The effect of intranasal oxytocin on neurocognition in people with schizophrenia: A randomized controlled trial.

Schizophrenia is characterized by persistent cognitive deficits that significantly impact functional outcomes. Despite the current available treatments, these deficits remain inadequately addressed, highlighting the need to explore the effect of more novel treatments on cognition. The current study examined the effect of intranasal oxytocin on cognitive functioning in people with schizophrenia by utilizing data from a 12-week, randomized controlled trial. Sixty-seven participants with schizophrenia or schizoaffective disorder were randomized to receive placebo or intranasal oxytocin. Participants completed a comprehensive neuropsychological battery at baseline and 12 weeks. The results demonstrated that intranasal oxytocin did not significantly improve cognition in people with schizophrenia compared to placebo. These findings suggest that oxytocin does not worsen or enhance cognition in people with schizophrenia. Yet, the current intervention did not standardize the timing of cognitive assessments relative to the timing of oxytocin administration, which may explain our findings. Future studies attempting to clarify this relationship would benefit from employing a more controlled approach to the timing of treatment and assessments.

Emotional processing in patients with single brain damage in the right hemisphere.

BACKGROUND: The interest in the relationship between brain damage and social cognition has increased in recent years. The objectives of the present study were the following: (1) to evaluate and compare emotional facial recognition and subjective emotional experience in patients who have suffered a single ischemic stroke in the right hemisphere (RH) and in healthy people, (2) to analyze the relationship between both variables in both groups of subjects, and (3) to analyze the association between the cerebral location of the stroke and these two variables. METHODS: Emotional facial recognition and the subjective emotional experience of 41 patients who had suffered a single ischemic stroke in the RH and 45 volunteers without previous cerebrovascular pathology were evaluated. RESULTS: Brain damaged patients performed lower in facial emotional recognition and had a less intense subjective emotional response to social content stimuli compared to healthy subjects. Likewise, among patients with RH ischemic stroke, we observed negative associations between facial recognition of surprise and reactivity to unpleasant images, and positive associations between recognition of disgust and reactivity to pleasant images. Finally, patients with damage in the caudate nucleus of the RH presented a deficit in the recognition of happiness and sadness, and those with damage in the frontal lobe exhibited a deficit in the recognition of surprise, compared to those injured in other brain areas. CONCLUSIONS: Emotional facial recognition and subjective emotional experience are affected in patients who have suffered a single ischemic stroke in the RH. Professionals caring for stroke patients should improve their understanding of the general condition of affected persons and their environment, assess for risk of depression, and facilitate their adaptation to work, family, and social environments.

Detection of bipolar disorder in the prodromal phase: A systematic review of assessment instruments.

BACKGROUND: Early detection of prodromal symptoms may contribute to improving the prognosis of patients with bipolar disorder (BD). The main objective of this systematic review is to present the different procedures for the identification of initial and relapse prodromes in these patients. METHODS: PsycINFO, Web of Science and PubMed databases were searched using a predetermined strategy, until January 4, 2022. Then, by means of a regulated process, studies that used a BD prodrome detection procedure, in English-language and all ages participants were selected. Quantitative and qualitative studies were assessed using a modified version of the Newcastle-Ottawa Scale and by Critical Appraisals Skills Programme checklist, respectively. RESULTS: Forty-five studies were selected. Of these, 26 used procedures for identifying initial prodromes (n = 8014) and 19 used procedures for detecting relapse prodromes (n = 1136). The interview was the most used method in the detection of both types of prodromes (k = 30 papers, n = 4068). It was variable in its degree of structure. Mobile applications and digital technologies are gaining importance in the detection of the relapse prodromes. LIMITATIONS: A retrospective design in most papers, small samples sizes, existence of persistent subsyndromal symptoms and difficulty to identify the end of the prodrome and the onset of the disorder. CONCLUSIONS: There is a wide variety of assessment instruments to detect prodromes in BD, among which the clinical interview is most frequently used. Future research should consider development of a brief tool to be applied in different formats to patients and family members.

User experiences of an American-adapted moderated online social media platform for first-episode psychosis: Qualitative analysis.

Objectives: The current study sought to qualitatively characterize the experiences of American users in a recent open trial of the Horyzons digital platform. Methods: In total, 20 users on Horyzons USA completed semistructured interviews 12 weeks after their orientation to the platform and addressed questions related to (1) the platform, (2) their online therapist, and (3) the peer workers and community space. A hybrid inductive-deductive coding strategy was used to conduct a thematic analysis of the data (NCT04673851). Results: The authors identified seven prominent themes that mapped onto the three components of self-determination theory. Features of the platform itself as well as inter- and intra-personal factors supported the autonomous use of Horyzons. Users also reflected that their perceived competence in social settings and in managing mental health was increased by the familiarity, privacy, and perceived safety of the platform and an emphasis on personalized therapeutic content. The behaviors or traits of online therapists as perceived by users and regular contact with peers and peer support specialists satisfied users' need for relatedness and promoted confidence in social settings. Users also described aspects of Horyzons USA that challenged their satisfaction of autonomy, competence, and relatedness, highlighting potential areas for future iterations of the platform's content and interface. Conclusions: Horyzons USA is a promising digital tool that provides young adults with psychosis with the means to access tailored therapy material on demand and a supportive digital community to aid in the recovery process.

Measuring practitioner attitudes toward psychosis and recovery: Exploratory factor analysis of the Psychosis Attitudes Scale.

OBJECTIVE: Practitioner attitudes regarding the nature of psychosis and prospects of recovery are important targets in supervision and training of practitioners who work therapeutically with this population. The 19-item Psychosis Attitudes Scale (PAS) was developed as a way to monitor changes in psychosis-related attitudes among practitioners being trained in an Evidence Based Treatment (EBT) for psychosis. This study reports the development and underlying factor structure of the PAS. METHOD: Three hundred twenty-five community mental health clinicians completed the PAS following a Cognitive Behavioral Therapy for psychosis (CBTp) multiday workshop training. We conducted an exploratory factor analysis to investigate the underlying structure of the initial set of items. RESULTS: Our analyses suggest that the PAS taps into four attitude groupings, which can be conceptualized as perceived confidence in working with individuals with psychosis (Factor 1), a recovery orientation (Factor 2), expectations of fulfillment (Factor 3), and a stress-vulnerability orientation (Factor 4). CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: Factors 1 and 3 appear to tap into general themes relevant to training practitioners in an evidence-based psychotherapeutic intervention for psychosis. Factors 2 and 4 are consistent with guiding principles of high-fidelity CBTp. At the individual level, practitioner attitudes have implications for training retention and treatment delivery. At the organizational level, the collective attitudes of staff in a given setting may serve as an indicator of readiness for EBT for psychosis implementation. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

The use of diary methods to evaluate daily experiences in first-episode psychosis.

Integrated Coping Awareness Therapy (I-CAT) is an intervention that targets stress reactivity in first-episode psychosis (FEP). This study extends prior outcome research on I-CAT by examining predictors of online daily diary completion among 38 young adults with FEP and treatment group differences in diary ratings. We found no significant predictors of daily diary completion rate and no effect of treatment condition on diary ratings. These results are consistent with Halverson et al. (2021) and suggest that diaries are a valuable method of data collection in FEP.

Mobile Health for Caregivers of Young Adults With Early Psychosis: A Survey Study Examining User Preferences.

OBJECTIVE: Caregivers play a key role in supporting the recovery of young adults with early psychosis. This role often involves considerable responsibilities and burden. Despite the considerable needs of caregivers, troubling service gaps addressing these needs remain. Digital technologies may increase caregivers' access to supportive resources; however, technologies developed specifically for caregivers lag far behind those developed for their relatives affected by early psychosis. In particular, little is known about the mobile health (mHealth) features that may be most acceptable to caregivers. METHODS: The authors surveyed a sample of 43 caregivers on their interests regarding various features of a proposed mHealth intervention. RESULTS: Caregivers of young adults with early psychosis were highly interested in a caregiver-facing mHealth intervention, specifically one providing information about psychosis, treatments, and communication with their affected family member. CONCLUSIONS: Future caregiver-focused mHealth intervention interventions may be highly acceptable to this population and may address pressing service gaps.

Cannabis use and metabolic syndrome among clients with first episode psychosis.

AIM: To explore the relationship between cannabis use and metabolic syndrome (MetS) among those who have experienced first episode psychosis (FEP). METHODS: A retrospective analysis of 404 participants enrolled in the Recovery After Initial Schizophrenia Episode-Early Treatment Program (RAISE-ETP) was conducted. Using multiple logistic regression, we investigated the correlation between cannabis use and rate of MetS at baseline and across time as well as the specific metabolic derangements among cannabis users and abstainers. RESULTS: Although cannabis users had similar rates of MetS at baseline when compared with abstainers, those who used cannabis at any time during the study period tended to have lower triglycerides and elevated high-density lipoprotein (HDL). Cannabis users were less likely to develop MetS, relative to nonusers. CONCLUSIONS: Cannabis use may be associated with lower incidence of MetS in patients who have experienced FEP. Further research is indicated to develop these observations.

Psychosis REACH: Effects of a Brief CBT-Informed Training for Family and Caregivers of Individuals With Psychosis.

OBJECTIVE: Psychosis Recovery by Enabling Adult Carers at Home (Psychosis REACH) is a training for families of individuals with psychosis that consists of recovery-oriented psychosis psychoeducation, caregiver self-care, and skills training informed by cognitive-behavioral therapy for psychosis (CBTp). The authors assessed the effects of a 1-day and a 4-day training on the natural supports (i.e., family and other caregivers) of individuals with psychotic disorders. METHODS: Attendees of a 1-day (N=168) and a 4-day (N=29) Psychosis REACH training were surveyed at three timepoints: pretraining, posttraining, and 4-month follow-up. Longitudinal changes across the full sample were evaluated by paired-sample t tests or a one-way repeated-measures analysis of variance (ANOVA). Two-way mixed ANOVAs were conducted with training condition, time, and the training condition × time interactions entered into the model. RESULTS: Reductions were noted in self-perceived depression, anxiety, negative aspects of the caregiving experience, and expressed emotion. Trainees also showed more prosocial attitudes toward psychosis immediately and at 4 months after the training. CONCLUSIONS: This evaluation of the launch of Psychosis REACH in the United States suggests that the training can improve the mental health, attitudinal, and relational outcomes of family and caregivers of individuals with psychosis. Given the dearth of CBTp and family interventions for psychosis in mental health services in the United States, short-term, intensive training that supplements clinical services has intuitive appeal as a means of surmounting the barriers that have plagued family interventions.

Understanding differences in family engagement and provider outreach in New Journeys: A coordinated specialty care program for first episode psychosis.

The present study examined clinician outreach efforts to families and family engagement; and predictors of engagement in a coordinated specialty care (CSC) for first episode psychosis. From 2015 to 2019, 211 clients experiencing their first episode of psychosis and their family members received services from New Journeys, a network of CSC programs in the United States. Analyses examined the association between race/ethnicity, insurance type, referral source, housing stability, and outreach efforts and family attendance. Overall, 70% of client family members attended at least one psychoeducation appointment and in the first month of treatment 40% of family members attended family psychoeducation. Outreach efforts including phone attempts (ß=1.09; p = 0.02) and phone contact (ß=1.10; p = 0.02) were significantly higher for Black families relative to White families; whereas Black families were scheduled less often for a family psychoeducation (ß=-0.28; p = 0.02) compared to Whites families. Significant differences in family attendance based on insurance type were also found (p<0.01). Referral source and housing stability were not significant predictors of outreach or attendance. These findings suggest that alternative engagement efforts that extend beyond in-person contact may be needed to continuously engage families, specifically Black families and those with public and no insurance.

Preliminary Evaluation of Washington State's Early Intervention Program for First-Episode Psychosis.

OBJECTIVE: Early intervention programs are designed to address the needs of youths experiencing first-episode psychosis (FEP). Washington State developed New Journeys, a network of coordinated specialty care programs for FEP. In this study, the authors have outlined components of the New Journeys model and preliminary findings since its initial implementation. METHODS: Youths and young adults diagnosed as having psychosis (N=112) completed measures at and after intake on a range of mental health assessments and functional outcomes for the first 12 months of treatment. Administrative data including state-funded emergency department and psychiatric hospitalizations were assessed 24 months before and after intake. Generalized estimating equations were used to assess change over time on multiple measures of mental health status. RESULTS: Compared with their condition at intake, clients had significant decreases in symptoms of anxiety (ß=-2.48, p<0.001), psychotic experiences (ß=-3.37, p<0.05), and clinician-rated psychotic symptoms (ß=-1.47, p<0.05) during treatment. Additionally, quality of life (ß=-5.95, p<0.001) and school attendance (odds ratio=1.42, p<0.05) significantly improved during treatment. Administrative data indicated that postintake, clients were less likely to visit the emergency department for psychiatric reasons (ß=0.22, p<0.05), utilize community psychiatric inpatient services (ß=0.31, p<0.001), and utilize public assistance (ß=0.71, p<0.05) compared with 24 months before intake. CONCLUSIONS: New Journeys clients experienced improved clinical and functional outcomes during their first year of treatment, and rates of state-funded service utilization decreased during their treatment.

Implementing Illness Management and Recovery Within Assertive Community Treatment: A Pilot Trial of Feasibility and Effectiveness.

OBJECTIVE: In a pilot feasibility and effectiveness study, illness management and recovery (IMR), a curriculum-based program to help people with serious mental illness pursue personal recovery goals, was integrated into assertive community treatment (ACT) to improve participants' recovery and functioning. METHODS: A small-scale cluster randomized controlled design was used to test implementation of IMR within ACT teams in two states. Eight high-fidelity ACT teams were assigned to provide IMR (ACT+IMR; four teams) or standard ACT services (ACT only; four teams). Clinical outcomes from 101 individuals with schizophrenia-spectrum or bipolar disorders were assessed at baseline, six months, and one year. RESULTS: Exposure to IMR (session attendance and module completion) varied between the ACT+IMR teams, with participants on one team having significantly less exposure. Results from intent-to-treat analyses showed that participants in ACT+IMR demonstrated significantly better outcomes with a medium effect size at follow-up on clinician-rated illness self-management. A nonsignificant, medium effect size was found for one measure of functioning, and small effect sizes were observed for client-rated illness self-management and community integration. Session and module completion predicted better outcomes on four of the 12-month outcome measures. CONCLUSIONS: Findings support the feasibility of implementing IMR within ACT teams. Although there were few significant findings, effect sizes on some variables in this small-scale study and the dose-response relationships within ACT+IMR teams suggest this novel approach could be promising for improving recovery for people with serious mental illness. Further large-scale studies utilizing a hybrid effectiveness-implementation design could provide a promising direction in this area.

Racial-Ethnic Disparities in First-Episode Psychosis Treatment Outcomes From the RAISE-ETP Study.

OBJECTIVE: This study examined racial and ethnic differences in treatment outcomes among participants in a randomized controlled trial of an intervention for first-episode psychosis called NAVIGATE. METHODS: Secondary data analyses were conducted for participants randomly assigned to usual community care (N=181) and NAVIGATE (N=223). Generalized estimating equations assessed whether race and ethnicity were associated with psychiatric symptoms and service use (medication management, family psychoeducation, and individual therapy) over a 24-month treatment period, accounting for baseline symptoms, duration of untreated psychosis, and insurance status. RESULTS: Among persons in usual community care, non-Hispanic blacks scored significantly higher throughout treatment on measures of positive symptoms (ß=2.15, p=.010), disorganized thoughts (ß=1.15, p=.033), and uncontrolled hostility (ß=.74, p=.027), compared with non-Hispanic whites, and non-Hispanic blacks were less likely than non-Hispanic whites to receive individual therapy (OR=.45, p=.001). Families of Hispanic participants in usual community care were less likely than non-Hispanic white families to receive family psychoeducation (OR=.20, p=.01). For NAVIGATE participants, race and ethnicity were not associated with differences in psychiatric symptoms over time; families of non-Hispanic black participants were less likely than those of non-Hispanic white participants to receive family psychoeducation (OR=.53, p=.009). Hispanic participants in NAVIGATE were more likely than non-Hispanic white participants to receive medication management (OR=2.93, p=.001). CONCLUSIONS: In usual community care, non-Hispanic blacks scored higher on measures of psychiatric symptoms and were less likely to receive important services, compared with non-Hispanic whites. In NAVIGATE, racial and ethnic differences in psychiatric symptoms were not evident, although non-Hispanic blacks were less likely than non-Hispanic whites to receive family psychoeducation.

Strategies for Detecting Biological Molecules on Titan.

Saturn's moon Titan has all the ingredients needed to produce "life as we know it." When exposed to liquid water, organic molecules analogous to those found on Titan produce a range of biomolecules such as amino acids. Titan thus provides a natural laboratory for studying the products of prebiotic chemistry. In this work, we examine the ideal locales to search for evidence of, or progression toward, life on Titan. We determine that the best sites to identify biological molecules are deposits of impact melt on the floors of large, fresh impact craters, specifically Sinlap, Selk, and Menrva craters. We find that it is not possible to identify biomolecules on Titan through remote sensing, but rather through in situ measurements capable of identifying a wide range of biological molecules. Given the nonuniformity of impact melt exposures on the floor of a weathered impact crater, the ideal lander would be capable of precision targeting. This would allow it to identify the locations of fresh impact melt deposits, and/or sites where the melt deposits have been exposed through erosion or mass wasting. Determining the extent of prebiotic chemistry within these melt deposits would help us to understand how life could originate on a world very different from Earth. Key Words: Titan-Prebiotic chemistry-Solar system exploration-Impact processes-Volcanism. Astrobiology 18, 571-585.

Evaluating and Extending the Ocean Wind Climate Data Record.

Satellite microwave sensors, both active scatterometers and passive radiometers, have been systematically measuring near-surface ocean winds for nearly 40 years, establishing an important legacy in studying and monitoring weather and climate variability. As an aid to such activities, the various wind datasets are being intercalibrated and merged into consistent climate data records (CDRs). The ocean wind CDRs (OW-CDRs) are evaluated by comparisons with ocean buoys and intercomparisons among the different satellite sensors and among the different data providers. Extending the OW-CDR into the future requires exploiting all available datasets, such as OSCAT-2 scheduled to launch in July 2016. Three planned methods of calibrating the OSCAT-2 σo measurements include 1) direct Ku-band σo intercalibration to QuikSCAT and RapidScat; 2) multisensor wind speed intercalibration; and 3) calibration to stable rainforest targets. Unfortunately, RapidScat failed in August 2016 and cannot be used to directly calibrate OSCAT-2. A particular future continuity concern is the absence of scheduled new or continuation radiometer missions capable of measuring wind speed. Specialized model assimilations provide 30-year long high temporal/spatial resolution wind vector grids that composite the satellite wind information from OW-CDRs of multiple satellites viewing the Earth at different local times.

Size and shape of Saturn's moon Titan.

Cassini observations show that Saturn's moon Titan is slightly oblate. A fourth-order spherical harmonic expansion yields north polar, south polar, and mean equatorial radii of 2574.32 +/- 0.05 kilometers (km), 2574.36 +/- 0.03 km, and 2574.91 +/- 0.11 km, respectively; its mean radius is 2574.73 +/- 0.09 km. Titan's shape approximates a hydrostatic, synchronously rotating triaxial ellipsoid but is best fit by such a body orbiting closer to Saturn than Titan presently does. Titan's lack of high relief implies that most--but not all--of the surface features observed with the Cassini imaging subsystem and synthetic aperture radar are uncorrelated with topography and elevation. Titan's depressed polar radii suggest that a constant geopotential hydrocarbon table could explain the confinement of the hydrocarbon lakes to high latitudes.

Titan's rotation reveals an internal ocean and changing zonal winds.

Cassini radar observations of Saturn's moon Titan over several years show that its rotational period is changing and is different from its orbital period. The present-day rotation period difference from synchronous spin leads to a shift of approximately 0.36 degrees per year in apparent longitude and is consistent with seasonal exchange of angular momentum between the surface and Titan's dense superrotating atmosphere, but only if Titan's crust is decoupled from the core by an internal water ocean like that on Europa.