Effects of cognitive stimulus therapy on middle-aged and elderly institutionalized patients with chronic schizophrenia with declined cognition.

PURPOSE: This study investigates whether using group Cognitive Stimulation Therapy (CST) effectively improves functioning among middle-aged and elderly patients with chronic schizophrenia and a below-normal cognitive range. METHODS: The study included an experimental group (N = 24), which was divided into two sub-groups to receive group CST, and a control group (N = 24), who received treatment as usual (TAU). We assessed cognitive functions using the Mini-Mental Status Examination (MMSE). We evaluated the emotional status, psychotic symptoms, and quality of life using the Geriatric Depression Scale short-form 15 (GDS-15), the Brief Psychiatric Rating Scale (BPRS), and the Dementia-Quality of Life (D-QoL) instrument. We performed all measures at three-time points: pre-CST, post-CST, and 3-month follow-up. RESULTS: We found group CST can significantly improve cognitive performance, especially the ability to use new information, after group CST intervention. However, the experimental group did not maintain this effect at the 3-month follow-up. RESULTS: We found group CST can significantly improve cognitive performance, especially the ability to use new information, after group CST intervention. However, the experimental group did not maintain this effect at the 3-month follow-up. CONCLUSION: This study supports group CST can delay the degradation of some cognitive functions in long-term hospitalized patients with chronic schizophrenia for the duration of the intervention. This finding has important clinical implications for long-term institutionalized middle-aged and elderly chronic schizophrenic patients with a below-normal cognitive range in an aging society.

Betel Quid Chewing, Personality and Mood: Betel Quid Chewing Associated with Low Extraversion and Negative Mood.

BACKGROUND: Betel quid (BQ), chewed by about 600 million people worldwide, is one of the most widely used addictive substances. Little is known about psychological factors in BQ chewers. OBJECTIVES: The present study was the first attempt to explore the relationships between BQ chewing, personality, and mood. METHODS: A survey was conducted with a purposive sample to assess BQ chewing habits in four subgroups: BQ-only users, BQ users who smoke and/or drink, smokers and/or drinkers only, and substance nonusers. A total of 494 participants were recruited from the civilian, non-institutionalized population in Taiwan. Habitual consumption of BQ, smoking and drinking; socio-demographic variables; extraversion; and mood (tension, depression, anger, vigor, fatigue, confusion, and self-esteem). All BQ chewers were evaluated on BQ dependence domains using DSM IV and ICD-10 criteria. RESULTS: The 6-month BQ dependency rate among BQ chewers, defined by either DSM-IV or ICD-10 criteria, ranged from 42.9 to 45.6%. BQ-only users had significantly lower scores on extraversion than substance nonusers. BQ-only users had statistically significant higher scores on confusion and total mood than substance nonusers. BQ-only users had significantly higher scores on fatigue, anger, tension, and depression, than substance nonusers, BQ users who smoke and/or drink, and smokers and/or drinkers only. The number of BQ dependence domains correlated significantly negatively with total mood scores. Conclusions/Importance: The results supported the two hypotheses: (a) BQ chewing is associated with low extraversion; and (b) BQ chewing is related to negative mood.

Religion and Subjective Well-Being: Western and Eastern Religious Groups Achieved Subjective Well-Being in Different Ways.

Culture can moderate which variables most influence subjective well-being (SWB). Because religion can be conceptualized as culture, religious differences can be considered cultural differences. However, there have been few studies comparing how different religious groups evaluate SWB at any given time. This study is among the first to investigate this issue. The present study compared Buddhists, Taoists, Christians, and atheists. In addition to demographic items, 451 Chinese adults completed Chinese version of the Socially Oriented Cultural Conception of SWB Scale. Religious belief was distributed as follows: 10 % Christian, 20 % Buddhist, 25 % Taoist, and 43 % atheists. As predicted, the socially oriented cultural conception of SWB was found to be highest among Buddhists, followed in order by Taoists, atheists, and Christians. It was concluded that the various religious groups achieved SWB in different ways.

Religion and health: anxiety, religiosity, meaning of life and mental health.

We examined the association among anxiety, religiosity, meaning of life and mental health in a nonclinical sample from a Chinese society. Four hundred fifty-one Taiwanese adults (150 males and 300 females) ranging in age from 17 to 73 years (M = 28.9, SD = 11.53) completed measures of Beck Anxiety Inventory, Medical Outcomes Study Health Survey, Perceived Stress Scale, Social Support Scale, and Personal Religiosity Scale (measuring religiosity and meaning of life). Meaning of life has a significant negative correlation with anxiety and a significant positive correlation with mental health and religiosity; however, religiosity does not correlate significantly anxiety and mental health after controlling for demographic measures, social support and physical health. Anxiety explains unique variance in mental health above meaning of life. Meaning of life was found to partially mediate the relationship between anxiety and mental health. These findings suggest that benefits of meaning of life for mental health can be at least partially accounted for by the effects of underlying anxiety.

Schizophrenia and the paranormal: more psi belief and superstition, and less déjà vu in medicated schizophrenic patients.

OBJECTIVE: The present study examined the relation between déjà vu experiences and paranormal beliefs in schizophrenic patients. METHODS: A total of 522 participants (54.5% female; mean age=33.3, SD=16.02) were recruited, including 422 healthy adults (60.9% female; mean age=29.48, SD=15.07) and 100 medicated adult schizophrenic patients (27.3% female; mean age=48.98, SD=8.57). The Chinese version of the Inventory of Déjà-vu Experiences Assessment was created via back translation. Chinese versions of the Revised Paranormal Belief Scale (CRPB), Beck Anxiety Inventory (CBAI), and Perceived Stress Scale (CPSS) were also used. RESULTS AND CONCLUSION: After controlling for age, gender, education, and anxiety, the results supported the following three hypotheses. Schizophrenic persons have fewer déjà vu experiences than normal persons. These experiences are positively related to paranormal beliefs in healthy adults but not in schizophrenic patients. Schizophrenic patients have higher scores than healthy adults on the psi and superstitious subscales of the CRPB.

Social cognition and apathy between two cognitive subtypes of schizophrenia: Are there the same or different profiles?

Objective: Cognitive impairment is an essential feature of schizophrenia, and it involves a broad array of nonsocial and social cognitive domains. This study aimed to examine whether there are the same or different social cognition profiles between two cognitive subtypes of schizophrenia. Method: There were one hundred and two chronic and institutionalized patients with schizophrenia from two referral tracks. One group is "Cognitively Normal Range" (CNR) (N = 52), and another group is "Below Normal Range" (BNR) (N = 50). We assessed or collected their apathy, emotional perception judgment, facial expression judgment, and empathy by the Apathy Evaluation Scale, the International Affective Picture System, the Japanese and Caucasian Facial Expression of Emotion, and the Interpersonal Reactivity Index, respectively. Results: We found different impairment profiles depending on the cognitive subtypes of the patient with schizophrenia. Surprisingly, the CNR presented impairments in apathy, emotional perception judgment, facial expression judgment, and empathy and feature impairment in empathy and affective apathy. In contrast, even though the BNR had significant neurocognition impairments, they had almost intact empathy with significantly impaired cognitive apathy. Both groups' global deficit scores (GDSs) were comparable, and all reached at least a mild impairment level. Conclusions: The CNR and the BNR had similar abilities in emotional perception judgment and facial emotion recognition. They also had differentiable deficits in apathy and empathy. Our findings provide important clinical implications for neuropsychological pathology and treatment in schizophrenia.

The effect of computerized working memory training on working memory and emotion perception for patients with chronic schizophrenia and normal cognition.

BACKGROUND: Cognitive impairment and affective symptoms are hallmark features of patients with schizophrenia. This study determines whether a computerized working memory training program improves the patient's working memory and affective perception. METHODS: Thirty-nine male patients with schizophrenia, aged 25-65, participated in this study. The study uses a single-blind randomized controlled design. Twenty subjects were assigned to the experimental group and received an eight-week working memory computerized training course comprising four modules of the CogniPlus system. Nineteen subjects were assigned to the control group and received treatment as usual. All subjects received the same assessments twice, including the Mini-Mental Status Examination (MMSE), Working Memory Index (WMI) of Wechsler Adult Intelligence Scale-Third Edition, and the subjective rating of pictures of the International affective picture system by Self-Assessment Manikin (SAM). RESULTS: This study shows that computerized working memory training improves WMI and the score for MMSE and produces a significant increase in the pleasure score for S.A.M. for negative pictures, between the pretest and post-test for the experimental group. CONCLUSIONS: Working memory training improves working memory and emotion perception for patients with chronic schizophrenia and normal cognition. The limitations of this study and suggestions for future study are also discussed.

Psychometric properties of the brief self-report questionnaire for screening putative pre-psychotic states and validation of clinical utility in young adult.

INTRODUCTION: The Brief Self-Report Questionnaire for Screening Putative Pre-Psychotic States (BQSPS), a brief, self-reported screening tool for risk of psychosis, can detect auditory perceptual disturbances significantly associated with perceived need for psychological services among young adults. However, the relationship is largely explained by the existence of neurotic traits, anxiety and depression symptoms. OBJECTIVE: This study explores possible explanations of previous results from factor structures of the BQSPS and the clinical implications underlying each factor. METHODS: Construct validity, criterion-related validity, discriminant validity, internal consistency, and test-retest reliability of the BQSPS are determined among young adults (N = 289). RESULTS: We find that Social Anxiety, Positive Symptoms, and Negative Symptoms are three components in the BQSPS for young adults. Moreover, we find that each component of the BQSPS can be explained by related forms of psychopathology, self-esteem, or personality traits. Finally, the BQSPS can satisfactorily distinguish cases from non-cases using the Symptoms Check List-90-Revised. CONCLUSIONS: We clarify the clinical implications of each component of the BQSPS and thus expand its clinical utility. The BQSPS has good psychometric properties in young adults from an ethnically Chinese population. Limitations and directions for future research are also discussed.

Survey of psychiatric impairment among residents exposed to environmental pollution from a petrochemical complex.

PURPOSE: This study first assessed the occurrence of major depressive disorder (MDD), post-traumatic stress disorder (PTSD), symptoms of poor sleep quality and high levels of distress among residents, caused by reported long-term stress from environmental pollution emitted from the biggest petroleum chemistry factory (PCF) in the world. METHODS: A total of 328 long-term residents (Mean age = 57.5, SD = 16.5 years, ranging from 22 to 95) were recruited randomly from a total population of 26,632 in Mailiao township in Taiwan next to the PCF. Trained assistants used the Disaster-Related Psychological Screening test, the Perception of Life Threats Caused by the SCNP questionnaire and the Sleep Quality Scale to interview the participants. RESULTS: The results support our hypotheses that most of the residents (71%) would report life threats caused by the PCF. The residents displayed higher rates of major depressive episodes (24.1%), PTSD (24.5%) and symptoms of poor sleep quality. The more they felt threat from the PCF, the stronger the connection with MDD and PTSD symptoms. CONCLUSION: The results indicate an increased prevalence of MDD, PTSD and symptoms of poor sleep quality in those exposed to environmental pollution from the PCF, highlighting the need for prompt prevention, diagnostic and therapeutic attention.

A pilot study on the Chinese Minnesota Multiphasic Personality Inventory-2 in detecting feigned mental disorders: Simulators classified by using the Structured Interview of Reported Symptoms.

The Minnesota Multiphasic Personality Inventory-2 (MMPI-2) is often used in forensic psychological/psychiatric assessment. This was a pilot study on the utility of the Chinese MMPI-2 in detecting feigned mental disorders. The sample consisted of 194 university students who were either simulators (informed or uninformed) or controls. All the participants were administered the Chinese MMPI-2 and the Structured Interview of Reported Symptoms-2 (SIRS-2). The results of the SIRS-2 were utilized to classify the participants into the feigning or control groups. The effectiveness of eight detection indices was investigated by using item analysis, multivariate analysis of covariance (MANCOVA), and receiver operating characteristic (ROC) analysis. Results indicated that informed-simulating participants with prior knowledge of mental disorders did not perform better in avoiding feigning detection than uninformed-simulating participants. In addition, the eight detection indices of the Chinese MMPI-2 were effective in discriminating participants in the feigning and control groups, and the best cut-off scores of three of the indices were higher than those obtained from the studies using the English MMPI-2. Thus, in this sample of university students, the utility of the Chinese MMPI-2 in detecting feigned mental disorders was tentatively supported, and the Chinese Infrequency Scale (ICH), a scale developed specifically for the Chinese MMPI-2, was also supported as a valid scale for validity checking.

Validation of the cognitively normal range and below normal range subtypes in chronically hospitalized patients with schizophrenia.

BACKGROUND: Many studies have found a substantial minority of patients whose performance puts them within the normal range of neuropsychological functioning. Recently, a study has seen the delineation of two neurocognitive subtypes of schizophrenia -'cognitively normal range' (CNR) and 'below normal range' (BNR) - based on neurocognitive performance across multiple domains. METHODS: The participants were from two studies that collected neurocognitive, psychopathology and social function data between 2008 and 2015. In total the complete data from one hundred and thirty one patients of Han Chinese ethnicity with schizophrenia were collected on 21 neurocognitive indexes (assessing the domains of processing speed, attention, working memory, verbal memory, visual memory, reasoning and problem solving and IQ). Fifty-five patients of the one hundred and thirty one participants received additional ratings on their psychopathology and social functions. An exploratory graphic analysis was conducted on the neurocognitive measures for the entire sample. Difference analyses were also performed according to the aims of the study using the Independent t test, Chi-square test, and Cohen's d effect size. RESULTS: Analyses revealed the existence of two patients subtypes. The post hoc tests showed that there were significant differences on all of their neurocognitive measures and on most of the psychopathology and social functions between the two subtypes. These two subtypes could be referred to as the CNR subtype and the BNR subtype respectively. CONCLUSIONS: There are neurocognitive subtypes of schizophrenia with differential illness characteristics comparable with the CNR and the BNR in patients of Han Chinese ethnicity with schizophrenia.

Chinese version of the separation-individuation inventory.

The importance of the separation-individuation process in object relations theory is well known in disciplines of psychology, counseling, and human development. Based on the Separation-Individuation Inventory of Christenson and Wilson, which measures the manifestations of disturbances in this process, a Chinese version of the inventory was developed. For college students Cronbach coefficient alpha was .89, and test-retest reliability over 28 days was .77. The scores of the inventory had positive correlations with both the number of borderline personality characteristics and the Individualism-Collectivism Scale, respectively. Also, the mean score on the inventory of patients diagnosed with borderline personality disorder was significantly higher than that of the two normal control groups (ns = 564). Thus the inventory possessed satisfactory construct validity. Cultural differences regarding the separation-individuation process need to be investigated further.

Validation of the Taiwanese Mandarin version of the Personal and Social Performance scale in a sample of 655 stable schizophrenic patients.

OBJECTIVES: The aim of this study was to determine the validity and reliability of the Taiwanese Mandarin version of the Personal and Social Performance scale (TMV-PSP) using a structured interview and a computerized scoring calculator. METHODS: In total, 655 patients with schizophrenia or schizoaffective disorder were assessed with the TMV-PSP, the Positive and Negative Syndrome Scale (PANSS), the Global Assessment of Functioning-Severity (CGI-S), the Mini-Mental State Examination (MMSE), activities of daily living (ADL) and instrumental activities of daily living (IADL). Construct validity was assessed by factorial analysis. The internal consistency and temporal stability of the PSP were obtained by calculating intra-class correlation coefficients. RESULTS: The Cronbach's alpha coefficients of the TMV-PSP were 0.73. The patients' PSP showed a negative correlation with the PANSS (r = -0.65) and its subscales, including positive (r = -0.35), negative (r = -0.67), general factors (r = -0.62) and the CGI-S scores (r = -0.47). The PSP showed a positive correlation with MMSE scores (r = 0.59), ADL (r = 0.45) and IADL scores (r = 0.6). All p-values for the correlation coefficients were less than 0.001. Good test-retest reliability was obtained (intraclass coefficient = 0.91, 95 CI: 0.82-0.96, p = 0.0001). Factor analysis explained a total of 83.6% of the variance, with Component 1 contributing 58.4% and Component 2 contributing 24.8%. CONCLUSIONS: These findings indicate that the TMV-PSP using a structured interview and a computerized scoring calculator is a reliable and valid instrument for the assessment of social functioning in patients with schizophrenia.