A psychosocial pathway to paranoia : The interplay between social connectedness and self-esteem

Altres ajuts: acords transformatius de la UABThe quantity and quality of social contacts have been related to self-esteem, and both social relationships and self-esteem have been implicated in the pathways to paranoia. However, how social relationships interplay with self-esteem to trigger paranoia is not well understood. This study aims to investigate whether different measures of social connectedness (social support, loneliness, and desired friendship), as well as the frequency of social contact, impact paranoia and other positive and negative psychotic-like experiences (PLE) through the indirect effect of self-esteem. Data from a sample of 169 nonclinically ascertained participants oversampled for schizotypy scores were analyzed using two different approaches: retrospective trait-like and ecological momentary measures of social connectedness. Results showed that self-esteem mediates the pathways from poor social support and social longing, but not from loneliness, to paranoia and other cognitive PLE. In contrast, pathways from social connectedness toperceptual PLE and negative PLE were not mediated by self-esteem. Results were consistent across trait-like and momentary measures. Finally, self-esteem was not implicated in the pathways from the frequency of social contact and paranoia or other forms of PLE. These results provide a comprehensive picture of how social connectedness drives specific symptoms of psychosis through self-esteem. Findings underscore the need to explore separately the quality and quantity of social relationships and suggest that the subjective experience of meaningful social bonds is key social determinants of mental health. Therefore, addressing inadequacies of social connectedness could substantially improve symptomatic and functional outcomes of psychosis

The impact of family environment on self-esteem and symptoms in early psychosis

Expressed emotion (EE) and self-esteem (SE) have been implicated in the onset and development of paranoia and positive symptoms of psychosis. However, the impact of EE on patients' SE and ultimately on symptoms in the early stages of psychosis is still not fully understood. The main objectives of this study were to examine whether: (1) patients' SE mediated the effect of relatives' EE on patients' positive symptoms and paranoia; (2) patients' perceived EE mediated the effect of relatives' EE on patients' SE; (3) patients' SE mediated between patients' perceived EE and patients' symptomatology; and (4) patients' perceived EE and patients' SE serially mediated the effect of relatives' EE on patients' positive symptoms and paranoia. Incipient psychosis patients (at-risk mental states and first-episode of psychosis) and their respective relatives completed measures of EE, SE, and symptoms. Findings indicated that: (1) patients' perceived EE mediated the link between relatives' EE and patients' negative, but not positive, SE; (2) patients' negative SE mediated the effect of patients' perceived EE on positive symptoms and paranoia; (3) the association of relatives' EE with positive symptoms and paranoia was serially mediated by an increased level of patients' perceived EE leading to increases in negative SE; (4) high levels of patients' distress moderated the effect of relatives' EE on symptoms through patients' perceived EE and negative SE. Findings emphasize that patients' SE is relevant for understanding how microsocial environmental factors impact formation and expression of positive symptoms and paranoia in early psychosis. They suggest that broader interventions for patients and their relatives aiming at improving family dynamics might also improve patients' negative SE and symptoms

Comparison of Self-reported Attachment in Young Adults from Spain and the United States

Background: Previous studies have provided mixed evidence in support of the structure of Bartholomew’s attachment framework. The current study examined the comparability of the correlations among the attachment prototypes as well as the underlying factor structure of the Relationship Questionnaire in independent samples of Spanish and American young adults. Method: Participants were 547 students from the Universitat Autònoma de Barcelona and 1425 from the University of North Carolina at Greensboro who completed the Relationship Questionnaire. Results: Secure attachment was negatively correlated with fearful attachment, as was preoccupied attachment with dismissing attachment. The secure-fearful association in the American sample represented a medium effect size, whereas the remaining correlations represented small effect sizes. Except for the secure-fearful association, the correlations among prototypes were comparable in magnitude across samples. A principal components analysis yielded two factors that explained similar amounts of variance in the two samples. The pattern of loadings was relatively comparable in both samples; however, it was not entirely consistent with the theoretical model. Conclusions: The findings provided only partial support to the structure of the theoretical framework invoked. We discuss an alternative interpretation of the two factors, as well as further measurement considerations and directions for future research

Emerging adulthood and prospective depression: A simultaneous test of cumulative risk theories

Past research indicates that a history of depression and exposure to abuse and neglect represent some of the most robust predictors of depression in emerging adults. However, studies rarely test the additive or interactive risk associated with these distinct risk factors. In response, the present study explored how these three risk factors (prior depression, abuse, and neglect) synergistically predicted prospective depressive symptoms in a sample of 214 emerging adults (Mage?=?21.4 years; SDage?=?2.4; 78% females). Subtypes of maltreatment and lifetime history of depression were assessed through semi-structured interviews, and depressive symptoms were assessed annually for three years via self-report measures. The results indicated that for both males and females, a lifetime history of depression, abuse, and neglect-exposure uniquely conferred risk for elevated depressive symptoms. Furthermore, the interaction between neglect and prior depression forecasted increasing depressive symptoms, and a history of abuse also predicted increasing depressive symptoms, but only in females. These findings are contextualized within extant developmental psychopathology theories, and translational implications for trauma-informed depression prevention efforts are discussed

Smooth pursuit eye tracking and visual fixation in psychosis-prone individuals

Subjects identified by Perceptual Aberration-Magical Ideation (Per-Mag) scores (n=97), Social Anhedonia (SocAnh) scores (n=45), and Physical Anhedonia (PhysAnh) scores (n=31) as well as normal controls (n=94), underwent psychophysiological and clinical assessment. This is the first published investigation of pursuit system functioning in three groups of questionnaire-identified at-risk individuals. Pursuit during a simple non-monitor tracking task was measured using root-mean-square error (RMSE) scores and pursuit gain scores. Fixation performance was measured in terms of number of saccades away from the central fixation point. The at-risk subjects were more likely to display aberrant smooth pursuit tracking than controls, though there were no significant differences between the at-risk subjects endorsing items relevant to positive-symptom schizotypy and those endorsing items pertaining to negative-symptom schizotypy. The groups did not differ significantly in their visual fixation performance. Participants were also evaluated for the presence of Axis I symptomatology and psychotic-like experiences. Neither the experimental subjects nor the control subjects displayed a significant association between ocular motor performance and psychotic-like experiences. These findings are consistent with prior evidence that pursuit tracking is a trait characteristic, independent of clinical status

Attachment style predicts 6-month improvement in psychoticism in persons at-risk mental states for psychosis.

Aim: Insecure attachment may influence vulnerability to and outcome of psychotic symptomatology. The present study examined whether attachment style predicted symptoms and functioning of at-risk mental state (ARMS) patients after 6 months of psychosocial intervention, over and above the effects of initial clinical severity and premorbid social adjustment (PSA). Methods: Symptoms and functioning were assessed at baseline and 6 months later in 31 ARMS patients (mean age = 15.7). No patient received antipsychotic medication, but all engaged in intense psychosocial needs-adapted treatment. Clinicians (unaware of the aims of the study) rated attachment, PSA, symptoms, and functioning. Results: Attachment was not related to baseline clinical severity. However, improvement in psychoticism was predicted by attachment (in particular by secure, preoccupied and dismissing) beyond the effects of baseline clinical severity and PSA. Secure attachment also predicted improvements in disorganization and functioning. Poor PSA predicted less improvement in disorganization and negative symptoms but did not impact psychoticism. Conclusions: The three attachment prototypes that predicted improvement in psychoticism (secure, preoccupied and dismissing) share the existence of at least one positive psychological model (either about self or about others). It may be that the psychosocial intervention helped ARMS patients to disconfirm negative models and/or reinforce positive ones. Patients' attachment styles were not related to baseline clinical severity but impacted improvement of positive symptoms. These findings appear consistent with evidence that impaired self-esteem and dysfunctional self and others schemas constitute risk factors for reality distortion

The association of affective temperaments and bipolar spectrum psychopathology: An experience sampling study

Affective temperaments are trait-like expressions of affect that underlie mood psychopathology. Numerous studies have examined affective temperaments in laboratory-based studies; however, few have examined the expression of these temperaments in daily life. The present study examined affective temperaments and their associations with the expression of bipolar spectrum characteristics in daily life using experience sampling methodology. Young adults (n?=?290) completed the TEMPS-A and were signaled eight times daily for 1 week to complete smartphone surveys assessing affect, cognition, and behavior. Hyperthymic temperament was associated with positive affect, sense of self, and success. In contrast, cyclothymic/irritable temperament was associated with negative affect, impulsivity, negative sense of self, and difficulty concentrating. Those high in cyclothymic/irritable temperament were especially reactive to the experience of stress. Affective temperaments were differentially associated with the expression of bipolar spectrum psychopathology in daily life. The findings offer validation of the TEMPS-A, as well as the adaptive and maladaptive characteristics of hyperthymic and cyclothymic/irritable temperaments

Comparisons of schizotypal traits across 12 countries: Results from the International Consortium for Schizotypy Research

Background: Schizotypal traits are expressions of underlying vulnerability to psychotic disorders which have a potential impact on mental health status, neurocognition, quality of life, and daily functioning. To date, little research has examined epidemiologic landscape of schizotypal traits at the cross-national level. Our aim was to study the expression of schizotypal traits by sex, age, and country in a combined sample gathered from 12 countries. Methods: A total of 27,001 participants completed the Schizotypal Personality Questionnaire (SPQ). The mean age of participants was 22.12 (SD = 6.28); 37.5% (n = 10,126) were males. Results: Schizotypal traits varied according to sex, age, and country. Females scored higher than males in the positive dimension, whereas males scored higher in the disorganization dimension. By age, a significant decrease in the positive schizotypal traits was observed. Epidemiological expression of schizotypal traits varied by country. Moreover, several interactions by sex, age, and country were found. Conclusions: This pattern is similar to those found in patients with psychosis and psychotic-like experiences. These findings provide new insights and the opportunity to explore the phenotypic expression of schizotypal traits at cross-national level

COMT and anxiety and cognition in children with chromosome 22q11.2 deletion syndrome

The COMT gene is thought to contribute to the cognitive/psychiatric phenotypes in 22q11.2 deletion syndrome. We measured these manifestations against the Val/Met alleles of the COMT gene, in 40 nonpsychotic 22q11DS children. The Val allele was associated with poor IQ, processing speed, executive function and a higher frequency of anxiety disorders, underscoring the importance of the COMT gene in the childhood psychopathology in 22q11DS

Impact of attachment style on the 1-year outcome of persons with an at-risk mental state for psychosis

Attachment theory provides key elements for understanding the psychosocial vulnerability for and response to the emergence of psychosis. This study examined (1) whether pre-treatment attachment styles are differentially associated with clinical and functional outcome in at-risk mental state (ARMS) for psychosis patients across one year of psychosocial treatment, and (2) whether clinical change is associated with changes in attachment ratings beyond the effect of baseline symptom severity. Thirty-eight ARMS patients (mean age=16.7, S.D.=5.9) identified from a psychosocial needs-adapted treatment were evaluated with the Positive and Negative Syndrome Scale, the Global Assessment of Functioning, and the Relationships Questionnaire. Lower levels of insecure–avoidant attachment predicted better clinical outcomes, whereas higher levels of secure attachment predicted improvement in functioning. A decrease in preoccupied–anxious attachment was associated with symptom amelioration. The findings suggest that the intensity of insecure attachment plays a significant role in the clinical outcome of ARMS patients involved in psychosocial treatment. Reducing the levels of insecure attachment in the therapeutic setting probably favors a better course in the early phases of psychosis. Furthermore, the finding that negative models of the self and others were associated with symptom outcome is consistent with current psychosocial models of psychosis