Relationship between psychopathology and cognitive functioning in schizophrenia spectrum disorders

Uurimistöö eesmärk oli uurida skisofreeniaspektri häirega inimeste WAIS-III intelligentsusskaala (Wechsler Adult Intelligence Scale) töömälu ja infotöötluskiiruse alltestide tulemuste ning kliiniliste haigustunnuste ehk positiivsete, negatiivsete sümptomite ja desorganiseerituse dimensioonidele antud hinnangute skooride vahelisi seoseid. Valimi moodustasid 46 patsienti ning analüüsid teostati kogu grupi tasandil ja vaadeldi lisaks sugudevahelisi erinevusi. Tulemustest ilmnes, et patsientide WAIS-III alltestide tulemused omasid tugevat või mõõdukat negatiivset seost üldisele psühhopatoloogia raskusastmele antud hinnangutega. Statistiliselt olulised mõõdukad kuni tugevad seosed ilmnesid positiivsete ja negatiivsete sümptomite dimensioonide ning WAIS-III alltestide skooride vahel. Kognitiivse võimekuse osas statistiliselt olulisi erinevusi nais- ja meepatsientide osas ei ilmnenud. Samas, kognitiivse funktsionaalsuse ja sümptomprofiilide seoste analüüsid tõid esile sugudevahelised erinevused. Tulemused kinnitavad kognitiivse funktsiooni ja kliiniliste sümptomite vahel esinevate seoste olemasolu ja seostemustrite eripära nais- ja meeshaigete gruppide tasandil

The Negative Symptom Rating Scale: Initial Evaluation of Reliability and Validity

Negative symptoms in schizophrenia are a major determinant of the social and occupational impairments that characterize the disorder, as well as a significant source of distress for caregivers, and predictors of poor long-term outcome. Despite the compelling evidence for the clinical relevance of negative symptoms, this domain of the illness remains inadequately addressed by current pharmacotherapy and psychotherapy. As identified at the NIMH-MATRICS Consensus Development Conference on Negative Symptoms, a significant barrier to progress in the treatment of this symptom domain is the current lack of an adequate measure for assessment of negative symptoms (Kirkpatrick et al., 2006). It was in response to this need that the NIMH-MATRICS Negative Symptom Workgroup developed a new measure, the Negative Symptom Rating Scale (NSRS). The current study provided the first evaluation of the psychometric properties of the newly developed NSRS, including the inter-rater agreement and internal consistency of the NSRS scales, and assessed convergent and discriminant validity. The results of this initial psychometric evaluation of the NSRS are generally quite encouraging, and provide information that has helped inform data-driven modifications to the measure for upcoming validation studies. With regards to reliability, the NSRS demonstrated adequate internal consistency for the scale as a whole, and for three of the five subscales. The results indicated that the Asociality and Avolition subscales warrant further revisions or modifications to improve internal consistency. Additionally, three of the five subscales were found to have good to excellent interrater reliability, with the Avolition and Alogia subscales falling in the fair range. Results generally demonstrated adequate convergent validity between the NSRS and other measures of negative symptoms, namely the SANS and the BPRS Anergia subscale. Additionally, results indicated general convergence between clinician-rated anhedonia using the NSRS and self-reported anhedonia as measured by the TEPS. Finally, the NSRS showed discrimination from ratings of psychotic and depressive symptoms. The results of the present study point to areas in which revisions are necessary, and has provided valuable information that is necessary for making revisions and modifications to the measure prior to larger scale evaluation

The relationship of social anxiety and social anhedonia to psychometrically identified schizotypy.

Schizotypy and schizophrenia involve social disinterest (anhedonia) and social anxiety. To clarify the role of social dysfunction in schizotypy, this study examined the relationship of social anxiety and social anhedonia in 364 young adults. As hypothesized, there was a moderate association between these constructs, which diminished after partialing out positive schizotypy. A series of CFAs found that a three-factor solution with positive schizotypy, negative schizotypy, and social anxiety factors provided the best fit for the data. Social anxiety is more strongly associated with positive schizotypy than negative schizotypy. A model in which social anxiety and anhedonia formed a general social dysfunction factor did not provide adequate fit, suggesting that social anhedonia and social anxiety are separate constructs with different relationships to schizotypy

Dimorphisme sexuel dans la schizophrénie

Récemment, des études neuroanatomiques ont suggéré une inversion du dimorphisme sexuel normal chez les personnes schizophrènes dans plusieurs structures limbiques et corticolimbiques, impliquées dans le fonctionnement émotionnel. Stimulée par ces études, nous avons analysé des données provenant de quinze hommes et de dix femmes, ayant un diagnostic de la schizophrénie, qui avaient été mesurés par l’imagerie en résonance magnétique fonctionnelle (IRMf) pendant l’exposition à deux tâches émotionnelles. En général, les deux essais ont évoqué des activations cérébrales beaucoup plus étendues et plus intenses chez les hommes que chez les femmes. L’échantillon des résultats obtenus diffère de manière significative de ce qui avait été observé dans la population générale. Ces résultats apportent un soutien à la suggestion d’une « masculinisation » des femmes et d’une « féminisation » des hommes ayant un diagnostic de schizophrénie. Une recherche auprès d’un plus grand nombre de patients et de sujets contrôles est actuellement en cours pour confirmer cette hypothèse.Recent neuroanatomical studies imply a reversal of normal sexual dimorphism in schizophrenia in several corticolimbic structures, including the anterior cingulate, orbitofrontal cortex and amygdala. Prompted by these reports we have analyzed data of fifteen men and ten women with the diagnosis of schizophrenia who underwent functional magnetic resonance imaging (fMRI) during exposure to two emotion processing tasks. Overall both tests evoked much more extensive and intense cerebral activations in men than in women with schizophrenia. The pattern of obtained results differs significantly from what has been observed in the general population, thus giving support for the recent suggestion of “masculinization” of females and “feminization” of males with schizophrenia. More thorough investigation of a larger number of patients and healthy participants is currently on its way to substantiate this hypothesis.Recientemente los estudios neuroanatómicos han sugerido una inversión del dimorfismo sexual normal en las personas esquizofrénicas, en varias estructuras límbicas y corticolímbicas implicadas en el funcionamiento emocional. Estimulados por estos estudios, analizamos los datos provenientes de quince hombres y diez mujeres diagnosticados con esquizofrenia, que habían sido evaluados por medio de imágenes de resonancia magnética funcional (IRMf) durante la exposición a dos tareas emocionales. En general, los dos intentos evocaron activaciones cerebrales mucho más extensas y más intensas en los hombres que en las mujeres. La muestra de los resultados obtenidos difiere de manera significativa de lo que se había observado en la población general. Estos resultados aportan apoyo a la sugerencia de una “masculinización” de las mujeres y una “feminización” de los hombres diagnosticados con esquizofrenia. Actualmente se está realizando una investigación de un mayor número de pacientes y personas de control para confirmar esta hipótesis.Recentemente, estudos neuroanatômicos sugeriram uma inversão da deformidade sexual normal nas pessoas esquizofrênicas, em várias estruturas límbicas e corticolímbicas, implicadas no funcionamento emocional. Estimulados por estes estudos, analisamos dados provenientes de quinze homens e dez mulheres, com diagnóstico de esquizofrenia, que tinham sido medidos por Imagem em Ressonância Magnética Funcional (IRMf) durante a exposição a duas tarefas emocionais. De maneira geral, os dois testes evocaram ativações cerebrais muito mais vastas e muito mais intensas nos homens que nas mulheres. A amostragem dos resultados obtidos difere de maneira significativa do que tinha sido observado na população geral. Estes resultados apóiam a hipótese de uma “masculinização” das mulheres e de uma “feminização” dos homens que possuem um diagnóstico de esquizofrenia. Uma pesquisa junto a um maior número de pacientes e de sujeitos controlados está atualmente sendo realizada para confirmar esta hipótese

Neurodegeneration in Schizophrenia: Evidence from In Vivo

Although schizophrenia is primarily considered to be a neurodevelopmental disorder, there is a growing consensus that the disorder may also involve neurodegeneration. Recent research using non-invasive neuroimaging techniques, such as magnetic resonance imaging, suggests that some patients with schizophrenia show progressive losses of gray matter in the frontal and temporal lobes of the brain. The cellular mechanisms responsible for such gray matter losses are unknown, but have been hypothesized to involve abnormal increases in apoptosis

Pathways to schizophrenic psychosis: a LISREL-tested model of the unfolding of the schizophrenic prodrome

In this article a literature-based model (the Schizotypic Syndrome Questionnaire [SSQ] model) is presented that gives a description of the temporal unfolding of the schizophrenic prodrome. As a guiding principle for the selection of the symptoms in the model, the hypothesis was held that the main prodromal features determine each other in terms of cause and effect. Furthermore, the developmental pathways between the symptoms were not allowed to be in conflict with the usual observation that negative symptoms precede psychotic-like ones nor--at least in broad outline--with J.P. Docherty, D.P. van Kammen, S.G. Siris, and S.R. Marder's (1978) description of the various onset stages in the development of a schizophrenic psychosis. For the definitive version of the SSQ model, 12 symptoms were selected (e.g., affective flattening, suspicion, and delusional thinking). After specifying the paths to be estimated, the model was examined in two randomly drawn samples from a total community-based sample of 771 normal subjects and in the total sample itself, in each case resulting in adequate fit values. Moreover, all postulated pathways were found to be significantly different from zero. The use of a normal sample was based on the continuum hypothesis. Given the present-day discussions concerning the tenability of the schizophrenia concept, the model's implications with respect to that issue are particularly emphasized. Furthermore, the concept of the schizophrenia prodrome itself is critically discusse