Metacognitive self-reflectivity moderates the relationship between distress tolerance and empathy in schizophrenia

Deficits in empathy seen in schizophrenia are thought to play a major role in the social dysfunction seen in the disorder. However, little work has investigated potential determinants of empathic deficits. This study aimed to fill that gap by examining the effects of two variables on empathy – distress tolerance and metacognitive self-reflectivity. Fifty-four people with schizophrenia-spectrum disorders receiving services at an urban VA or community mental health center were assessed for empathy, metacognition, and distress tolerance. Bivariate correlations and moderation methods were used to ascertain associations amongst these variables and examine interactions. Results revealed that, against hypotheses, empathy was not related at the bivariate level to either distress tolerance or metacognitive self-reflectivity. However, consistent with hypotheses, moderation analyses revealed that participants with higher self-reflectivity showed no relationship between distress tolerance and empathy, while those with lower self-reflectivity showed a relationship such that reduced ability to tolerate distress predicted reduced empathy. Taken together, results of this study suggest that lack of distress tolerance can negatively affect empathy in people with schizophrenia with lesser capacity for metacognitive self-reflection; thus, fostering self-reflectivity may help overcome that negative impact. Future work is needed investigating the impact of metacognitively-tailored interventions on empathy in this population

Metacognitive function and fragmentation in schizophrenia: Relationship to cognition, self-experience and developing treatments

Bleuler suggested that fragmentation of thought, emotion and volition were the unifying feature of the disorders he termed schizophrenia. In this paper we review research seeking to measure some of the aspects of fragmentation related to the experience of the self and others described by Bleuler. We focus on work which uses the concept of metacognition to characterize and quantify alterations or decrements in the processes by which fragments or pieces of information are integrated into a coherent sense of self and others. We describe the rationale and support for one method for quantifying metacognition and its potential to study the fragmentation of a person\u27s sense of themselves, others and the relative place of themselves and others in the larger human community. We summarize research using that method which suggests that deficits in metacognition commonly occur in schizophrenia and are related to basic neurobiological indices of brain functioning. We also present findings indicating that the capacity for metacognition in schizophrenia is positively related to a broad range of aspects of psychological and social functioning when measured concurrently and prospectively. Finally, we discuss the evolution and study of one therapy that targets metacognitive capacity, Metacognitive Reflection and Insight Therapy (MERIT) and its potential to treat fragmentation and promote recovery

The HARPS search for southern extra-solar planets. VI. A Neptune-mass planet around the nearby M dwarf Gl 581

We report the discovery of a Neptune-mass planet around Gl 581 (M3V, M = 0.31 Msol), based on precise Doppler measurements with the HARPS spectrograph at La Silla Observatory. The radial velocities reveal a circular orbit of period P = 5.366 days and semi-amplitude K1 = 13.2 m/s. The resulting minimum mass of the planet (m2 sin i) is only 0.052 Mjup = 0.97 Mnep = 16.6 Mearth making Gl 581b one of the lightest extra-solar planet known to date. The Gl 581 planetary system is only the third centered on an M dwarf, joining the Gl 876 three-planet system and the lone planet around Gl 436. Its discovery reinforces the emerging tendency of such planets to be of low mass, and found at short orbital periods. The statistical properties of the planets orbiting M dwarfs do not seem to match a simple mass scaling of their counterparts around solar-type stars.Comment: letter submitted to A&

The HARPS search for southern extra-solar planets XIX. Characterization and dynamics of the GJ876 planetary system

Precise radial-velocity measurements for data acquired with the HARPS spectrograph infer that three planets orbit the M4 dwarf star GJ876. In particular, we confirm the existence of planet "d", which orbits every 1.93785 days. We find that its orbit may have significant eccentricity (e=0.14), and deduce a more accurate estimate of its minimum mass of 6.3 Earth masses. Dynamical modeling of the HARPS measurements combined with literature velocities from the Keck Observatory strongly constrain the orbital inclinations of the "b" and "c" planets. We find that i_b = 48.9 degrees and i_c = 48.1 degrees, which infers the true planet masses of M_b = 2.64 Jupiter masses and M_c = 0.83 Jupiter masses, respectively. Radial velocities alone, in this favorable case, can therefore fully determine the orbital architecture of a multi-planet system, without the input from astrometry or transits. The orbits of the two giant planets are nearly coplanar, and their 2:1 mean motion resonance ensures stability over at least 5 Gyr. The libration amplitude is smaller than 2 degrees, suggesting that it was damped by some dissipative process during planet formation. The system has space for a stable fourth planet in a 4:1 mean motion resonance with planet "b", with a period around 15 days. The radial velocity measurements constrain the mass of this possible additional planet to be at most that of the Earth.Comment: 10 pages, 10 figures, accepted for publication in Astronomy & Astrophysic

Sexuality and intimacy among people living with serious mental illnesses: Factors contributing to sexual activity

OBJECTIVE: Limited research has focused on sexuality for those diagnosed with a severe mental illness. We aimed to extend existing work by exploring relationships between mastery (perception of control of one's life and future), sexual self-esteem (perceptions of one's capacity to engage in healthy sexual behavior), sexual attitudes (permissive ideas about sexuality), and perceived importance of relationships/sexuality and number of sexual partners. METHOD: A secondary analysis of survey data from adult participants living with a severe mental illness (N = 401) in the Indiana Mental Health Services and HIV-Risk Study (Perry & Wright, 2006) was conducted. Analysis of covariance (controlling for marital status) compared those with 0 partners, 1 partner, or multiple partners over the past 3 months on the dependent variables of mastery, sexual self-esteem, sexual attitudes, and perceived importance. RESULTS: Participants with more permissive attitudes, greater perceived importance, and higher mastery were more likely to be sexually active with multiple partners. Self-esteem did not differentiate groups. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: Given the key role of sexual satisfaction in quality of life and the high rates of sexual risk behavior in this population, it is important that clinicians systematically assess mastery, perceived importance, and attitudes about sexuality when working with consumers diagnosed with a severe mental illness. Individually tailoring existing interventions on the basis of consumers' levels of mastery, related to self-efficacy for implementing changes in life, could improve long-term outcomes for these programs. Future research should examine other constructs that may account for more variance in sexual activity, such as perceptions of risk, intentions for sexual safety, or romantic relationship functioning

Schizotypy in an online sample: Associations with functioning, wellbeing, and stigma toward psychological treatment

poster abstractBackground: Social functioning and positive attitudes toward treatment have been strongly linked with recovery in people with schizophrenia, yet less is known for schizotypy – traits that are associated with risk for schizophrenia. Previous studies of schizotypy have used primarily undergraduate or small community samples. The aim of the current study was to investigate correlates of schizotypy in a large online sample. We hypothesized that people with schizotypy traits would report lower functioning, well-being, and greater stigmatizing attitudes regarding treatment. Methods: In a sample (N=856) recruited using Amazon’s Mechanical Turk (MTurk), participants were dichotomized into non-schizotypy or schizotypy groups based on their endorsement of schizotypal traits on the Schizotypal Personality Questionnaire – Brief Revised (SPQ-BR; schizotypy group n=101; non-schizotypy group n=431). Participants completed a demographic survey and several measures related to functioning, well-being, and stigma, including the Romantic Relationship Functioning Scale (RRFS), the Social Adjustment Scale – Self-Report: Screener (SAS-SR: Screener), the SPQ-BR, the Short Form-12 Health Survey (SF-12), and the Stigma Scale for Receiving Psychological Help (SSRPH). Independent-samples t-tests were conducted to compare schizotypy groups on these variables. Results: Those who reported high levels of schizotypy reported significantly poorer social functioning, t(122.74)=-10.66, p<.001; poorer romantic relationship functioning, t(129.01)=12.00, p<.001; poorer mental wellbeing ,t(132.58)=13.42, p=.001; and greater stigma toward receiving psychological treatment, t(137.06)=-3.89, p=.037. There was no significant difference in physical wellbeing. Discussion: These findings support the use of online samples and suggest schizotypy is associated with poorer functioning and wellbeing and increased stigma toward seeking treatment. Results support the emergence of deficits in key social domains among those at risk for developing greater psychosis symptoms. Given the links between these deficits and attitudes and poorer functioning in clinical samples, these findings suggest social functioning and help-seeking attitudes may be important targets of early intervention services

Parenthood and severe mental illness: Relationships with recovery

Objective Parenting is an important life domain for many people, but little research examines the parenting experience and its role in recovery for those with a severe mental illness. The current study provides preliminary evidence of how these concepts are related in a sample of individuals living with severe mental illness attending a community mental health center. We also explored potential differences between mothers and fathers, which could help better tailor services to meet the needs of parents with severe mental illness. Methods Data were obtained during baseline interviews for a study testing an intervention designed to increase shared decision-making in psychiatric treatment. Participants (N = 167) were administered measures of patient activation, recovery, autonomy preference, hope, and trust in providers. We compared parents and non-parents and compared mothers and fathers using chi-square, t-tests, and, where appropriate, analysis of covariance. Results Parents had a significantly higher level of trust in their psychiatric care provider than non-parents. Contrary to hypotheses, parents were less active in their treatment and preferred less information-seeking autonomy than did non-parents, but did not differ on other recovery-related indices. No differences on recovery-related indices were detected between mothers and fathers. Secondary analyses revealed parents with minor children had more hope than parents of older children. Conclusions and Implications for Practice Although parents may have higher levels of trust in their physicians, our preliminary findings suggest that parents with severe mental illness may benefit from increased efforts to help them be more active and interested in information about their illnesses

Factor structure of the autonomy preference index in people with severe mental illness

People vary in the amount of control they want to exercise over decisions about their healthcare. Given the importance of patient-centered care, accurate measurement of these autonomy preferences is critical. This study aimed to assess the factor structure of the Autonomy Preference Index (API), used widely in general healthcare, in individuals with severe mental illness. Data came from two studies of people with severe mental illness (N=293) who were receiving mental health and/or primary care/integrated care services. Autonomy preferences were assessed with the API regarding both psychiatric and primary care services. Confirmatory factor analysis was used to evaluate fit of the hypothesized two-factor structure of the API (decision-making autonomy and information-seeking autonomy). Results indicated the hypothesized structure for the API did not adequately fit the data for either psychiatric or primary care services. Three problematic items were dropped, resulting in adequate fit for both types of treatment. These results suggest that with relatively minor modifications the API has an acceptable factor structure when asking people with severe mental illness about their preferences to be involved in decision-making. The modified API has clinical and research utility for this population in the burgeoning field of autonomy in patient-centered healthcare

M dwarf stars in the light of (future) exoplanet searches

We present a brief overview of a splinter session on M dwarf stars as planet hosts that was organized as part of the Cool Stars 17 conference. The session was devoted to reviewing our current knowledge of M dwarf stars and exoplanets in order to prepare for current and future exoplanet searches focusing in low mass stars. We review the observational and theoretical challenges to characterize M dwarf stars and the importance of accurate fundamental parameters for the proper characterization of their exoplanets and our understanding on planet formation.Comment: 4 pages, 1 figure. Summary of the splinter session "M dwarf stars in the light of (future) exoplanet searches" held at the 17th Cambridge Workshop on Cool Stars, Stellar Systems, and the Sun, June 28th 2012, Barcelona, Spain. Submitted for publication in Astronomische Nachrichten - Astronomical Notes (AN) 334, Issue 1-2, Eds Klaus Strassmeier and Mercedes L\'opez-Morale

Why are you here again? Concordance between consumers and providers about the primary concern in recurring psychiatric visits

Patient-centered care has become increasingly important over the last decade, both in physical and mental health care. In support of patient-centered care, providers need to understand consumers׳ primary concerns during treatment visits. The current study explored what primary concerns were brought to recurring psychiatric visits for a sample of adults with severe mental illness (N=164), whether these concerns were concordant with those recognized by providers, and which factors predicted concordance. We identified 17 types of primary concerns, most commonly medications and symptoms, with only 50% of visits showing evidence of at least partial agreement between consumers and providers. Contrary to expectations, consumer demographics, activation, trust, and perceptions of patient-centeredness were not predictive, while greater preferences for autonomy predicted poorer agreement. Our findings highlight the need for interventions to promote a shared understanding of primary concerns in recurring psychiatric visits. Further attention is needed to ensure the provision of patient-centered care such that consumer concerns are acknowledged and addressed within recurring psychiatric visits