The effect of limited cognitive resources on communication disturbances in serious mental illness

Semantically incoherent speech is a pernicious clinical feature of serious mental illness (SMI). The precise mechanisms underlying this deficit remain unclear. Prior studies have found that arousal of negative emotion exaggerates the severity of these communication disturbances; this has been coined "affective reactivity". Recent research suggests that "cognitive reactivity" may also occur, namely reflecting reduced "on-line" cognitive resources in SMI. We tested the hypothesis that communication disturbances manifest as a function of limited cognitive resources in SMI above and beyond that associated with state affectivity. We also investigated individual differences in symptoms, cognitive ability, and trait affect that may be related to cognitive reactivity. We compared individuals with SMI (n=52) to nonpsychiatric controls (n=27) on a behavioral-based coding of communication disturbances during separate baseline and experimentally-manipulated high cognitive-load dual tasks. Controlling for state affective reactivity, a significant interaction was observed such that communication disturbances decreased in the SMI group under high cognitive-load. Furthermore, a reduction in communication disturbances was related to lower trait and state positive affectivity in the SMI group. Contrary to our expectations, limited cognitive resources temporarily relieved language dysfunction. Implications, particularly with respect to interventions, are discussed

Deformations and dilations of chaotic billiards, dissipation rate, and quasi-orthogonality of the boundary wavefunctions

We consider chaotic billiards in d dimensions, and study the matrix elements M_{nm} corresponding to general deformations of the boundary. We analyze the dependence of |M_{nm}|^2 on \omega = (E_n-E_m)/\hbar using semiclassical considerations. This relates to an estimate of the energy dissipation rate when the deformation is periodic at frequency \omega. We show that for dilations and translations of the boundary, |M_{nm}|^2 vanishes like \omega^4 as \omega -> 0, for rotations like \omega^2, whereas for generic deformations it goes to a constant. Such special cases lead to quasi-orthogonality of the eigenstates on the boundary.Comment: 4 pages, 3 figure

Category fluency in psychometric schizotypy: How altering emotional valence and cognitive load affects performance

Introduction. In clinical high-risk populations, category fluency deficits are associated with conversion to psychosis. However, their utility as clinical risk markers is unclear in psychometric schizotypy, a group experiencing schizophrenia-like traits that is at putative high risk for psychosis. Methods. We examined whether introducing affective or cognitive load, two important stress vulnerability markers, altered category fluency performance in schizotypy (n = 42) and non-schizotypy (n = 38) groups. To investigate this question, we developed an experimental paradigm where all participants were administered category fluency tests across baseline, pleasant valence, unpleasant valence, and cognitive load conditions. Results. Compared to the non-schizotypy group, those with schizotypy performed significantly worse in pleasant and unpleasant valence conditions, but not cognitive load or baseline fluency tests. Conclusions. This study demonstrated the role of affect – but not cognitive load – on category fluency in psychometric schizotypy, as group differences only emerged once affective load was introduced. One explanation for this finding is that semantic memory may be unimpaired under normal conditions in psychometric schizotypy, but may be compromised once affective load is presented. Future studies should examine whether fluency deficits – particularly when affect is induced – predict future conversion to psychosis in psychometric schizotypy cohorts

Vocal Expression in Schizophrenia: Less Than Meets the Ear

Abnormalities in nonverbal communication are a hallmark of schizophrenia. Results from studies using symptom rating scales suggest that these abnormalities are profound (i.e., 3-5 SDs) and occur across virtually every channel of vocal expression. Computerized acoustic analytic technologies, used to overcome practical and psychometric limitations with symptom rating scales, have found much more benign and isolated abnormalities. To better understand vocal deficits in schizophrenia and to advance acoustic analytic technologies for clinical and research applications, we examined archived speech samples from 5 separate studies, each using different speaking tasks (patient N = 309; control N = 117). We sought to: (a) use Principal Component Analysis (PCA) to identify independent vocal expression measures from a large set of variables, (b) quantify how patients with schizophrenia are abnormal with respect to these variables, (c) evaluate the impact of demographic and contextual factors (e.g., study site, speaking task), and (d) examine the relationship between clinically-rated psychiatric symptoms and vocal variables. PCA identified 7 independent markers of vocal expression. Most of these vocal variables varied considerably as a function of context and many were associated with demographic factors. After controlling for context and demographics, there were no meaningful differences in vocal expression between patients and controls. Within patients, vocal variables were associated with a range of psychiatric symptoms-though only pause length was significantly associated with clinically rated negative symptoms. The discussion centers on explaining the apparent discordance between clinical and computerized speech measures

Alternative Stacking Sequences in Hexagonal Boron Nitride

The relative orientation of successive sheets, i.e. the stacking sequence, in layered two-dimensional materials is central to the electronic, thermal, and mechanical properties of the material. Often different stacking sequences have comparable cohesive energy, leading to alternative stable crystal structures. Here we theoretically and experimentally explore different stacking sequences in the van der Waals bonded material hexagonal boron nitride (h-BN). We examine the total energy, electronic bandgap, and dielectric response tensor for five distinct high symmetry stacking sequences for both bulk and bilayer forms of h-BN. Two sequences, the generally assumed AA' sequence and the relatively unknown (for h-BN) AB (Bernal) sequence, are predicted to have comparably low energy. We present a scalable modified chemical vapor deposition method that produces large flakes of virtually pure AB stacked h-BN; this new material complements the generally available AA' stacked h-BN

Schizotypy as An Organizing Framework for Social and Affective Sciences

Schizotypy, defined in terms of commonly occurring personality traits related to the schizophrenia spectrum, has been an important construct for understanding the neurodevelopment and stress-diathesis of schizophrenia. However, as schizotypy nears its sixth decade of application, it is important to acknowledge its impressively rich literature accumulating outside of schizophrenia research. In this article, we make the case that schizotypy has considerable potential as a conceptual framework for understanding individual differences in affective and social functions beyond those directly involved in schizophrenia spectrum pathology. This case is predicated on (a) a burgeoning literature noting anomalies in a wide range of social functioning, affiliative, positive and negative emotional, expressive, and social cognitive systems, (b) practical and methodological features associated with schizotypy research that help facilitate empirical investigation, and (c) close ties to theoretical constructs of central importance to affective and social science (eg, stress diathesis, neural compensation). We highlight recent schizotypy research, ie providing insight into the nature of affective and social systems more generally. This includes current efforts to clarify the neurodevelopmental, neurobiological, and psychological underpinnings of affiliative drives, hedonic capacity, social cognition, and stress responsivity systems. Additionally, we discuss neural compensatory and resilience factors that may mitigate the expression of stress-diathesis and functional outcome, and highlight schizotypy's potential role for understanding cultural determinants of social and affective function

Extending the usefulness of the verbal memory test: The promise of machine learning

The evaluation of verbal memory is a core component of neuropsychological assessment in a wide range of clinical and research settings. Leveraging story recall to assay neurocognitive function could be made more useful if it were possible to administer frequently (i.e., would allow for the collection of more patient data over time) and automatically assess the recalls with machine learning methods. In the present study, we evaluated a novel story recall test with 24 parallel forms that was deployed using smart devices in 94 psychiatric inpatients and 80 nonpatient adults. Machine learning and vector-based natural language processing methods were employed to automate test scoring, and performance using these methods was evaluated in their incremental validity, criterion validity (i.e., convergence with trained human raters), and parallel forms reliability. Our results suggest moderate to high consistency across the parallel forms, high convergence with human raters (r values ~ 0.89), and high incremental validity for discriminating between groups. While much work remains, the present findings are critical for implementing an automated, neuropsychological test deployable using remote technologies across multiple and frequent administrations

Loneliness and Schizotypy Are Distinct Constructs, Separate from General Psychopathology

Loneliness is common in youth and associated with a significantly increased risk of psychological disorders. Although loneliness is strongly associated with psychosis, its relationship with psychosis proneness is unclear. Our aim in this paper was to test the hypothesis that loneliness and schizotypal traits, conveying risk for schizophrenia spectrum disorders, are similar but separate constructs. Pooling data from two non-clinical student samples (N = 551) we modeled the structure of the relationship between loneliness and trait schizotypy. Loneliness was assessed with the University of California, Los Angeles Loneliness Scale (UCLA-3), whilst negative (Social Anhedonia) and positive (Perceptual Aberrations) schizotypal traits were assessed with the Wisconsin Schizotypy Scales-Brief (WSS-B). Fit statistics indicated that the best fitting model of UCLA-3 scores comprises three correlated factors (Isolation, Related Connectedness, and Collective Connectedness), consistent with previous reports. Fit statistics for a two factor model of positive and negative schizotypy were excellent. Next, bi-factor analysis was used to model a general psychopatholgy factor (p) across the three loneliness factors and separate negative and positive schizotypy traits. The results showed that all items (except 1) co-loaded on p. However, with the influence of p removed, additional variance remained within separate sub-factors, indicating that loneliness and negative and positive trait schizotypy are distinct and separable constructs. Similarly, once shared variance with p was removed, correlations between sub-factors of loneliness and schizotypal traits were non-significant. These findings have important clinical implications since they suggest that loneliness should not be conflated with the expression of schizotypy. Rather, loneliness needs to be specifically targeted for assessment and treatment in youth at risk for psychosis

Economic inequalities in the effectiveness of a primary care intervention for depression and suicidal ideation.

BACKGROUND: Economic disadvantage is associated with depression and suicide. We sought to determine whether economic disadvantage reduces the effectiveness of depression treatments received in primary care. METHODS: We conducted differential-effects analyses of the Prevention of Suicide in Primary Care Elderly: Collaborative Trial, a primary-care-based randomized, controlled trial for late-life depression and suicidal ideation conducted between 1999 and 2001, which included 514 patients with major depression or clinically significant minor depression. RESULTS: The intervention effect, defined as change in depressive symptoms from baseline, was stronger among persons reporting financial strain at baseline (differential effect size = -4.5 Hamilton Depression Rating Scale points across the study period [95% confidence interval = -8.6 to -0.3]). We found similar evidence for effect modification by neighborhood poverty, although the intervention effect weakened after the initial 4 months of the trial for participants residing in poor neighborhoods. There was no evidence of substantial differences in the effectiveness of the intervention on suicidal ideation and depression remission by economic disadvantage. CONCLUSIONS: Economic conditions moderated the effectiveness of primary-care-based treatment for late-life depression. Financially strained individuals benefited more from the intervention; we speculate this was because of the enhanced treatment management protocol, which led to a greater improvement in the care received by these persons. People living in poor neighborhoods experienced only temporary benefit from the intervention. Thus, multiple aspects of economic disadvantage affect depression treatment outcomes; additional work is needed to understand the underlying mechanisms

Semantic coherence in psychometric schizotypy: An investigation using Latent Semantic Analysis

Technological advancements have led to the development of automated methods for assessing semantic coherence in psychiatric populations. Latent Semantic Analysis (LSA) is an automated method that has been used to quantify semantic coherence in schizophrenia-spectrum disorders. The current study examined whether: 1) Semantic coherence reductions extended to psychometrically-defined schizotypy and 2) Greater cognitive load further reduces semantic coherence. LSA was applied to responses generated during category fluency tasks in baseline and cognitive load conditions. Significant differences between schizotypy and non-schizotypy groups were not observed. Findings suggest that semantic coherence may be relatively preserved at this point on the schizophrenia-spectrum