Validation of the aberrant salience inventory in a general and clinical Spanish population.

The concept of aberrant salience is related to the onset of psychosis. Its study is important for early identification and possible intervention in processes activating later positive symptoms. This study validated the Spanish Aberrant Salience Inventory (ASI) for adult and clinical populations. The sample consisted of 6178 participants, of whom 4523 were adolescents, 1292 were general population adults and 363 were patients with a psychopathology. The evidence provided validates the instrument's structure. Invariance of measurement suggests that both men and women, patients and nonclinical population (adults and adolescents) interpreted the items on the ASI similarly. The distribution of scores by age also suggests stabilization of the trend at about 19 years of age, showing a developmental change in motivational response. The hypothesis that patients, and in particular, those diagnosed with schizophrenia and other psychotic disorders and bipolar disorders would have the highest average scores in aberrant salience was met. This is a valuable instrument for evaluating a complex process related to abnormal motivation in the development of schizophrenia

The role of premorbid personality and social cognition in suicidal behaviour in first-episode psychosis: a one-year follow-up study

Background: High suicide attempt (SA) rates have been reported in first-episode psychosis (FEP) patients, particularly during the first year after the illness onset. Despite previous studies establishing several risk factors for suicidal behaviour in FEP, premorbid personality and social cognition have not been sufficiently investigated to date. Objective: To test whether personality traits and social cognition are associated with SAs in FEP over a 12-month follow-up. Method: Sixty-five FEP patients were evaluated at first contact with mental health services. The presence of SAs was recorded at six and twelve months after first presentation. Bivariate and multivariate analyses explored the influence of a range of sociodemographic and clinical variables, including premorbid personality and social cognition-related Theory of Mind (ToM) measures, on SAs. Results: SAs were associated with greater severity of symptoms at first hospitalization with psychotic symptoms (OR = 2.18, 95% CI = 1.25–3.82), schizoid personality traits (OR = 1.62, 95% CI = 1.02–2.57) and impairment in a first-order false belief task (OR = 4.26, 95% CI = 1.05–17.31) in the multivariate models. Conclusions: Symptom severity at illness onset, premorbid schizoid personality traits and ToM impairment emerged as predictors of SA in this FEP sample, which, if replicated, may be useful in identifying high-risk groups and implementing more targeted suicide prevention programs in FEP

Coping with voices: A group approach for managing auditory hallucinations.

This article describes a group intervention designed to help people with severe mental illnesses cope with auditory hallucinations. Each session is comprised of both a supportive discussion and skills training. The skills training component utilizes a modeling sequence to promote the development of behavioral coping strategies. These strategies are empirically derived and have been organized into a user-friendly format based on the input of persons who experience hallucinations and mental health professionals. Practical information is also provided to serve as a guide for organizing and implementing this group.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/61163/1/Auditory.pd

Perplexity

The sense of perplexity is a key feature of delusional mood/atmosphere which plays an important role in the phenomenology of early psychosis. Here we begin this chapter by presenting a clinical scenario of the psychosis prodrome and refer to this case study as our basis of discussion. We provide a detailed picture of psychiatric and philosophical literature to investigate in depth the phenomenon of perplexity drawing from theories such as Conrad’s stage model of beginning schizophrenia before placing the original case study into context and discuss concepts related to a loss of common sense and delusional elaboration in the pathogenesis of the perplexed feelings experienced by many prodromal individuals. We end the chapter with clinical implications and offer potential suggestions for improving the assessment, diagnosis and treatment of early psychosis, in particular the importance of recognising the individual’s suffering and acknowledge his own reality