Effects of metacognitive training (MCT) on social cognition for schizophrenia spectrum and related psychotic disorders: a systematic review and meta-analysis.

BACKGROUND: Individuals with schizophrenia spectrum and related psychotic disorders (SSD) experience significant impairments in social cognition that impede functioning. Social cognition is a multidimensional construct consisting of four domains: 1. theory of mind, 2. emotion processing, 3. attributional style and 4. social perception. Metacognitive training (MCT) is an intervention designed to target cognitive biases in psychosis containing two modules addressing social cognition. METHODS: A systematic review and meta-analysis was conducted to investigate the effects of MCT on social cognition and two of its domains: theory of mind and emotion processing. Ten electronic databases were scoured from 2007 to 1 February 2022 for MCT studies reporting social cognition outcomes for people with SSD (1050 identified, 282 assessed). Effect sizes were calculated using Cohen's d in R. RESULTS: Nine studies were included in the meta-analysis (nMCT = 212, ncontrol = 194). MCT had a small but positive effect on global social cognition (d = 0.28 [95% CI 0.07-0.49]) and theory of mind (d = 0.27 [95% CI 0.01-0.52]). MCT showed no evidence of an effect on emotion processing (d = 0.03 [95% CI -0.26 to 0.32]). CONCLUSION: MCT has a small but significant effect on social cognition for people with SSD. Our results add to other recent meta-analyses showing significant effects of MCT on clinically relevant outcomes such as positive symptoms, cognitive biases and cognitive insight. We recommend that future studies on MCT report outcomes on all four domains of social cognition. TRIAL REGISTRATION: PROSPERO (in the process of registration) available at https://www.crd.york.ac.uk/prospero/#recordDetails.

Minds@Work: A New Manualized Intervention to Improve Job Tenure in Psychosis Based on Scoping Review and Logic Model.

Introduction A significant proportion of people experiencing psychosis are unemployed, despite a strong desire to work. Current supported employment programs appear effective in helping them obtain employment, yet job tenure remains an arduous challenge. The objective of this study was to review the literature and model the results to inform the development of a new manualized group psychosocial intervention-'Minds@Work'-aimed specifically at improving job tenure in psychosis. Methods The study was registered on the Open Science Framework platform ( https://osf.io/he68z ). The literature was searched in Medline, Embase, PsycInfo and Cochrane Library databases for studies examining predictors of job tenure in psychosis and existing occupational psychosocial interventions. Data were extracted using a pre-established form and synthesized using logic models. Results A total of 94 studies were included and their findings were modeled using different categories: intervention typologies, mechanisms of action, predictors of job tenure, outcomes and contextual factors. The 'Minds@Work' program was built based on these modeled findings and aimed to target specific predictors of job tenure while addressing some of the limitations of existing interventions. The program uses evidence-based techniques and is divided into 9 modules covering 4 themes: positive psychology (motivation, character strengths, self-compassion), neurocognitive remediation (attention, memory, problem-solving), cognitive biases training (jumping to conclusions, defeatists beliefs, theory of mind, attributional styles) and socioemotional coping skills (emotion regulation, communication). Conclusions Once validated, this new program is meant to be used either as a stand-alone intervention or integrated in supported employment initiatives, by employment specialists or healthcare workers.

Tuning the Properties of Azadipyrromethene-Based Near-Infrared Dyes Using Intramolecular BO Chelation and Peripheral Substitutions.

Tetraphenylazadipyrromethenes (ADPs) are attractive near-infrared (NIR) dyes because of their simple synthesis and exceptional optical and electronic properties. The typical BF2 and less explored intramolecular BO coordination planarize the molecule, making them promising π-conjugated materials for organic electronic applications. However, their use has been mostly limited to vacuum-deposited devices. To improve the properties, we synthesized and characterized a series of ADP complexes and used density functional theory calculations to further explain the properties. Hexyloxy solubilizing groups increase the complexes' solubility in organic solvents and enable film formation from solution. Phenylethynyls at the pyrrolic positions extend π conjugation, red-shift absorption and emission peaks, and increase the ionization potential (IP) and electron affinity. When the properties of complexes with hexyloxy and phenyethynyl substitutions are compared, the BO complex is more planar and has a smaller IP than the corresponding BF2 complex because of increased electron density on the proximal phenyls. The BO complex has an unusual combination of properties: a solution λmax of 781 nm, emission at 805 nm, a small Stokes shift, and a quantum yield of 6%. It forms transparent films with a low optical gap of 1.22 eV. This new complex is a promising candidate for transparent solar cells and NIR photodetectors.

Designing Alternative Non-Fullerene Molecular Electron Acceptors for Solution-Processable Organic Photovoltaics.

Until recently, solution-processable organic photovoltaics (OPVs) mainly relied on fullerene derivatives as the n-type material, paired with a p-type conjugated polymer. However, fullerene derivatives have disadvantages that limit OPV performance, thus fueling research of non-fullerene acceptors (NFAs). Initially, NFAs showed poor performance due to difficulties in obtaining favorable blend morphologies. One example is our work with 2,6-dialkylamino core-substituted naphthalene diimides. Researchers then learned to control blend morphology by NFA molecular design. To limit miscibility with polymer while preventing excessive self-aggregation, non-planar, twisted or 3D structures were reported. An example of a 3D structure is our work with homoleptic zinc(II) complexes of azadipyrromethene. The most recent design is a planar A-D-A conjugated system where the D unit is rigid and has orthogonal side chains to control aggregation. These have propelled power conversion efficiencies (PCEs) to ∼14 %, surpassing fullerene-based OPVs. These exciting new developments prompt further investigations of NFAs and provide a bright future for OPVs.

The probability of object-scene co-occurrence influences object identification processes.

Contextual information allows the human brain to make predictions about the identity of objects that might be seen and irregularities between an object and its background slow down perception and identification processes. Bar and colleagues modeled the mechanisms underlying this beneficial effect suggesting that the brain stocks information about the statistical regularities of object and scene co-occurrence. Their model suggests that these recurring regularities could be conceptualized along a continuum in which the probability of seeing an object within a given scene can be high (probable condition), moderate (improbable condition) or null (impossible condition). In the present experiment, we propose to disentangle the electrophysiological correlates of these context effects by directly comparing object-scene pairs found along this continuum. We recorded the event-related potentials of 30 healthy participants (18-34 years old) and analyzed their brain activity in three time windows associated with context effects. We observed anterior negativities between 250 and 500 ms after object onset for the improbable and impossible conditions (improbable more negative than impossible) compared to the probable condition as well as a parieto-occipital positivity (improbable more positive than impossible). The brain may use different processing pathways to identify objects depending on whether the probability of co-occurrence with the scene is moderate (rely more on top-down effects) or null (rely more on bottom-up influences). The posterior positivity could index error monitoring aimed to ensure that no false information is integrated into mental representations of the world.

Synthesis and characterization of fluorinated azadipyrromethene complexes as acceptors for organic photovoltaics.

Homoleptic zinc(II) complexes of di(phenylacetylene)azadipyrromethene (e.g., Zn(WS3)2) are potential non-fullerene electron acceptors for organic photovoltaics. To tune their properties, fluorination of Zn(WS3)2 at various positions was investigated. Three fluorinated azadipyrromethene-based ligands were synthesized with fluorine at the para-position of the proximal and distal phenyl groups, and at the pyrrolic phenylacetylene moieties. Additionally, a CF3 moiety was added to the pyrrolic phenyl positions to study the effects of a stronger electron withdrawing unit at that position. The four ligands were chelated with zinc(II) and BF2+ and the optical and electrochemical properties were studied. Fluorination had little effect on the optical properties of both the zinc(II) and BF2+ complexes, with λmax in solution around 755 nm and 785 nm, and high molar absorptivities of 100 × 103 M-1cm-1 and 50 × 103 M-1cm-1, respectively. Fluorination of Zn(WS3)2 raised the oxidation potentials by 0.04 V to 0.10 V, and the reduction potentials by 0.01 V to 0.10 V, depending on the position and type of substitution. The largest change was observed for fluorine substitution at the proximal phenyl groups and CF3 substitution at the pyrrolic phenylacetylene moieties. The later complexes are expected to be stronger electron acceptors than Zn(WS3)2, and may enable charge transfer from other conjugated polymer donors that have lower energy levels than poly(3-hexylthiophene) (P3HT).

Union perceptions of factors related to the return to work of employees with depression.

PURPOSE: Between 30 and 60% of the societal cost of depression is due to losses related to decreased work productivity. To date, only a few studies have focused on union perspectives related to factors influencing the return-to-work of employees absent due to depression, despite evidence of the importance of these perspectives. The purpose of this study is to develop a better understanding of union perspectives on the factors surrounding the return-to-work of employees who were absent from work due to depression. METHODS: In this qualitative study, conducted in Canada (Québec), 23 individuals (union representatives and peer workers) from the three largest unions (mixed industries) in Quebec took part in one of three focus groups. RESULTS: Fourteen emerging themes (e.g., work environment, attitudes toward depression) were distributed over five categories of stakeholders involved in the return-to-work of employees on sick leave (i.e., employers and immediate supervisors, co-workers, employees on sick leave due to depression, general physicians, and unions). We observed four major cross-cutting themes that arose beyond these five categories: (1) organizational culture in which mental health issues and human aspects of work are central, (2) support and follow-up during the work absence and the return-to-work, (3) lack of resources to assist the employee in the return-to-work, and (4) stakeholders' prejudices and discomfort regarding depression. CONCLUSIONS: Our results clarify the factors, from a union perspective, that may facilitate or hinder the return-to-work of employees absent from work due to depression.

How Cognitive Ability Shapes Personality Differentiation in Real Job Candidates: Insights from a Large-Scale Study.

The differentiation of personality by the cognitive ability hypothesis proposes that individuals with higher cognitive ability have more variability in their personality structure than those with lower cognitive ability. A large sample of actual job candidates (n = 14,462) who participated in an online proctored test session, providing socio-demographic information and completing cognitive ability, personality, and language proficiency assessments, was used to test this hypothesis. The total sample was divided into three equal groups (low, average, high) using percentiles as the cutoff point to investigate the effects of cognitive ability. An ANCOVA demonstrated the significant effect of cognitive ability on personality traits, controlling for language proficiency. Principal component analyses showed that the personality structure differed between the cognitive ability groups, with the high-cognitive-ability group having an additional personality component. Similarly, analyses across job complexity levels indicated more personality components for high-job-complexity positions. The implications, limitations, and future directions of this study are discussed.

Transdiagnostic cognitive biases in psychiatric disorders: A systematic review and network meta-analysis.

Psychiatric disorders are characterized by cognitive deficits, which have been proposed as a transdiagnostic feature of psychopathology ("C" factor). Similarly, cognitive biases (e.g., in attention, memory, and interpretation) represent common tendencies in information processing that are often associated with psychiatric symptoms. However, the question remains whether cognitive biases are also transdiagnostic or are specific to certain psychiatric disorders/symptoms. The current systematic review sought to address whether the proposed "C" factor of transdiagnostic cognitive dysfunction in psychopathology can be extended to cognitive biases. Overall, 31 studies comprising 4401 participants (2536 patients, 1865 non-clinical controls) met inclusion criteria, assessing 19 cognitive biases across 20 diagnostic categories, with most studies focusing on interpretation (k = 22) and attention (k = 11) biases and only 2 assessing memory biases. Traditional meta-analyses found a moderate effect size (g = 0.32) for more severe cognitive biases in all patients relative to non-clinical controls, as well as small but significant associations between interpretation biases and transdiagnostic symptom categories (general psychopathology: r = 0.20, emotion dysfunction: r = 0.17, psychotic symptoms: r = 0.25). Network meta-analyses revealed significant patient versus non-clinical control differences on attention and interpretation biases across diagnoses, as well as significant differences between diagnoses, with highest severity in panic disorder for attention biases and obsessive-compulsive disorder for interpretation biases. The current findings extend the big "C" interpretation of transdiagnostic cognitive dysfunction in psychiatric disorders to cognitive biases and transdiagnostic symptom dimensions. Results also suggest that while the presence of cognitive biases is transdiagnostic, bias severity differs across diagnoses, as in traditional neurocognitive deficits.

The clinical and psychosocial correlates of self-stigma among people with schizophrenia spectrum disorders across cultures: A systematic review and meta-analysis.

BACKGROUND: Individuals with schizophrenia spectrum disorders (SSD) are at heightened risk of experiencing self-stigma, and some cultures are more stigmatizing towards SSD than others. The first purpose of this review is to provide an estimate of the relationship between self-stigma and clinical and psychosocial outcomes. The second purpose is to examine how these relationships vary across cultures. METHOD: Studies reporting correlations between self-stigma and outcome variable(s) were identified through electronic database searches from June 1, 2021, to January 2, 2022. Mean effect sizes were calculated using Fisher's r-to-Z-transformation. RESULTS: Sixty-three articles (N = 8925, 22 countries) were included in the systematic review and fifty-three articles (N = 7756) were included in the meta-analysis. For the most studied clinical correlates, self-stigma had a moderate, positive correlation with depressive symptoms (r = 0.49, p < .001), a moderate, negative correlation with functioning (r = -0.39, p < .001), and a positive, small correlation with severity of psychotic symptoms (r = 0.29, p < .001), negative symptoms (r = 0.18, p < .001) and positive symptoms (r = 0.13, p = .01). For the most studied psychosocial correlates, self-stigma had a strong, negative correlation with quality of life (r = -0.52, p < .001) and self-esteem (r = -0.55, p < .001). The correlates of self-stigma were similar across cultures. DISCUSSION: Self-stigma shows strong to small correlations with clinical and psychosocial variables similarly across cultures. More research is needed to examine underlying mechanisms to develop effective interventions.

Immediate and Sustained Outcomes and Moderators Associated With Metacognitive Training for Psychosis: A Systematic Review and Meta-analysis.

Importance: A substantial increase in the number of trials examining metacognitive training (MCT) for psychosis necessitates an updated examination of the outcomes associated with MCT. Objectives: To review the immediate and sustained associations of MCT with proximal (directly targeted) and distal (indirectly influenced) outcomes and assess treatment- and participant-related moderators to identify the potential factors associated with the expected heterogeneity of effect sizes. Data Sources: Eleven electronic databases were searched from 2007 to June 3, 2021 (alert until September 10, 2021). Reference lists of earlier meta-analyses and included reports were screened. Study Selection: Reports examined MCT and included participants with schizophrenia spectrum and related psychotic disorders (1045 reports identified; 281 assessed). There were no age, sex, gender, race and ethnicity, language, or study design restrictions. Two reviewers performed the selection of studies to be analyzed. Data Extraction and Synthesis: The Preferred Reporting Items for Systematic Reviews and Meta-analyses reporting guideline was followed. Data were extracted by 3 reviewers and pooled using random effects models. Hedges g effect sizes were computed. The Mixed-Methods Appraisal tool was used to assess study quality. Main Outcomes and Measures: Proximal outcomes were global positive symptoms, delusions, hallucinations, and cognitive biases. Distal outcomes were self-esteem, negative symptoms, quality of life, well-being, and functioning. Immediate and sustained outcomes were examined. Meta-regressions, subgroup, and sensitivity analyses assessed moderators. Results: This systematic review and meta-analysis included 43 studies (46 reports). Forty reports were synthesized in meta-analysis (N=1816 participants) and 6 reports were included in narrative review. In the studies examined, MCT was associated with positive symptoms (g = 0.50; 95% CI, 0.34-0.67), delusions (g = 0.69; 95% CI, 0.45-0.93), hallucinations (g = 0.26; 95% CI, 0.11-0.40), cognitive biases (g = 0.16; 95% CI, 0.03-0.29), self-esteem (g = 0.17; 95% CI, 0.03-0.31), negative symptoms (g = 0.23; 95% CI, 0.10-0.37), and functioning (g = 0.41; 95% CI, 0.12-0.69). These associations were maintained up to 1 year. The quality of life effect size was nonsignificant (g = 0.20; 95% CI, -0.07 to 0.47); only 1 study assessed well-being. Publication year was associated with moderated hallucinations (ß = 0.04; 95% CI, 0.00-0.07). Overall, narrative review results corroborated meta-analytic findings. Conclusions and Relevance: In this meta-analysis, MCT for psychosis was associated with benefits up to 1 year postintervention in several treatment contexts. These findings suggest that MCT may merit integration in treatment guidelines for schizophrenia.

Remote group therapies for cognitive health in schizophrenia-spectrum disorders: Feasible, acceptable, engaging.

Severe cognitive impairments and cognitive distortions are core to schizophrenia-spectrum disorders (SSDs) and are associated with deteriorated social functioning. Despite well-established efficacy of group psychosocial therapies targeting cognitive health in SSDs, dissemination of these programs remains limited. Remote delivery offers a promising strategy for increasing the programs' accessibility. Yet, little research has evaluated group therapies for cognitive health delivered in this way. Thus, we aimed to assess, from participants' and therapists' perspectives, the feasibility, acceptability, as well as levels and process of engagement in a videoconference delivery of group psychosocial therapies for SSD patients' cognitive health. Participants, outpatients, attended Action Based Cognitive Remediation or Metacognitive Training, both adapted for videoconference. Then, participants and therapists completed post-therapy questionnaires. Of the 28 participants attending at least one session, 75% completed more than half of sessions and seven dropped out. Technology did not appear to significantly hinder participation in the programs. All completing participants reported a positive experience with therapy, 67% were not bothered by the distance from the therapist, and 77% trusted that the information shared was kept confidential. Therapist-rated levels of attention M = 7.5/9 (SD = 1.04), participation M = 6.91/9 (SD = 1.32), and social interactions M = 5.31/9 (SD = 1.96) were satisfactory. Nonetheless, participants indicated that they would have appreciated more social interactions with group members. These positive results validate the earliest stage in the implementation process for remote group therapies targeting cognitive health in SSDs. Remote delivery promises to improve access to therapies targeting cognitive health and, ultimately, facilitate functional recovery for SSD patients.

Remote cognitive assessment in severe mental illness: a scoping review.

Many individuals living with severe mental illness, such as schizophrenia, present cognitive deficits and reasoning biases negatively impacting clinical and functional trajectories. Remote cognitive assessment presents many opportunities for advancing research and treatment but has yet to be widely used in psychiatric populations. We conducted a scoping review of remote cognitive assessment in severe mental illness to provide an overview of available measures and guide best practices. Overall, 34 studies (n = 20,813 clinical participants) were reviewed and remote measures, psychometrics, facilitators, barriers, and future directions were synthesized using a logic model. We identified 82 measures assessing cognition in severe mental illness across 11 cognitive domains and four device platforms. Remote measures were generally comparable to traditional versions, though psychometric properties were infrequently reported. Facilitators included standardized procedures and wider recruitment, whereas barriers included imprecise measure adaptations, technology inaccessibility, low patient engagement, and poor digital literacy. Our review identified several remote cognitive measures in psychiatry across all cognitive domains. However, there is a need for more rigorous validation of these measures and consideration of potentially influential factors, such as sex and gender. We provide recommendations for conducting remote cognitive assessment in psychiatry and fostering high-quality research using digital technologies.

Understanding others as a mediator between verbal memory and negative symptoms in schizophrenia-spectrum disorder.

From the onset of schizophrenia, verbal memory (VM) deficits and negative symptoms are strongly associated, and both additively predict functional outcomes. Emotion recognition (ER) and theory of mind (ToM; the ability to infer others' mental states), two components of social cognition, are also particularly affected in schizophrenia. Explanatory models of negative symptoms have integrated these cognitive impairments as potential precursors and previous studies revealed relationships between ER and/or ToM and VM, as well as with negative symptoms, but the organization of these associations remains unclear. We aimed to determine whether impairments in VM and social cognition sequentially pave the way for negative symptoms in schizophrenia. To this end, we used mediation analyses. One hundred and forty participants with a diagnosis of schizophrenia or schizoaffective disorder were recruited. First, correlational analyses were conducted between our variables of interest. The mediating effect of social cognition between VM and negative symptoms was then examined using the PROCESS macro. Variables of interest were significantly correlated (r = |0.166| to |0.391|), except for ER and negative symptoms. Only the serial multiple mediation model with 2 mediators (ER followed by ToM) revealed a significant indirect effect of VM on negative symptoms (ß = - 0.160, 95% CI = -.370 to -.004). This relationship was selective for expressive negative symptoms (e.g., blunted affect and alogia). This study illustrates the richness of the relationship between cognitive deficits and negative symptoms and provides additional information for the involvement of social cognition in negative symptoms' etiology.

Efficacy of psychological interventions targeting cognitive biases in schizophrenia: A systematic review and meta-analysis.

Cognitive biases, which are tendencies to systematically process, select and remember certain information (e.g., jumping to conclusions), are exacerbated in schizophrenia and associated with delusions. Here we review and quantitatively assess psychological interventions targeting cognitive biases (e.g., metacognitive training, reasoning training, Maudsley review training programme) to evaluate their efficacy in improving cognitive biases, positive symptoms, and insight. Overall, thirty-two studies, including 15 distinct interventions and 2738 participants, were identified through a comprehensive keyword database search. Meta-analytic effect sizes were calculated and heterogeneity, publication bias, and subgroup analyses (study bias, active/passive intervention) were conducted. We observed significant small to moderate beneficial effects of cognitive interventions on cognitive biases (Hedges' g = 0.27; 95% CI = [0.13-0.41]; z = 3.77; p < .001), positive symptoms (Hedges' g = 0.30; 95% CI = [0.13-0.48]; z = 3.44, p < .005), and insight (Hedges' g = 0.35; 95% CI = [0.15-0.56]; z = 3.37,p < .005). Interestingly, studies with high risk of bias or passive control condition did not differ significantly from those with low risk or active control condition, respectively. Thus, cognitive biases are malleable via psychological interventions, which also exert, either directly or indirectly through reduced cognitive biases, beneficial effects on positive symptoms and insight.

Large Non-planar Conjugated Molecule with Strong Intermolecular Interactions Achieved with Homoleptic Zn(II) Complex of Di(5-quinolylethynyl)-tetraphenylazadipyrromethene.

Zinc(II) complexes of tetraphenylazadipyrromethenes are potential non-planar n-type conjugated materials. To tune the properties, we installed 5-quinolylethynyl groups at the pyrrolic positions. Compared to the complex with 1-napthylethynyl, we found evidence for stronger intermolecular interactions in the new complex, including much higher overlap integrals in crystals. X-ray analysis revealed unconventional C-H···N hydrogen bonding between two quinolyls of neighboring molecules, pointing to a new strategy for the development of non-planar molecular semiconductors with stronger intermolecular interactions.

High-lamellar ordering and amorphous-like pi-network in short-chain thiazolothiazole-thiophene copolymers lead to high mobilities.

Owing to their superior transport properties, poly(alkylthiophenes) and their derivatives emerged as one of the most widely studied semiconducting polymers with potential applications in organic electronics. It is now generally acknowledged that one of the particularly effective ways to increase the carrier mobility in these materials is by increasing the length of the conjugated backbones. Some recent reports suggest also that carrier mobilities can be further enhanced by highly crystalline arrangement (and interdigitation) of alkyl side chains possibly because it promotes the formation of extensive layered structures favorable for carrier transport. Results presented here demonstrate that, surprisingly, none of these factors are actually necessary for good electronic performance of polythiophene-like systems. Thiophene-based semiconducting polymers bearing thiazolothiazole unit (PTzQT) described here were shown to have very high carrier mobilities (approximately 0.3 cm(2)/Vs) despite their low molecular weight and uneven spacing of alkyl side chains, which suppressed high side chain crystallinity/interdigitation as revealed by thermal analysis and X-ray scattering. The highly disordered nature of these materials extended to the nanoscale level as evident from atomic force microscopy images, which have shown only the presence of small domains packed into isotropic amorphous-like superstructures with lateral correlation lengths increasing with the length of alkyl side chains. The observed concomitant increase of carrier mobilities points to the possible role of characteristic length of surface roughness as the key parameter controlling carrier transport in disordered, noninterdigitating systems.

The Prevalence of Negative Symptoms Across the Stages of the Psychosis Continuum.

BACKGROUND: Patients in every stage of the psychosis continuum can present with negative symptoms. While no treatment is currently available to address these symptoms, a more refined characterization of their course over the lifetime could help in elaborating interventions. Previous reports have separately investigated the prevalence of negative symptoms within each stage of the psychosis continuum. Our aim in this review is to compare those prevalences across stages, thereby disclosing the course of negative symptoms. METHODS: We searched several databases for studies reporting prevalences of negative symptoms in each one of our predetermined stages of the psychosis continuum: clinical or ultra-high risk (UHR), first-episode of psychosis (FEP), and younger and older patients who have experienced multiple episodes of psychosis (MEP). We combined results using the definitions of negative symptoms detailed in the Brief Negative Symptom Scale, a recently developed tool. For each negative symptom, we averaged and weighted by the combined sample size the prevalences of each negative symptom at each stage. RESULTS: We selected 47 studies totaling 1872 UHR, 2947 FEP, 5039 younger MEP, and 669 older MEP patients. For each negative symptom, the prevalences showed a comparable course. Each negative symptom decreased from the UHR to FEP stages and then increased from the FEP to MEP stages. CONCLUSIONS: Certain psychological, environmental, and treatment-related factors may influence the cumulative impact of negative symptoms, presenting the possibility for early intervention to improve the long-term course.

Cognitive capacity similarly predicts insight into symptoms in first- and multiple-episode psychosis.

BACKGROUND: Lack of insight is a frequent characteristic of psychotic disorders, both in patients who recently experienced a first episode of psychosis (FEP) and those who experience recurrent multiple episodes (MEP). Insight is a multifaceted construct: its clinical form notably includes the unawareness of being ill, of symptoms, and of the need for treatment. Cognitive capacity is among the key determinants of insight into symptoms, but less is known about whether stage of illness (FEP vs. MEP) moderates this association. METHODS: Our aim is to evaluate the association between cognitive capacity and symptom unawareness using structural equation modeling and moderated multiple regression. A total of 193 FEP and MEP patients were assessed using the CogState battery and the Scale to Assess Unawareness of Mental Disorder. RESULTS: Analyses suggest that cognitive capacity accounts for a relatively small proportion of the total variation in symptom unawareness (6.4%). There was no evidence to suggest a moderating effect of stage of illness on this association. CONCLUSIONS: The effect of general cognitive capacity on symptom unawareness is relatively small, and this basic relation was unrelated to stage of illness. It is possible that stage of illness could moderate this association only for certain facets of insight not assessed in this study (e.g., unawareness of the need for treatment).

Highly disordered polymer field effect transistors: N-alkyl dithieno[3,2-b:2',3'-d]pyrrole-based copolymers with surprisingly high charge carrier mobilities.

A series of novel electroactive and photoactive conjugated copolymers based on N-alkyl dithieno[3,2-b:2',3'-d]pyrroles (DTP) and thiophene (TH) units (DTP-co-THs) were synthesized using a Stille coupling reaction and exhibited molecular weights of 1.6 x 10(4) to 5.0 x 10(4) g/mol. The incorporation of soluble substituted thiophenes and planar DTP units resulted in low band gap, highly conductive polymers. DTP-co-THs exhibited excellent solubility in common organic solvents and formed high-quality films. Optical characterization revealed that the band gaps of DTP-co-THs were between 1.74 and 2.00 eV, lower than regioregular poly(3-alkylthiophenes). Electrochemical characterization showed that the HOMO energy levels of DTP-co-THs are between -4.68 and -4.96 eV. When doped, DTP-co-THs exhibited high conductivities up to 230 S/cm with excellent stability. The different thiophene substituent patterns' effect on the polymers' optical and electronic properties was then examined by density functional theory computations. The microstructure and surface morphologies of poly(2,6-(4-dodecyl-4H-bisthieno[3,2-b:2',3'-d]pyrrole)-random-2,5-(3-dodecylthiophene)) (P4) and poly(2-(4,4'-didodecyl-2,2'-bithiophen-5-yl)-4-octyl-4H-bisthieno[3,2-b:2',3'-d]pyrrole) (P6) thin films were studied by X-ray diffraction and atomic force microscopy. As-cast P4 and P6 thin films exhibited poorly defined, randomly ordered lamellar structure that improved significantly after thermal annealing. Field effect transistor devices fabricated from P4 and P6 showed typical p-channel transistor behavior. Interestingly, the mobilities of as-cast, less ordered samples were much higher than those observed after annealing. The highest values of maximum and average mobilities were observed for the polymer P6 as-cast (0.21 and 0.13 cm(2) V(-1) s(-1), respectively). One of our goals was to test the idea that high mobility and excellent electrical and structural reproducibility could perhaps be achieved by the creation of amorphous pi-conjugated materials that could possess long arrange pi connectivity on the microscopic scale. The results of these studies strongly suggest that the presence of highly ordered microcrystalline structures in thin films of organic semiconductors is not necessary for excellent performance of organic transistors.