[Schizophrenia spectrum disorders (aspects of psychopathology and clinical taxonomy)]. / Rasstroistva shizofrenicheskogo spektra (aspekty psikhopatologii i klinicheskaya sistematika).

OBJECTIVE: To create a new taxonomy of schizophrenia spectrum disorders (SSD) based on the comparability of the design of SSD and borderline states. MATERIAL AND METHODS: The total sample consists of 205 patients with an established diagnosis of SSD (F21; F25; F22 according to ICD-10) collected from studies of the department of borderline mental pathology and psychosomatic disorders of the Federal State Budgetary Institution Mental Health Research Center and the Department of Psychiatry and Psychosomatics of Moscow State Medical University in the period 2014 to 2024. Clinical, psychometric, statistical methods were used. RESULTS: A new two-level model of schizotypal personality disorder (STPD) has been developed: the first level is psychopathic-like disorders of the «Ferschroben¼ type; the second level are psychopathological disorders (positive, negative, etc.), appearing under their «mask¼, constituting a «tracing paper¼ of manifestations of schizophrenia «in miniature¼. The two-level psychopathological model of STPD is a complex clinical phenotype, including independent but overlapping phenotypic formations: psychopathic-like - the «Ferschroben¼ type; and basic - schizophreniform disorders. CONCLUSION: The clinical classification of schizophrenia spectrum disorders has been developed; pseudoneuroses and stress-induced disorders of the endogenous circle are considered in the aspect of the dynamics of STPD.

Factor analysis of the Chinese version of the Autism Spectrum Quotient 10 and its association with schizotypal traits in adolescents and young adults in Hong Kong.

BACKGROUND: There is evidence suggesting that autistic traits are associated with schizotypal traits. This study examined the factor structure of the Autism Spectrum Quotient 10 (AQ-10) and its associations with schizotypal traits (measured by the Schizotypal Personality Questionnaire-Brief [SPQ-B]) in a cohort of Chinese adolescents and young adults. METHODS: Invitation letters, stratified by locations and housing types, were randomly sent to individuals aged 15 to 24 years for participation. Assessments were made using face-to-face or online interviews. Autistic traits were assessed using the Chinese version of the AQ-10. Schizotypal personality traits were assessed using the Chinese version of the 22-item SPQ-B. RESULTS: In total, 395 male and 536 female participants (mean age, 19.93 years) were recruited between July 2020 and May 2021. Exploratory factor analysis of the AQ-10 yielded three factors (theory of mind, task switching, and attention deficits) explaining 55.11% of the total variance. Autistic traits were positively correlated with schizotypal traits of disorganised features (r = 0.21, p < 0.001), interpersonal relationship deficits (r = 0.19, p < 0.001), and cognitive-perceptual deficits (r = 0.11, p = 0.001). CONCLUSION: In Chinese adolescents and young adults, autistic traits, especially task switching and attention deficits (compared with theory of mind) are more closely correlated with schizotypal personality traits. Disentangling the overlapping and diametrical structure of autistic traits and schizotypal traits may help understand their aetiologies, assessment, and interventions.

Exploring the effects of family and life events on genetic and environmental architecture of schizotypal and hypomanic dimensions: Insights from a twin study.

BACKGROUND: Strategies of prevention for psychiatric disorders need a deep understanding of the aetiological factors involved in the psychopathological processes. Our twin study aims at disentangling the contributions of genes and environment to schizotypal and hypomanic dimensions, considering the role of stressful life events (LEs) and the quality of family relationships. METHODS: The Magical Ideation Scale (MIS) and Perceptual Aberration Scale (PAS) were used to assess positive schizotypy, while Hypomanic Personality Scale (HPS) and its sub-scales were used to investigate proneness to affective disorders. 268 twins (54.5 % female; aged 18.0 ± 6.68) were included. Participants filled out a questionnaire on LEs and their parents provided an evaluation of intra-family relationship (Relationship Quality Index, RQI). Classic univariate twin models for quantitative traits were fitted for scales, and the effects of covariates (LEs and RQI) were assessed. RESULTS: For MIS, HPS and its sub-scales, significant common and unique environmental effects were detected, with genetic factors affecting only HPS Social Vitality sub-scale. Unique environment was the only source of variance of PAS score. The number of recent LEs influenced MIS and PAS models, while RQI score affected MIS model. LIMITATIONS: The main limitation of the study is the small sample size, which reduces statistical power and may potentially lead to an underestimation of heritability. Additionally, the cross-sectional design limits the possibility to draw causal considerations. CONCLUSIONS: Findings provide preliminary evidence for a significant environmental role in modulating states of vulnerability. Moreover, the expression of positive schizotypy resulted influenced by recent stressors and intra-family relationships.

Comparison of trait and state mind wandering among schizotypal, subclinically depressed, and control individuals.

BACKGROUND: Mind wandering is a common phenomenon in daily life. However, the manifestations and cognitive correlates of mind wandering in different subclinical populations remain unclear. In this study, these aspects were examined in individuals with schizotypal traits and individuals with depressive symptoms, i.e., subclinical populations of patients with schizophrenia and depression. METHODS: Forty-two individuals with schizotypal traits, 42 individuals with subclinical depression, and 42 controls were recruited to complete a mind wandering thought sampling task (state level) and a mind wandering questionnaire (trait level). Measures of rumination and cognitive functions (attention, inhibition, and working memory) were also completed by participants. RESULTS: Both subclinical groups exhibited more state and trait mind wandering than did the control group. Furthermore, individuals with schizotypal traits demonstrated more trait mind wandering than individuals with subclinical depression. Rumination, sustained attention, and working memory were associated with mind wandering. In addition, mind wandering in individuals with subclinical depression can be accounted for by rumination or attention, while mind wandering in individuals with high schizotypal traits cannot be accounted for by rumination, attention, or working memory. CONCLUSIONS: The results suggest that individuals with high schizotypal traits and subclinical depression have different patterns of mind wandering and mechanisms. These findings have implications for understanding the unique profile of mind wandering in subclinical individuals.

Cue-Reactive Phenomenology Mediates the Relationship Between Positive Schizotypy and Cue-Reactive Urge to Gamble in Poker-Machine Gamblers.

Although ubiquitous in numerous nightlife cultures, poker-machines present a high risk for problematic use and addiction. Previous research has demonstrated that gambling cues (e.g., flashing lights) can activate gambling urges in poker-machine gamblers. However, the processes that contribute to the maintenance of cue-reactive urges to gamble remain unclear. Consequently, the present study explored whether positive schizotypy predicted gambling urge, and whether cue-reactive altered state of awareness, cue-reactive altered time sense, and cue-reactive absorption mediated this relationship. Seventy adults aged between 19 and 68 (M = 48.86, SD = 12.82) participated in an online cue-reactivity experiment. Participants first completed the Problem Gambling Severity Index and the Unusual Experiences subscale of the Short Oxford-Liverpool Inventory of Feelings and Experiences. Subsequently, at three time points (i.e., baseline, directly after a neutral cue, and directly after a gambling cue) participants completed the Altered State of Awareness, Altered Time Sense, and Absorption subscales of the Phenomenology of Consciousness Inventory and a visual analogue scale measuring cue-reactive urge to gamble. It was found that positive schizotypy was significantly positively correlated with cue-reactive urge to gamble. Additionally, cue-reactive altered state of awareness, cue-reactive altered time sense, and cue-reactive absorption mediated this relationship. The theoretical, clinical and practical implications are discussed.

Pattern glare sensitivity distinguishes subclinical autism and schizotypy.

INTRODUCTION: Schizophrenia and autism spectrum disorder are distinct neurodevelopmental disorders sharing clinically relevant behaviours. However, early sensory responses show divergent responses. Individuals with schizophrenia typically exhibit cortical hypo-excitability whereas individuals with autism show cortical hyperexcitability. Identifying reliable neurobiological differences between the disorders can diminish misdiagnosis and optimise treatments. METHODS: The pattern glare test (PGT) is a simple measure of behavioural hyperexcitability. It measures the number of illusions seen in a static horizontal grating. We collected PGT data from non-clinical adults varying in traits of autism and schizophrenia (schizotypy). 576 undergraduate students completed an online survey consisting of the Schizotypal Personality Questionnaire - Brief Revised, the Autism Spectrum Quotient, and the PGT. RESULTS: Subclinical autism and schizotypy traits were highly positively correlated. However, only schizotypy scores were significantly predictive of reporting more pattern glare (PG) illusions. When assessing the subcomponents of the schizotypy and autism scores, positive and disorganised schizotypy traits were predictive of reporting more PG illusions. Whereas, subclinical autism factors were not predictive of PG illusions. CONCLUSIONS: High schizotypy performed the PGT in a manner consistent with behavioural hyperexcitability. The PGT distinguished subclinical autistic traits from schizotypy, suggesting potential clinical application.

Quantifying the effects of practicing a semantic task according to subclinical schizotypy.

The learning ability of individuals within the schizophrenia spectrum is crucial for their psychosocial rehabilitation. When selecting a treatment, it is thus essential to consider the impact of medications on practice effects, an important type of learning ability. To achieve this end goal, a pre-treatment test has to be developed and tested in healthy participants first. This is the aim of the current work, which takes advantage of the schizotypal traits present in these participants to preliminary assess the test's validity for use among patients. In this study, 47 healthy participants completed the Schizotypal Personality Questionnaire (SPQ) and performed a semantic categorization task twice, with a 1.5-hour gap between sessions. Practice was found to reduce reaction times (RTs) in both low- and high-SPQ scorers. Additionally, practice decreased the amplitudes of the N400 event-related brain potentials elicited by semantically matching words in low SPQ scorers only, which shows the sensitivity of the task to schizotypy. Across the two sessions, both RTs and N400 amplitudes had good test-retest reliability. This task could thus be a valuable tool. Ongoing studies are currently evaluating the impact of fully deceptive placebos and of real antipsychotic medications on these practice effects. This round of research should subsequently assist psychiatrists in making informed decisions about selecting the most suitable medication for the psychosocial rehabilitation of a patient.

Schizotypy and perceptual span in a non-clinical sample: a virtual reality study.

INTRODUCTION: Individuals with high schizotypy or schizophrenia exhibit difficulties in distributing their attention across space, leading to a reduction in their "perceptual span" - the extent of visual space that can be attended to at once. In this study, we aim to explore the correlation between schizotypy and perceptual span in a non-clinical sample to investigate whether perceptual span correlates with schizotypy across its range. METHODS: Schizotypy was assessed in fifty-five participants using the Schizotypy Personality Questionnaire (SPQ; Raine, 1991). Participants were required to attend to two dynamic targets displayed in a head-mounted virtual reality display. Perceptual span was estimated as the lateral angle of separation between the two targets beyond which performance in the task dropped to threshold. RESULTS: Participants with higher schizotypy scores performed significantly worse on the task. Of all the factors associated with schizotypy, the shared variance between Disorganisation and Cognitive/Perceptual Factors was most predictive of task performance. CONCLUSION: The results support the hypothesis that schizotypy predicts perceptual span in non-clinical samples. Furthermore, the demonstration of a reduced perceptual span in individuals with higher trait schizotypy shows that variations in an individual's capacity to divide attention across space can be accurately captured using a virtual reality head-mounted display.

The role of the differential outcomes procedure and schizotypy in the recognition of dynamic facial expressions of emotions.

Emotional facial expression recognition is a key ability for adequate social functioning. The current study aims to test if the differential outcomes procedure (DOP) may improve the recognition of dynamic facial expressions of emotions and to further explore whether schizotypal personality traits may have any effect on performance. 183 undergraduate students completed a task where a face morphed from a neutral expression to one of the six basic emotions at full intensity over 10 s. Participants had to press spacebar as soon as they identified the emotion and choose which had appeared. In the first block, participants received no outcomes. In the second block, a group received specific outcomes associated to each emotion (DOP group), while another group received non-differential outcomes after correctly responding (NOP group). Employing generalized linear models (GLMs) and Bayesian inference we estimated different parameters to answer our research goals. Schizotypal personality traits did not seem to affect dynamic emotional facial expression recognition. Participants of the DOP group were less likely to respond incorrectly to faces showing Fear and Surprise at fewer intensity levels. This may suggest that the DOP could lead to better identification of the main features that differentiate each facial expression of emotion.

Cold executive function processes and their hot analogs in schizotypy.

OBJECTIVE: To examine cold (based on logical reasoning) versus hot (having emotional components) executive function processes in groups with high individual schizotypal traits. METHOD: Two-hundred and forty-seven participants were administered the Schizotypal Personality Questionnaire and were allocated into schizotypal (cognitive-perceptual, paranoid, negative, disorganized) or control groups according to pre-specified criteria. Participants were also administered a battery of tasks examining working memory, complex selective attention, response inhibition, decision-making and fluid intelligence and their affective counterparts. The outcome measures of each task were reduced to one composite variable thus formulating five cold and five hot cognitive domains. Between-group differences in the cognitive domains were examined with repeated measures analyses of covariance. RESULTS: For working memory, the control and the cognitive-perceptual groups outperformed negative schizotypes, while for affective working memory controls outperformed the disorganized group. Controls also scored higher compared with the disorganized group in complex selective attention, while both the control and the cognitive-perceptual groups outperformed negative schizotypes in complex affective selective attention. Negative schizotypes also had striking difficulties in response inhibition, as they scored lower compared with all other groups. Despite the lack of differences in fluid intelligence, controls scored higher compared with all schizotypal groups (except from cognitive-perceptual schizotypes) in emotional intelligence; the latter group reported higher emotional intelligence compared with negative schizotypes. CONCLUSION: Results indicate that there is no categorical association between the different schizotypal dimensions with solely cold or hot executive function processes and support impoverished emotional intelligence as a core feature of schizotypy.

Childhood trauma moderates schizotypy-related brain morphology: analyses of 1182 healthy individuals from the ENIGMA schizotypy working group.

BACKGROUND: Schizotypy represents an index of psychosis-proneness in the general population, often associated with childhood trauma exposure. Both schizotypy and childhood trauma are linked to structural brain alterations, and it is possible that trauma exposure moderates the extent of brain morphological differences associated with schizotypy. METHODS: We addressed this question using data from a total of 1182 healthy adults (age range: 18-65 years old, 647 females/535 males), pooled from nine sites worldwide, contributing to the Enhancing NeuroImaging Genetics through Meta-Analysis (ENIGMA) Schizotypy working group. All participants completed both the Schizotypal Personality Questionnaire Brief version (SPQ-B), and the Childhood Trauma Questionnaire (CTQ), and underwent a 3D T1-weighted brain MRI scan from which regional indices of subcortical gray matter volume and cortical thickness were determined. RESULTS: A series of multiple linear regressions revealed that differences in cortical thickness in four regions-of-interest were significantly associated with interactions between schizotypy and trauma; subsequent moderation analyses indicated that increasing levels of schizotypy were associated with thicker left caudal anterior cingulate gyrus, right middle temporal gyrus and insula, and thinner left caudal middle frontal gyrus, in people exposed to higher (but not low or average) levels of childhood trauma. This was found in the context of morphological changes directly associated with increasing levels of schizotypy or increasing levels of childhood trauma exposure. CONCLUSIONS: These results suggest that alterations in brain regions critical for higher cognitive and integrative processes that are associated with schizotypy may be enhanced in individuals exposed to high levels of trauma.

Schizotypy Moderates the Relationship Between Sleep Quality and Social Cognition.

ABSTRACT: Poor sleep quality has been tied to worse social cognition. Social cognitive deficits have been noted in those with high schizotypy. Yet, no study has assessed whether schizotypy moderates the relationship between sleep quality and social cognition, which may be vital to our understanding of contributors to social functioning. We conducted a cross-sectional analysis of associations of sleep quality and social cognition, with potential moderation by schizotypy. Participants ( n = 906) completed self-report measures of schizotypy, sleep quality, and social cognition. Levels of schizotypy significantly moderated some of the relationships between sleep and social cognition. For participants low in total or interpersonal schizotypy, worse sleep quality was associated with worse theory of mind scores. For participants low in total, disorganized, or cognitive perceptual schizotypy, worse sleep quality was associated with worse self-reported cognitive empathy. For those high in these facets of schizotypy, worse sleep quality was associated with better self-reported cognitive empathy. These results suggest that the individual facets of schizotypy provide additional information and, therefore, are important to assess when examining social cognition and sleep.

Conceptualizing a less paranoid schizophrenia.

Schizophrenia stands as one of the most studied and storied disorders in the history of clinical psychology; however, it remains a nexus of conflicting and competing conceptualizations. Patients endure great stigma, poor treatment outcomes, and condemnatory prognosis. Current conceptualizations suffer from unstable categorical borders, heterogeneity in presentation, outcome and etiology, and holes in etiological models. Taken in aggregate, research and clinical experience indicate that the class of psychopathologies oriented toward schizophrenia are best understood as spectra of phenomenological, cognitive, and behavioral modalities. These apparently taxonomic expressions are rooted in normal human personality traits as described in both psychodynamic and Five Factor personality models, and more accurately represent explicable distress reactions to biopsychosocial stress and trauma. Current categorical approaches are internally hampered by axiomatic bias and systemic inertia rooted in the foundational history of psychological inquiry; however, when such axioms are schematically decentralized, convergent cross-disciplinary evidence outlines a more robust explanatory construct. By reconceptualizing these disorders under a dimensional and cybernetic model, the aforementioned issues of instability and inaccuracy may be resolved, while simultaneously opening avenues for both early detection and intervention, as well as for more targeted and effective treatment approaches.

Assessing the diametrical model of schizotypal and autistic traits in emotion recognition and social functioning in a community sample.

BACKGROUND: Some research suggests that schizotypal and autistic traits can produce opposing effects on the mentalizing domain of social cognition. Although such findings support a diametrical model proposing that psychotic and autistic traits represent opposite extremes of the social brain continuum, results from recent studies have been more inconsistent, and the applicability of this model to other social cognition domains remains unclear. To test the diametrical model more broadly, this study examined the interactions between schizotypal and autistic traits on emotion recognition and social functioning. METHOD: A total of 791 participants recruited from the general population self-reported schizotypal traits using the Schizotypal Personality Questionnaire-Brief Revised (SPQ-BR) and autistic traits using the Broad Autism Phenotype Questionnaire (BAPQ). Participants also completed the Emotion Recognition 40 task and the Specific Levels of Functioning (SLOF) scale. RESULTS: The SPQ subscales of interpersonal relationships and disorganized symptoms interacted significantly with social BAP on overall emotion recognition performance and the accuracy of identifying neutral faces. Supporting the diametrical model, elevated levels of both schizotypal and autistic traits contributed to higher emotion recognition accuracy compared to elevations on only one trait. For social functioning, however, the diametrical model was not supported. A main effect was found such that higher interpersonal relationship difficulties on SPQ predicted lower work skills on SLOF, and higher levels of both schizotypal and autistic traits combined to produce even lower social functioning. CONCLUSIONS: These findings suggest that the diametrical model may be more relevant to social cognition than to social functioning.

[Rumination and schizotypal personality traits]. / A rumináció és a szkizotip személyiségvonások összefüggései pszichotikus zavarral élok és sine morbo személyek körében.

Background and purpose:

Although ru­mination and schizotypal traits can be considered transdiagnostic phenomena and can occur within non-clinical population as well, a relatively small number of research has been carried out on the topic involving both patient and non clinical participants. The aim of this study is to examine the rela­tionship between schizotypal traits and rumination using a transdiagnostic approach, involving participants living with psychotic disorders and sine morbo individuals.

We recruited participants living with psychotic disorders (paranoid schizophrenia, hebephrenia, schizoaffective disorder, etc.) (n = 30) and controls who had not been diagnosed with any mental illnesses (n = 67). The connection between rumination and schizotypal traits was examined by self-report questionnaire method in a cross-sectional arrangement. The Oxford-Liverpool Inventory was used to measure schizotypal traits, and the Ruminative Thought Style Questionnaire was used to determine the level of rumination. 

Schizotypal symptoms (β = 0.575; p < 0.001), especially cognitive disorganization (β = 0.459; p < 0.001) and unusual experiences (β = 0.221; p = 0.029) significantly explained the degree of rumination. 

Our results support the hypothesis that the association between rumination and schizotypic traits is due to decreased cognitive inhibitory functions.

Schizotypal traits in a large sample of high-school and university students from Tunisia: correlates and measurement invariance of the arabic schizotypal personality questionnaire across age and sex.

BACKGROUND: The main goal of the present study was to examine the characteristics of schizotypal traits and their correlations with genetic (i.e., family history of mental illness), demographic (i.e., age, sex), environmental (e.g., income, urbanicity, tobacco/alcohol/cannabis use), and psychological (i.e., personal history of mental illness other than psychosis) factors in Tunisian high-school and university students. Our secondary goal was to contribute the literature by examining the factor structure and factorial invariance of the Arabic Schizotypal Personality Questionnaire (SPQ) across sex and age (adolescents [12-18 years] vs. young adults [18-35 years]) groups. METHOD: This was a cross-sectional study involving 3166 students: 1160 (36.6%) high-school students (53.0% females, aged 14.9 ± 1.8); and 2006 (63.4%) university students (63.9% females, aged 21.8 ± 2.3). All students were asked to complete a paper-and-pencil self-administered questionnaire containing sociodemographic characteristics as well as the Arabic version of the SPQ. RESULTS: The total sample yielded total SPQ scores of 24.1 ± 16.6 out of 74. The SPQ yielded good composite reliability as attested by McDonald's omega values ranging from .68 to .80 for all nine subscales. Confirmatory Factor Analysis indicated that fit of the 9-factor model of SPQ scores was acceptable. This model is invariant (at the configural, metric and structural levels) across sex and age. Except for "Odd or eccentric behavior", all schizotypy features were significantly higher among female students compared to males. Multivariable analyses showed that female sex, being a university student, lowest family incomes, tobacco use, and having a personal history of psychiatric illness were significantly associated with higher positive, negative and disorganized schizotypy subscales scores. CONCLUSION: Future research still needs to confirm our findings and investigate the contribution of the identified factors in the development of clinical psychosis. We can also conclude that the Arabic SPQ is appropriate for measuring and comparing schizotypy across age and sex in clinical and research settings. These findings are highly relevant and essential for ensuring the clinical utility and applicability of the SPQ in cross-cultural research.

Negative Symptom Inventory-Self-Report (NSI-SR): Initial development and validation.

Negative symptoms (i.e., anhedonia, avolition, asociality, blunted affect, alogia) are frequently observed in the schizophrenia-spectrum (SZ) and associated with functional disability. While semi-structured interviews of negative symptoms represent a gold-standard approach, they require specialized training and may be vulnerable to rater biases. Thus, brief self-report questionnaires measuring negative symptoms may be useful. Existing negative symptom questionnaires demonstrate that this approach may be promising in schizophrenia, but no measure has been devised for use across stages of psychotic illness. The present study reports initial psychometric validation of the Negative Symptom Inventory-Self-Report (NSI-SR), the self-report counterpart of the Negative Symptom Inventory-Psychosis Risk clinical interview. The NSI-SR is a novel transphasic negative symptoms measure assessing the domains of anhedonia, avolition, and asociality. The NSI-SR and related measures were administered to two samples: 1) undergraduates (n = 335), 2) community participants, including: SZ (n = 32), clinical-high risk for psychosis (CHR, n = 25), and healthy controls matched to SZ (n = 31) and CHR (n = 30). The psychometrically trimmed 11-item NSI-SR showed good internal consistency and a three-factor solution reflecting avolition, asociality, and anhedonia. The NSI-SR demonstrated convergent validity via moderate to large correlations with clinician-rated negative symptoms and related constructs in both samples. Discriminant validity was supported by lower correlations with positive symptoms in both samples; however, correlations with positive symptoms were still significant. These initial psychometric findings suggest that the NSI-SR is a reliable and valid brief questionnaire capable of measuring negative symptoms across phases of psychotic illness.

An examination of the relationship between positive schizotypy and suicide risk using five distinct samples.

Individuals with schizophrenia are at increased risk for suicide. However, much less is known about suicide risk among individuals with schizotypic features. To address this gap in the literature, the current report examines the relationship between positive schizotypy and suicide risk using five distinct samples. Each of these five studies addresses unique, but complementary, questions regarding the relationship between positive schizotypy and suicide risk. Studies 1 and 2 investigate the cross-sectional relationship between perceptual aberrations and suicidal ideation. Study 3 examines the relationship between suicidal ideation and multiple positive schizotypic features (perceptual aberrations, magical thinking, paranoia, and referential thinking). Study 4 investigates the long-term relationship between perceptual aberrations and suicide risk through a 17-year follow-up. Finally, Study 5 examines the specificity of our findings using a psychiatric control group. Results across all five studies support a relationship between suicide risk and positive schizotypy. Specifically, perceptual aberrations were associated with suicide risk both cross-sectionally and longitudinally. Results also suggest that individuals with positive schizotypic features have rates of suicidal ideation that are comparable to those with high negative affect and are significantly greater than healthy controls. Taken together, these findings establish an empirical connection between positive schizotypy and suicide risk, thus expanding the purview of the suicide risk construct. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Examining Cognitive Biases Uniquely Associated with Schizotypy.

INTRODUCTION: Individuals with schizotypy can experience a number of cognitive biases that may increase their risk in developing schizophrenia-spectrum psychopathology. However, cognitive biases are also present in mood and anxiety disorders, and it is currently unclear which biases are specific to schizotypy and which may be a result of comorbid depression and/or anxiety. METHODS: 462 participants completed measures of depression, anxiety, cognitive biases, cognitive schemas, and schizotypy. Correlation analyses were conducted to examine the relationship between these constructs. Three hierarchical regression analyses were conducted to examine if schizotypy, depression, and anxiety explained a statistically significant amount of variance in cognitive biases after controlling for depression and anxiety, schizotypy and anxiety, and schizotypy and depression, respectively. Moderated regression analyses were also conducted to investigate the moderating role of biological sex and ethnicity in the association between cognitive biases and schizotypy. RESULTS: Self-referential processing, belief inflexibility, and attention for threat were associated with schizotypy. The belief inflexibility bias and social cognition problems were specifically associated with schizotypy after controlling for depression and anxiety and were not directly associated with either depression or anxiety. These associations were not moderated by biological sex or ethnicity. CONCLUSION: The belief inflexibility bias may be an important cognitive bias underlying schizotypal personality, and further research will be important to determine whether this bias is also associated with an increased likelihood of transitioning to psychosis.

Protocol for the development and testing of the schiZotypy Autism Questionnaire (ZAQ) in adults: a new screening tool to discriminate autism spectrum disorder from schizotypal disorder.

BACKGROUND: Autism spectrum disorder (ASD) and schizotypal disorder (SD) both have a heterogenous presentation, with significant overlaps in symptoms and behaviour. Due to elevated recognition and knowledge of ASD worldwide, there is a growing rate of referrals from primary health professionals to specialised units. At all levels of assessment, the differential diagnostic considerations between ASD and SD exert major challenges for clinicians. Although several validated screening questionnaires exist for ASD and SD, none have differential diagnostic properties. Accordingly, in this study, we aim to develop a new screening questionnaire, the schiZotypy Autism Questionnaire (ZAQ), which provides a combined screening for both conditions, while also indicating the relative likelihood of each. METHODS: We aim to test 200 autistic patients and 100 schizotypy patients recruited from specialised psychiatric clinics and 200 controls from the general population (Phase 1). The results from ZAQ will be compared to the clinical diagnoses from interdisciplinary teams at specialised psychiatric clinics. After this initial testing phase, the ZAQ will be validated in an independent sample (Phase 2). CONCLUSIONS: The aim of the study is to investigate the discriminative properties (ASD vs. SD), diagnostic accuracy, and validity of the schiZotypy Autism Questionnaire (ZAQ). FUNDING: Funding was provided by Psychiatric Centre Glostrup, Copenhagen Denmark, Sofiefonden (Grant number: FID4107425), Trygfonden (Grant number:153588), Takeda Pharma. TRIAL REGISTRATION: Clinical Trials, NCT05213286, Registered 28 January 2022, clinicaltrials.gov/ct2/show/NCT05213286?cond = RAADS&draw = 2&rank = 1.