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BACKGROUND: Individuals with psychotic disorders often report feelings of loneliness, fewer social contacts and less satisfaction with their social support prior to diagnosis. However, temporal relationships between these variables remain unclear. The primary aim of this study was to examine whether subjective and objective social factors predict, or are predicted by, psychotic-like experiences (PLEs) in healthy young adults. METHODS: 196 undergraduates completed baseline and 3-month follow-up assessments for PLEs, loneliness, social support size, and satisfaction. Cross-lagged panel models were conducted to investigate the temporal relationships between these variables. RESULTS: Higher loneliness scores, fewer social contacts, and being less satisfied with social support at both time points were significantly associated with higher endorsement of PLEs. Furthermore, after controlling for baseline levels, cross-lagged analyses revealed that individuals who reported feeling more lonely and having less social support at baseline, predicted higher PLEs three months later but not vice versa. No cross-lagged effect was found between the satisfaction of social support and PLEs. CONCLUSION: The study highlights the significant relationships between loneliness, social support and PLEs. Higher levels of loneliness and smaller social support networks predicted future PLEs. These findings need to be given full consideration in future clinical practice and intervention for young adults with PLEs.
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Soledad , Trastornos Psicóticos , Humanos , Apoyo Social , Estudiantes , Adulto JovenRESUMEN
INTRODUCTION: We aimed to investigate the association between schizotypy and intentionality bias, the tendency to interpret ambiguous actions as being intentional, for social and non-social actions separately. This bias contributes to interpersonal difficulties, and has been associated with psychotic symptoms, such as delusions. However, results have been inconsistent for an association between putative psychosis proneness, schizotypy, and intentionality bias. Further, the multidimensional nature of schizotypy has not been considered. Agreeableness was measured to examine the specificity of the relationship, and inhibition to examine its potential role as a mediator. METHODS: Two online studies are reported (n = 280 and n = 163) in which participants made intentionality judgements about ambiguous actions described in sentences. They also completed questionnaire measures of schizotypy and agreeableness, and inhibitory efficiency (a sentence completion task). RESULTS: Schizotypy was associated with perceiving ambiguous actions as intentional, particularly in social contexts, after controlling for agreeableness. The association with social intentionality was stronger for schizotypy subscales capturing paranoia and unusual beliefs. Inhibitory efficiency as not a significant predictor of intentionality bias. CONCLUSION: These finding suggest intentionality biases for social and non-social events are distinguishable. In relation to schizotypy, social situations appear to generate perceptions of intentionality. Intentionality bias represents a phenotypic cognitive risk for psychosis which should be further investigated.
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Trastornos Psicóticos , Trastorno de la Personalidad Esquizotípica , Sesgo , Humanos , Intención , JuicioRESUMEN
The COMT Val158Met polymorphism affects the availability of synaptic dopamine in the prefrontal cortex and has been widely studied as a genetic risk factor for psychosis. Schizotypy is associated with an increased risk of psychosis, with some studies implicating similar neurobiological mechanisms to schizophrenia. The present study sought to interrogate the link between the COMT Val158Met polymorphism and schizotypy using electroencephalogram (EEG) to identify neurophysiological mechanisms underpinning psychosis risk. Neurotypical (N = 91) adults were genotyped for the COMT Val158Met polymorphism, completed the Schizotypal Personality Questionnaire (SPQ), and had eyes open resting-state EEG recorded for 4 min. SPQ suspiciousness subscale scores were higher for individuals homozygous for Val/Val and Met/Met versus Val/Met genotypes. Delta, theta, alpha-2, beta-1, and beta-2 amplitudes were lower for Val/Val than Met/Met individuals. Lower theta amplitudes were correlated with higher total SPQ scores (P = 0.050), and multiple regression revealed that higher delta, and lower theta and beta-2 amplitudes (but not COMT genotype) best predicted total SPQ scores (P = 0.014). This study demonstrates the importance of COMT genotype in determining trait suspiciousness and EEG oscillatory activity. It also highlights relationships between dopaminergic alterations, EEG and schizotypy that are dissimilar to those observed in schizophrenia.
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Encéfalo/fisiopatología , Catecol O-Metiltransferasa/genética , Trastorno de la Personalidad Esquizotípica/genética , Trastorno de la Personalidad Esquizotípica/fisiopatología , Electroencefalografía , Femenino , Genotipo , Humanos , Masculino , Polimorfismo de Nucleótido Simple , Adulto JovenRESUMEN
BACKGROUND: Individuals high on schizotypy complain of increased cognitive failures in everyday life. However, the neuropsychological performance of this group does not consistently indicate underlying ability deficits. It is possible that current neuropsychological tests lack ecological validity. Given the increased affective reactivity of high schizotypes, they may be more sensitive to emotional content interfering with cognitive ability. This study sought to explore whether an affective n-back working memory task would elicit impaired performance in schizotypy, echoing complaints concerning real world cognition. METHODS: 127 healthy participants completed self-report measures of schizotypy and cognitive failures and an affective n-back working memory task. This task was varied across three levels of load (1- to 3-back) and four types of stimulus emotion (neutral, fearful, happy, sad). Differences between high (n=39) and low (n=48) schizotypy groups on performance outcomes of hits and false alarms were examined, with emotion and load as within-groups variables. RESULTS: As expected, high schizotypes reported heightened vulnerability to cognitive failures. They also demonstrated a relative working memory impairment for emotional versus neutral stimuli, whereas low schizotypes did not. High schizotypes performed most poorly in response to fearful stimuli. For false alarms, there was an interaction between schizotypy, load, and emotion, such that high schizotypy was associated with deficits in response to fearful stimuli only at higher levels of task difficulty. Inclusion of self-reported cognitive failures did not account for this. CONCLUSION: These findings suggest that the "gap" between subjective and objective cognition in schizotypy may reflect the heightened emotional demands associated with cognitive functioning in the real world, although other factors also seem to play a role. There is a need to improve the ecological validity of objective assessments, whilst also recognizing that self-reported cognitive failures tap into a range of factors difficult to assess in the lab, including emotion. Cognitive interventions for at-risk individuals will likely be more beneficial if they address emotional processing alongside other aspects of cognition.
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Disfunción Cognitiva/psicología , Emociones , Trastornos de la Memoria/psicología , Trastorno de la Personalidad Esquizotípica/psicología , Adulto , Disfunción Cognitiva/complicaciones , Femenino , Humanos , Masculino , Trastornos de la Memoria/complicaciones , Memoria a Corto Plazo , Pruebas Neuropsicológicas , Trastorno de la Personalidad Esquizotípica/complicaciones , AutoinformeRESUMEN
BACKGROUND: Cognitive failures are disruptions in cognitive functioning during everyday life. Vulnerability to these failures is increased in a range of psychological disorders, including schizophrenia. In addition, healthy individuals with personality-based psychosis proneness, or schizotypy, often complain of heightened failures. A factor known to exacerbate cognitive failures is negative affect. Negative affectivity is linked to both schizophrenia and schizotypy. It is therefore possible that affect is responsible for the increased everyday cognitive failures in "high schizotypes". This poses 2 possibilities: are cognitive failures only present in high schizotypes who also have negative affect (moderation)? Or does negative affect account for the relationship between schizotypy and cognitive failures (mediation)? We sought to explore whether negative affect mediates or moderates the relationship between schizotypy and cognitive failures in young adults. SAMPLING AND METHODS: Healthy young adults from a student and community sample (n = 863, 71% female) aged 18-25 years (mean = 19.5, SD = 1.87) completed online questionnaires measuring self-report schizotypy, negative affect, and cognitive failures. Moderation and mediation analyses were carried out using the PROCESS macro in SPSS to examine how negative affect exerted its effect on the relationship between schizotypy and cognitive failures. RESULTS: All 3 factors were positively correlated. Negative affect was not a moderator for the relationship between schizotypy and cognitive failures; however, it did partially mediate this relationship. CONCLUSIONS: Our findings suggest that whilst schizotypy and negative affect do not interact to produce cognitive failures, negative affect contributes to (but does not fully account for) the mechanism by which schizotypy increases failures in young adults. Other, as yet unidentified, facets of schizotypy also appear to contribute to cognitive failures. In attempting to address the cognitive complaints of at-risk individuals, clinicians need to be aware of the role of negative affect and other pertinent aspects of schizotypy.
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Trastornos del Conocimiento/psicología , Trastorno de la Personalidad Esquizotípica/psicología , Adolescente , Adulto , Femenino , Humanos , Masculino , Encuestas y Cuestionarios , Adulto JovenRESUMEN
Not all individuals who smoke cannabis report psychotic-like experiences. Given that risk factors for psychotic disorders are multifaceted, precipitating factors to psychotic-like experiences after cannabis are likely to be equally complex. Reduced neurocognitive performance is associated with both psychosis risk and cannabis use. Therefore, it is possible cognitive performance may differentiate those who report psychotic-like experiences after cannabis from those who do not. We determined whether those reporting psychotic/dysphoric experiences after cannabis had reduced neurocognitive performance compared to those reporting primarily euphoric experiences. METHODS: Participants were recruited on the basis of responses to the cannabis high captured by the Psychosis-Dysphoric and Euphoric experiences subscales from the Cannabis Experiences Questionnaire (CEQ). RESULTS: Compared to participants reporting primarily euphoric cannabis experiences (n = 36; 44% male; mean age (SD) = 28 (9) years), those who reported psychotic/dysphoric experiences (n = 40; 45% male; mean age (SD) = 26 (5) years) demonstrated significantly faster responses to a trial and error learning task. In the presence of distracters, those with psychotic/dysphoric experiences after cannabis made more errors on a Continuous Performance Task. CONCLUSIONS: Those who report psychotic/dysphoric experiences after cannabis have subtle inefficiencies in their cognitive processes. The multiple factors which predict vulnerability to psychotic-like experiences after cannabis require further investigation.
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Cognición/efectos de los fármacos , Disfunción Cognitiva/inducido químicamente , Fumar Marihuana/psicología , Psicosis Inducidas por Sustancias/psicología , Adulto , Femenino , Humanos , Masculino , Fumar Marihuana/efectos adversos , Pruebas Neuropsicológicas , Tiempo de Reacción , Factores de Riesgo , Encuestas y Cuestionarios , Adulto JovenRESUMEN
INTRODUCTION: Cognitive failures are errors in normal everyday functioning. Individuals with psychological disorders may possess heightened vulnerability. We sought to review the literature on cognitive failures in psychological disorders to determine the nature of this association, and whether failures relate to neuropsychological performance. We also examine the relationship between cognitive failures and substance use since it is relevant to everyday cognition and co-occurs in many psychological disorders. METHODS: We conducted a systematic review of self-reported cognitive failures in psychological disorders and substance use, identifying 21 papers in total. RESULTS: Papers identified studied trauma, mood, and anxiety disorders, and schizophrenia. Substance use papers included nicotine, alcohol, cannabis, and ecstasy use. Cognitive failures were increased in some but not all papers; the most consistent findings were for depression, PTSD, and daily smokers of nicotine. Subjective failures did not correlate closely with neuropsychological outcomes in any disorders. We were unable to discern distinct profiles of failures for each disorder; rather they may reflect emotional dysregulation more broadly. CONCLUSIONS: The real world cognitive experiences of people with psychological disorders may differ to their performance in the clinic or lab. It is important that self-reports of minor cognitive issues are considered as both a potential risk and a maintaining factor of illness. Substance use also needs to be considered in assessing cognitive failures.
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Cognición/fisiología , Trastornos Mentales/fisiopatología , Trastornos del Conocimiento/etiología , Trastornos del Conocimiento/fisiopatología , Humanos , Trastornos Relacionados con Sustancias/complicaciones , Trastornos Relacionados con Sustancias/fisiopatologíaRESUMEN
Schizotypal personality comprises traits such as odd beliefs, perceptual abnormalities, and social difficulties; these traits are distributed throughout the general population. While not meeting the clinical threshold for schizophrenia or schizotypal personality disorder, schizotypal personality traits still provide insights for understanding early clinical risk factors. Ketogenic diet reportedly reduces psychotic symptoms in preclinical and clinical studies. Therefore, we investigated whether ketogenic diet is associated with lower schizotypal traits in the general population. Participants following a ketogenic or other diet were recruited using opportunity sampling. Individuals completed a survey investigating general demographic, socioeconomic, health, diet and lifestyle questions, followed by the Schizotypal Personality Questionnaire - Brief Revised version (SPQ-BR). We found that individuals following a ketogenic diet (n = 118) had lower ideas of reference, magical thinking, suspiciousness, unusual perceptions, constricted affect, social anxiety scores, cognitive (positive) perceptual scores, interpersonal (negative) scores and total SPQ-BR compared to individuals on the other diets (n = 139). Magical thinking, constricted affect, social anxiety, cognitive perceptual, interpersonal scores and total SPQ-BR scores remained significant when we controlled for body mass index (BMI) and age. Disorganised features were not influenced by ketogenic diet. The longer individuals adhered to a ketogenic diet the lower their positive and negative schizotypy traits. These findings highlight that ketogenic diet is associated with lower non-clinical schizotypal personality traits. Our results suggest that ketogenic diet might have potential prophylactic properties for individuals at-risk for psychosis.
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Dieta Cetogénica , Trastorno de la Personalidad Esquizotípica , Humanos , Femenino , Masculino , Adulto , Trastorno de la Personalidad Esquizotípica/dietoterapia , Adulto Joven , Persona de Mediana Edad , Adolescente , Escalas de Valoración PsiquiátricaRESUMEN
OBJECTIVES: A ketogenic diet reduces pathologic stress and improves mood in neurodegenerative and neurodevelopmental disorders. However, the effects of a ketogenic diet for people from the general population have largely been unexplored. A ketogenic diet is increasingly used for weight loss. Research in healthy individuals primarily focuses on the physical implications of a ketogenic diet. It is important to understand the holistic effects of a ketogenic diet, not only the physiological but also the psychological effects, in non-clinical samples. The aim of this cross-sectional study with multiple cohorts was to investigate the association of a ketogenic diet with different aspects of mental health, including calmness, contentedness, alertness, cognitive and emotional stress, depression, anxiety, and loneliness, in a general healthy population. METHODS: Two online surveys were distributed: cohort 1 used Bond-Lader visual analog scales and Perceived Stress Scale (n = 147) and cohort 2 the Depression Anxiety Stress Scale and revised UCLA Loneliness Scale (n = 276). RESULTS: A ketogenic diet was associated with higher self-reported mental and emotional well-being behaviors, including calmness, contentedness, alertness, cognitive and emotional stress, depression, anxiety, and loneliness, compared with individuals on a non-specific diet in a general population. CONCLUSION: This research found that a ketogenic diet has potential psychological benefits in the general population.
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Ansiedad , Depresión , Dieta Cetogénica , Salud Mental , Estrés Psicológico , Humanos , Dieta Cetogénica/métodos , Dieta Cetogénica/psicología , Masculino , Femenino , Estudios Transversales , Adulto , Persona de Mediana Edad , Depresión/dietoterapia , Estrés Psicológico/psicología , Soledad/psicología , Emociones , Adulto Joven , Encuestas y Cuestionarios , Estudios de Cohortes , Anciano , AdolescenteRESUMEN
BACKGROUND: Over the past decade policy makers have emphasised the importance of healthcare technology in the management of long-term conditions. Mobile-phone based assessment may be one method of facilitating clinically- and cost-effective intervention, and increasing the autonomy and independence of service users. Recently, text-message and smartphone interfaces have been developed for the real-time assessment of symptoms in individuals with schizophrenia. Little is currently understood about patients' perceptions of these systems, and how they might be implemented into their everyday routine and clinical care. METHOD: 24 community based individuals with non-affective psychosis completed a randomised repeated-measure cross-over design study, where they filled in self-report questions about their symptoms via text-messages on their own phone, or via a purpose designed software application for Android smartphones, for six days. Qualitative interviews were conducted in order to explore participants' perceptions and experiences of the devices, and thematic analysis was used to analyse the data. RESULTS: Three themes emerged from the data: i) the appeal of usability and familiarity, ii) acceptability, validity and integration into domestic routines, and iii) perceived impact on clinical care. Although participants generally found the technology non-stigmatising and well integrated into their everyday activities, the repetitiveness of the questions was identified as a likely barrier to long-term adoption. Potential benefits to the quality of care received were seen in terms of assisting clinicians, faster and more efficient data exchange, and aiding patient-clinician communication. However, patients often failed to see the relevance of the systems to their personal situations, and emphasised the threat to the person centred element of their care. CONCLUSIONS: The feedback presented in this paper suggests that patients are conscious of the benefits that mobile-phone based assessment could bring to clinical care, and that the technology can be successfully integrated into everyday routine. However, it also suggests that it is important to demonstrate to patients the personal, as well as theoretical, benefits of the technology. In the future it will be important to establish whether clinical practitioners are able to use this technology as part of a personalised mental health regime.
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Teléfono Celular , Esquizofrenia/diagnóstico , Actividades Cotidianas , Adulto , Estudios Cruzados , Femenino , Humanos , Masculino , Satisfacción del Paciente , Trastornos Psicóticos/diagnóstico , Trastornos Psicóticos/psicología , Reproducibilidad de los Resultados , Psicología del Esquizofrénico , Envío de Mensajes de TextoRESUMEN
BACKGROUND: Mobile phone-based assessment may represent a cost-effective and clinically effective method of monitoring psychotic symptoms in real-time. There are several software options, including the use of native smartphone applications and text messages (short message service, SMS). Little is known about the strengths and limitations of these two approaches in monitoring symptoms in individuals with serious mental illness. OBJECTIVE: The objective of this study was to compare two different delivery modalities of the same diagnostic assessment for individuals with non-affective psychosis-a native smartphone application employing a graphical, touch user interface against an SMS text-only implementation. The overall hypothesis of the study was that patient participants with sewrious mental illness would find both delivery modalities feasible and acceptable to use, measured by the quantitative post-assessment feedback questionnaire scores, the number of data points completed, and the time taken to complete the assessment. It was also predicted that a native smartphone application would (1) yield a greater number of data points, (2) take less time, and (3) be more positively appraised by patient participant users than the text-based system. METHODS: A randomized repeated measures crossover design was employed. Participants with currently treated Diagnostic and Statistical Manual (Fourth Edition) schizophrenia or related disorders (n=24) were randomly allocated to completing 6 days of assessment (four sets of questions per day) with a native smartphone application or the SMS text-only implementation. There was then a 1-week break before completing a further 6 days with the alternative delivery modality. Quantitative feedback questionnaires were administered at the end of each period of sampling. RESULTS: A greater proportion of data points were completed with the native smartphone application in comparison to the SMS text-only implementation (ß = -.25, SE=.11, P=.02), which also took significantly less time to complete (ß =.78, SE= .09, P<.001). Although there were no significant differences in participants' quantitative feedback for the two delivery modalities, most participants reported preferring the native smartphone application (67%; n=16) and found it easier to use (71%; n=16). 33% of participants reported that they would be willing to complete mobile phone assessment for 5 weeks or longer. CONCLUSIONS: Native smartphone applications and SMS text are both valuable methods of delivering real-time assessment in individuals with schizophrenia. However, a more streamlined graphical user interface may lead to better compliance and shorter entry times. Further research is needed to test the efficacy of this technology within clinical services, to assess validity over longer periods of time and when delivered on patients' own phones.
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Teléfono Celular , Trastornos Psicóticos/diagnóstico , Telemedicina/métodos , Envío de Mensajes de Texto , Estudios Cruzados , Humanos , Cooperación del Paciente , Esquizofrenia/diagnóstico , Encuestas y CuestionariosRESUMEN
Social anxiety and paranoia often co-occur and exacerbate each other. While loneliness and negative schemas contribute to the development of social anxiety and paranoia separately, their role in the development of the two symptoms co-occurring is rarely considered longitudinally. This study examined the moment-to-moment relationship between social anxiety and paranoia, as well as the effects of loneliness and negative schemas on both experiences individually and coincidingly. A total of 134 non-clinical young adults completed experience sampling assessments of momentary social anxiety, paranoia, and loneliness ten times per day for six consecutive days. Participants' negative-self and -other schemas were assessed with the Brief Core Schema Scale. Dynamic structural equation modelling revealed a bidirectional relationship between social anxiety and paranoia across moments. Loneliness preceded increases in both symptoms in the next moment. Higher negative-self schema was associated with a stronger link from paranoia to social anxiety; whereas higher negative-other schema was associated with a stronger link from social anxiety to paranoia. Our findings support the reciprocal relationship between social anxiety and paranoia. While loneliness contributes to the development of social anxiety and paranoia, negative self and other schemas appear to modify the relationships between the two symptoms.
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Soledad , Trastornos Paranoides , Adulto Joven , Humanos , Ansiedad/complicacionesRESUMEN
INTRODUCTION: Dark Triad (DT) personality traits (psychopathy, Machiavellianism, and narcissism) show sex differences and associations with hormones. Understanding aetiology may assist in mitigating the harm of these potentially adverse characteristics. Low second-to-fourth digit ratio (2D:4D) is hypothesised to be a marker of high prenatal testosterone exposure and may provide important information about organisational hormones. The aim of the present study was to measure Dark Triad and Big 5 personality traits in relation to digit ratio, salivary testosterone, and cortisol. METHODS: A non-clinical sample (N = 268; 49.25% Female, age M25.20 ± 8.77 yrs) completed the Short Dark Triad and International Personality Inventory Pool - Mini. Afternoon saliva was analysed for testosterone and cortisol, and 2D:4D finger ratios were measured. RESULTS: Males scored higher on DT traits than females. Females scored higher on Big 5 agreeableness and neuroticism. Males had higher testosterone and cortisol levels and lower 2D:4D than females. Digit ratio correlated inversely with salivary testosterone, Machiavellianism, and psychopathy. Testosterone levels correlated positively with cortisol levels and psychopathy and negatively with agreeableness, neuroticism, and Machiavellianism. CONCLUSIONS: These results provide indications that Machiavellianism and psychopathy (Dark Triad) traits, but not narcissism or Big 5 traits, are linked to markers of prenatal testosterone exposure. Results also replicate sex differences seen in 2D:4D digit ratios, with males having a shorter second-relative-to-forth finger. Links between circulating testosterone, digit ratios, cortisol and personality traits provide further information about potential biological bases of personality.
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Ratios Digitales , Hidrocortisona , Humanos , Masculino , Femenino , Adolescente , Adulto Joven , Adulto , Testosterona , Personalidad , Maquiavelismo , Trastorno de Personalidad AntisocialRESUMEN
Mindfulness is increasingly offered to parents of children presenting with behavioral problems, either as a stand-alone intervention, or integrated within existing behavioral parenting interventions. There is relatively modest support for mindful parenting, with small to medium effect size improvements demonstrated across child and parent outcome measures. Here we introduce a mindfulness and imagery enhanced behavioral parenting program. We argue blending mindfulness, imagery and behavioral skills could produce improved parenting engagement and perseverance, leading to stronger outcomes. Pilot data is presented from two contrasting real world clinical settings. Parents attending the 8-week Confident Carers Cooperative Kids (CCCK) group program in a university clinic setting were invited to be included in the study (n = 20). Permission was also gained to use archival data from a community organisation offering CCCK groups to parents who were at risk of child welfare involvement (n = 14). Pre- and post-intervention measures were completed across both groups on parent-reported child behavior, parent wellbeing, adaptive parenting, and mindful parenting. Parents from both groups achieved significant pre- to post-intervention improvements in child behavior problems, parent wellbeing, adaptive parenting, and mindful parenting, with large effect sizes. Larger improvements in child behavior problems were reported by parents from the community group compared with the university group. The CCCK intervention appears beneficial across child and parent outcomes, including for families most in need. A larger sample is required to replicate and extend these promising findings.
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Background: Borderline Personality Disorder (BPD) is a chronic, debilitating, and difficult to treat condition. BPD has recently been linked to steroid hormone dysregulation and medical conditions characterized by disturbed androgen metabolism. This study aimed to investigate cortisol and testosterone levels in BPD, and changes in hormones following psychological treatment. Methods: Participants with BPD (n = 33) completed a 12-week Dialectical Behavior Therapy group program. Pre and post salivary testosterone and cortisol were analyzed. Baseline hormones in the BPD group were compared to age-and-sex matched controls (n = 33). Non-parametric tests were utilized to investigate group differences, pre-post treatment hormone and symptom changes, and associations between symptoms and hormone levels. Results: Participants with BPD had significantly higher testosterone levels than controls. Mean testosterone levels in females with BPD were double that of female controls. Testosterone and cortisol levels were related, and some BPD symptoms were associated with with hormone levels. BPD symptoms reduced significantly with treatment, however pre to post hormone levels did not change. Conclusions: This study supports an association between BPD symptoms and neuroendocrine dysfunction at baseline, however we found no reduction in hormone dysfunction post treatment. Further research into relationships between stress signaling and neuroendocrine disturbances in BPD may inform aetiological and treatment models. Trial registration: Australian New Zealand Clinical Trials Registry ACTRN12618000477224. Registered on 3 April 2018.
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BACKGROUND: Semi-structured interview scales for psychosis are the gold standard approach to assessing psychotic and other symptoms. However, such assessments have limitations such as recall bias, averaging, insensitivity to change and variable interrater reliability. Ambulant, real-time self-report assessment devices may hold advantages over interview measures, but it needs to be shown that the data thus collected are valid, and the collection method is acceptable, feasible and safe. We report on a monitoring system for the assessment of psychosis using smartphone technology. The primary aims were to: i) assess validity through correlations of item responses with those on widely accepted interview assessments of psychosis, and ii) examine compliance to the procedure in individuals with psychosis of varying severity. METHODS: A total of 44 participants (acute or remitted DSM-4 schizophrenia and related disorders, and prodromal) completed 14 branching self-report items concerning key psychotic symptoms on a touch-screen mobile phone when prompted by an alarm at six pseudo-random times, each day, for one week. Face to face PANSS and CDS interviews were conducted before and after the assessment period blind to the ambulant data. RESULTS: Compliance as defined by completion of at least 33% of all possible data-points over seven days was 82%. In the 36 compliant participants, 5 items (delusions, hallucinations, suspiciousness, anxiety, hopelessness) showed moderate to strong (rho 0.6-0.8) associations with corresponding items from interview rating scales. Four items showed no significant correlation with rating scales: each was an item based on observable behaviour. Ambulant ratings showed excellent test-retest reliability and sensitivity to change. CONCLUSIONS: Ambulatory monitoring of symptoms several times daily using smartphone software applications represents a feasible and valid way of assessing psychotic phenomena for research and clinical management purposes. Further evaluation required over longer assessment periods, in clinical trials and service settings.
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Autoevaluación Diagnóstica , Monitoreo Ambulatorio/métodos , Trastornos Psicóticos/diagnóstico , Adulto , Teléfono Celular , Estudios de Factibilidad , Femenino , Humanos , Masculino , Persona de Mediana Edad , Psicometría , Reproducibilidad de los Resultados , Autoinforme , Programas InformáticosRESUMEN
The article provides commentary on Wong et al.'s investigation of the relationship between schizotypal traits, social mistrust and aggression, mental and physical health outcomes across three waves of data collection commencing in April 2020. The researchers aimed to consider the nature of the relationship between these variables and the stability of these relationships as coronavirus (Covid-19) restrictions fluctuated over time. Their results suggested that loneliness reflects a hub which links the trait variables of schizotypal and social mistrust to aggression and mental and physical health symptoms. Their network did not vary by demographic factors nor wave of data collection, suggesting that stable individual differences were driving results. Their results propose that interventions which increase social connection could provide positive health benefits as well as decreasing aggression (via reductions in social mistrust). Their data contributes to understanding about how schizotypal traits link to outcomes under conditions of social stress.
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Learning from feedback is essential for daily functioning, with factors that impact learning having implications for healthy and clinical populations. Reinforcement learning appears impaired across the psychosis continuum, with deficits reported in patients with psychotic disorders as well as high schizotypes from the general population. Stress can impair learning, and sensitivity to stress is present along the psychosis continuum. The aim of the present study was to understand if stress impairs reinforcement learning in those at the lower end of the psychosis continuum. We investigated both naturalistic stress in everyday life using daily hassles (Study 1: n = 70; 31% male, M age = 22.67 years) and acute psychosocial stress using the Trier Social Stress Test (Study 2: n = 57; 32% male, M age = 22.43 years). In the presence of naturalistic stress, learning did not differ across schizotypes. However, under acute psychosocial stress, high schizotypes experienced impaired learning. Our results suggest trail-and-error learning is robust to the ebbs and flows of everyday stress for high schizotypes; however, acute stress is associated with decrements in learning. This indicates that the magnitude of stressors should be considered when designing cognitive and functional interventions for those along the psychosis continuum.
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Trastornos Psicóticos , Trastorno de la Personalidad Esquizotípica , Adulto , Femenino , Humanos , Masculino , Trastorno de la Personalidad Esquizotípica/psicología , Adulto JovenRESUMEN
Cognitive interpretations of daily events may differ in people from the general population who hold unusual beliefs. It is also important to understand whether different belief profiles exist to appreciate which patterns of beliefs are less psychologically healthy. Cluster analysis was used to form unusual belief profiles in a general population sample (n = 578; Mage = 22 years, SD = 6.98; 80% female) across paranoid, paranormal, and magical ideation beliefs, and we assessed whether they differed in attribution style and metacognitive beliefs about worry. Four clusters were formed: low on all measures (low all); high on all measures (high all); comparably higher on paranormal beliefs (paranormal group); and comparably higher on paranoid beliefs (paranoid group). For total Metacognitions Questionnaire-30, the high all and high paranoid clusters did not differ, and both clusters scored higher than the high paranormal group, who all scored higher than the low all cluster. For attributional styles (Attributional Styles Questionnaire), lower scores on internal positive attribution were found for the high all and high paranoid clusters compared to the low all and high paranormal clusters. The high paranormal cluster had higher scores than the high paranoid cluster on self-serving bias. Differences in attributional style appeared to be driven by mental health diagnosis. Our results suggest different profiles of unusual beliefs are detectable in the general population that differ in their metacognitive beliefs and perceived causation of events in their environment. Future studies investigating delusional proneness need to consider multiple unusual beliefs as well as assessing mood state and distress.
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Metacognición , Percepción Social , Adulto , Femenino , Humanos , Masculino , Encuestas y Cuestionarios , Adulto JovenRESUMEN
Objectives: While mindfulness-based parenting programs (MPPs) are increasingly popular for reducing child behavior problems, the evidence for the advantages of MPP over existing behavioral parent training is unclear. Existing systematic reviews have largely excluded the breadth of MPP protocols, including those that integrate behavioral skills components. Therefore, a scoping review was conducted to map the nature and extent of research on MPPs for parents of children aged 3 to 12 years with behavioral problems. Methods: PRISMA-ScR guidelines were used to conduct an encompassing peer literature review of cross-disciplinary databases. Studies were included if they reported mindfulness interventions for parents of children aged between 3 and 12 years with externalizing behavior problems and had an outcome measure of child behavioral problems that could be represented as an effect size. Randomized controlled trials as well as quasi-experimental, pre-post studies and unpublished dissertations were included. Results: Sixteen studies met the inclusion criteria (N = 1362). The majority of MPPs delivered mindfulness adapted to parenting based on the Bögels' protocol within clinical settings. There was a dearth of fully integrated mindfulness and behavioral programs. MPPs generally produced pre-to-post-intervention improvements with small effect sizes across child behavior and parent style, stress, and mindfulness measures. Examining longer follow-up periods compared to pre-intervention, effects reached a moderate size across most outcome measures. Conclusions: MPPs continue to show promise in improving child behavior and parental mindfulness, well-being, and style. Further research is needed to determine how to best leverage the advantages of mindfulness in augmenting the well-established effectiveness of behavioral programs.