impairments of various types (distortion of abstraction level and motivational de!cit) emerged as prominent characteristics in the majority of subjects. Finally, it was determined that clinical assessment allows for a more comprehensive evaluation of the psychology of odd personalities than self-report measures, due to a number of the personality, temperamental, and cognitive characteristics that the latter tend to exhibit. Conclusion. “Odd” individuals can be characterized by a number of cognitive, emotional, and behavioral features independent of social perception and relevant to clinical practice; they can be captured more successfully by the application of qualitative methods. Further research is needed to elaborate this set of traits and test this hypothesis on new samples.

Feeling Oneself Requires Embodiment: Insights From the Relationship Between Own-Body Transformations, Schizotypal Personality Traits, and Spontaneous Bodily Sensations

Subtle bodily sensations such as itching or fluttering that occur in the absence of any external trigger (i.e., spontaneous sensations, or SPS) may serve to locate the spatial boundaries of the body. They may constitute the normal counterpart of extreme conditions in which body-related hallucinations and perceptual aberrations are experienced. Previous investigations have suggested that situations in which the body is spontaneously experienced as being deformed are related to the ability to perform own-body transformations, i.e., mental rotations of the body requiring disembodiment. We therefore decided to consider whether the perception of SPS might relate to embodiment as assessed through (i) the ability to perform own-body transformations (OBT task) and (ii) schizotypal traits (Schizotypal Personality Questionnaire, or SPQ), since high degrees of schizotypy in the general population have been associated with more vivid perceptions and aberrant perceptual experiences. Then participants completed a standard SPS task. Our analysis revealed that the slower the response time in the OBT task, the more frequent the perception of SPS. This suggests that difficulties in disembodying and mentally transforming one’s own body facilitate feeling oneself. Furthermore, a greater number of correct responses in the OBT task was associated with less frequent perception of SPS. This suggests that finding it easier to disembody and perform mental own-body transformations interferes with the ability to sense oneself. The results also show that higher schizotypal traits, as assessed through the SPQ, are associated with more frequent perception of SPS. Taken together, these results provide a coherent picture and suggest that embodiment is required in order to correctly feel oneself, as expressed through the perception of SPS. The ability to easily experience disembodiment reduces the sense of feeling oneself, and proneness to schizotypal traits produces body misperceptions that enhance and amplify this feeling. The results are discussed in the light of current knowledge and theories about body representations, taking into account attention and interoception as factors that influence body awareness. We offer explanations for perceptual aberrations, body-related delusions, and hallucinations based on misperceived or misinterpreted SPS, and we discuss possible mechanisms that may contribute to feeling and misperceiving oneself.

Semantic priming and schizotypal personality: reassessing the link between thought disorder and enhanced spreading of semantic activation

The term schizotypy refers to a group of stable personality traits with attributes similar to symptoms of schizophrenia, usually classified in terms of positive, negative or cognitive disorganization symptoms. The observation of increased spreading of semantic activation in individuals with schizotypal traits has led to the hypothesis that thought disorder, one of the characteristics of cognitive disorganization, stems from semantic disturbances. Nevertheless, it is still not clear under which specific circumstances (i.e., automatic or controlled processing, direct or indirect semantic relation) schizotypy affects semantic priming or whether it does affect it at all. We conducted two semantic priming studies with volunteers varying in schizotypy, one with directly related prime-target pairs and another with indirectly related pairs. Our participants completed a lexical decision task with related and unrelated pairs presented at short (250 ms) and long (750 ms) stimulus onset asynchronies (SOAs). Then, they responded to the brief versions of the Schizotypal Personality Questionnaire and the Oxford-Liverpool Inventory of Feelings and Experiences, both of which include measures of cognitive disorganization. Bayesian mixed-effects models indicated expected effects of SOA and semantic relatedness, as well as an interaction between relatedness and directness (greater priming effects for directly related pairs). Even though our analyses demonstrated good sensitivity, we observed no influence of cognitive disorganization over semantic priming. Our study provides no compelling evidence that schizotypal symptoms, specifically those associated with the cognitive disorganization dimension, are rooted in an increased spreading of semantic activation in priming tasks.