When Parents Are at Fault: Development and Validation of the Parental Guilt and Shame Proneness Scale.

Research has linked individuals' dispositional guilt and shame to their interpersonal processes. Although caregivers' guilt and shame proneness in the parenting context likely have important implications for their mental health and parenting, there is a lack of validated measures for such dispositions. In three studies with Chinese parents, we developed and validated the Parental Guilt and Shame Proneness scale (PGASP), which was based on the Guilt and Shame Proneness scale (GASP). The PGASP comprises two guilt subscales-negative behavior-evaluations (guilt-NBE) and repair action tendencies (guilt-repair)-and two shame subscales-negative self-evaluations (shame-NSE) and withdrawal action tendencies (shame-withdraw). Study 1 (N = 604) provided support for the four-factor structure of the PGASP, which was replicated in Study 2 (N = 451). The concurrent validity of the PGASP was examined in Study 2 and Study 3 (N = 455). The two guilt subscales were associated with better mental health and more positive parenting, whereas parents' shame-withdraw exhibited the opposite pattern; weak or no relations were found for shame-NSE. Findings highlight the need to differentiate between parents' shame-NSE and shame-withdraw. PGASP may be a useful tool for identifying parents at risk of engaging in negative parenting.

Linking childhood trauma and dissociation to psychotic symptoms in major depressive disorder, bipolar disorders, and schizophrenia: A transdiagnostic examination using patient and clinician ratings.

OBJECTIVE: Symptomatic overlap between dissociation and psychosis is well documented; however, the pathogenesis of these two phenomena might be distinct. Few studies have analyzed the relation of dissociative and psychotic symptoms transdiagnostically. The current study examines an emerging trauma-dissociation theoretical model that accounts for psychotic symptoms across affective disorders and schizophrenia (SCZ). METHOD: Psychiatric inpatients with DSM-5 major depressive disorder (MDD), bipolar disorders (BD) currently in a major depressive episode, and SCZ, and healthy controls (HC) were recruited. Potentially traumatizing events in childhood, dissociative symptoms, and psychotic symptoms were assessed. In addition to participant's self-report, dissociative and psychotic symptoms were rated by psychiatrists blind to the hypothesis. Path analysis was conducted. RESULTS: Dissociation was commonly experienced by clinical participants, particularly for those with MDD or BD. For the SCZ group, ratings of dissociation differed between patient and clinician; specifically, patient-reported dissociation scores, but not clinician-rated scores, were higher than that of the HC group. Importantly, the links between childhood trauma, dissociation, and psychotic symptoms were not homogenous across the diagnostic groups. Dissociation mediated the relationship between childhood trauma and psychotic symptoms in the MDD and BD groups, but not the SCZ group. CONCLUSION: Depending on the psychiatric condition, dissociation and psychosis have different clinical implications. Childhood trauma and dissociation provide an account for psychotic symptoms in patients diagnosed with MDD and BD, but not with SCZ. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Remember walking in their shoes? The relation of self-referential source memory and emotion recognition.

Deficits in the ability to read the emotions of others have been demonstrated in mental disorders, such as dissociation and schizophrenia, which involve a distorted sense of self. This study examined whether weakened self-referential source memory, being unable to remember whether a piece of information has been processed with reference to oneself, is linked to ineffective emotion recognition. In two samples from a college and community, we quantified the participants' ability to remember the self-generated versus non-self-generated origins of sentences they had previously read or partially generated. We also measured their ability to read others' emotions accurately when viewing photos of people in affect-charged situations. Multinomial processing tree modelling was applied to obtain a measure of self-referential source memory that was not biased by non-mnemonic factors. Our first experiment with college participants revealed a positive correlation between correctly remembering the origins of sentences and accurately recognising the emotions of others. This correlation was successfully replicated in the second experiment with community participants. The current study offers evidence of a link between self-referential source memory and emotion recognition.

Erroneous Thought in Inpatients with Major Depressive Disorder: The Role of Psychological Trauma During Childhood and Adulthood.

Background: The pathogenic role of trauma in psychotic-like experiences has yet to be clarified. The aim of this study was to investigate the role of childhood and adulthood trauma on erroneous thoughts among patients with major depressive disorder. Materials and Methods: Inpatients with major depressive disorder (MDD) and healthy controls (HCs) were enrolled, and paper-and-pencil questionnaires were applied. Clinical rating and self-reported scales were used to measure levels of depression, dissociation, psychological trauma, parental maltreatment, and erroneous thoughts. Pearson's correlation analysis was conducted to explore potentially significant associations between erroneous thoughts and other independent variables, and standardized regression coefficients of hierarchical regression analysis were used to predict the significant relationships between erroneous thoughts and adulthood or childhood trauma. Results: A total of 99 participants were included into the analysis, of whom 59 were patients with MDD and 40 were HCs. After treatment, the patients with MDD showed significantly higher levels of depression, childhood maltreatment, interpersonal trauma and erroneous thoughts than the HCs. After estimating and verifying correlations with hierarchical regression among the patients with MDD, a link between adulthood betrayal trauma and higher level of conviction along with the number of erroneous thoughts was found. However, no significant association was identified between childhood trauma and erroneous thought. The concurrent level of depression significantly predicted a higher level of being preoccupied, along with the number of erroneous thoughts. Conclusion: The current study fills a gap in the literature by showing a link between adulthood trauma and erroneous thoughts in non-psychotic patients. Further studies with well-controlled comparisons and prospective cohort with longer follow-up are warranted to extend the applicability and generalizability of the current study.

18-month trajectories of delusional dimensions in young adults: Relationship with reasoning biases and worry.

BACKGROUND: It has been argued that what differentiates delusional ideation from full-blown delusions (indicating need for care) is not the number of beliefs, but the experiential dimensions such as conviction, distress, and preoccupation. However, how these dimensions evolve over time and affect outcomes is under-researched. While delusional conviction and distress are associated with reasoning biases and worry respectively in clinical samples, how these processes predict trajectories of delusional dimensions in the general population remains unclear. METHOD: Young adults (age 18-30) were screened for delusional ideation on the Peters et al. Delusions Inventory. Participants with at least one delusional ideation were randomly selected for a 4-wave assessment (6-month apart). Trajectories of delusional dimensions were separately identified by latent class growth analyses, then compared on baseline levels of jumping-to-conclusions bias, belief inflexibility, worry, and meta-worry. RESULTS: The longitudinal sample consisted of 356 individuals (drawn from a community sample of 2,187). For each of the three dimensions (conviction, distress, and preoccupation), four-group linear models were identified-high stable, moderate stable, moderate decreasing, and low stable. The high stable group exhibited worse emotional and functional outcomes at 18 months than the other three groups. Worry and meta-worry predicted group differences, and notably differentiated the moderate decreasing groups from the moderate stable groups. Contrary to hypothesis, jumping-to-conclusions bias was milder in the high/moderate stable groups than the low stable group for conviction. CONCLUSIONS: Distinct trajectories of delusional dimensions were predicted by worry and meta-worry. Differences between the decreasing and stable groups carried clinical implications. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Stressors and Destressors in Working From Home Based on Context and Physiology From Self-Reports and Smartwatch Measurements: International Observational Study Trial.

BACKGROUND: The COVID-19 pandemic has greatly boosted working from home as a way of working, which is likely to continue for most companies in the future, either in fully remote or in hybrid form. To manage stress levels in employees working from home, insights into the stressors and destressors in a home office first need to be studied. OBJECTIVE: We present an international remote study with employees working from home by making use of state-of-the-art technology (ie, smartwatches and questionnaires through smartphones) first to determine stressors and destressors in people working from home and second to identify smartwatch measurements that could represent these stressors and destressors. METHODS: Employees working from home from 3 regions of the world (the United States, the United Kingdom, and Hong Kong) were asked to wear a smartwatch continuously for 7 days and fill in 5 questionnaires each day and 2 additional questionnaires before and after the measurement week. The entire study was conducted remotely. Univariate statistical analyses comparing variable distributions between low and high stress levels were followed by multivariate analysis using logistic regression, considering multicollinearity by using variance inflation factor (VIF) filtering. RESULTS: A total of 202 people participated, with 198 (98%) participants finishing the experiment. Stressors found were other people and daily life getting in the way of work (P=.05), job intensity (P=.01), a history of burnout (P=.03), anxiety toward the pandemic (P=.04), and environmental noise (P=.01). Destressors found were access to sunlight (P=.02) and fresh air (P<.001) during the workday and going outdoors (P<.001), taking breaks (P<.001), exercising (P<.001), and having social interactions (P<.001). The smartwatch measurements positively related to stress were the number of active intensity periods (P<.001), the number of highly active intensity periods (P=.04), steps (P<.001), and the SD in the heart rate (HR; P<.001). In a multivariate setting, only a history of burnout (P<.001) and family and daily life getting in the way of work (P<.001) were positively associated with stress, while self-reports of social activities (P<.001) and going outdoors (P=.03) were negatively associated with stress. Stress prediction models based on questionnaire data had a similar performance (F1=0.51) compared to models based on automatic measurable data alone (F1=0.47). CONCLUSIONS: The results show that there are stressors and destressors when working from home that should be considered when managing stress in employees. Some of these stressors and destressors are (in)directly measurable with unobtrusive sensors, and prediction models based on these data show promising results for the future of automatic stress detection and management. TRIAL REGISTRATION: Netherlands Trial Register NL9378; https://trialsearch.who.int/Trial2.aspx?TrialID=NL9378.

The co-occurrence of multidimensional loneliness with depression, social anxiety and paranoia in non-clinical young adults: A latent profile analysis.

Introduction: Loneliness is a negative experience arising from a mismatch between perceived and actual social relationships. Several dimensions of loneliness have been suggested, namely intimate, relational and collective loneliness. Loneliness has been linked to poorer mental health, with its co-occurrence with depression, social anxiety, and paranoia most widely reported. While expressions of these symptoms are heterogeneous across individuals in the non-clinical population, it remains unclear how these symptoms co-occur with one another and with various dimensions of loneliness. It is also of interest how trait factors such as core schemas about self/others may moderate these relationships between loneliness and co-occurring symptoms. Methods: A demographically diverse sample of young adults was recruited from multiple sources. The validated sample consisted of 2,089 participants (68.4% female), who completed an online survey consisting of questionnaires assessing levels of multidimensional loneliness, depression, social anxiety, paranoia, core schemas, and demographic characteristics. Latent profile analysis (LPA) was used to identify distinct profiles of loneliness and the three symptoms. Positive and negative core schemas about self and others were modeled as predictors of these profiles. Results: Five distinct profiles were identified. Profile 1 had low levels across all symptoms and dimensions of loneliness (n = 1,273, 60.9%). Profiles 2-5 were elevated on dimensions of loneliness, and were heightened in depression (n = 189, 9.0%), social anxiety (n = 206, 9.9%), paranoia (n = 198, 9.5%), and all symptoms (n = 223, 10.7%), respectively. Relative to Profile 1, the other four profiles scored higher on negative-self (adjusted ORs = 1.36-1.49, ps < 0.001) and negative-other schemas (adjusted ORs = 1.24-1.44, ps < 0.001), and lower on positive-self (adjusted ORs = 0.82-0.85, ps < 0.001) and positive-other schemas (adjusted ORs = 0.81-0.90, ps < 0.001). Conclusion: More marked intimate, relational and collective loneliness were evident across profiles that had heightened depression, social anxiety and/or paranoia, suggesting that loneliness may serve as a general risk factor for these psychopathologies. Our findings shed light on the heterogeneity of the co-occurrence of loneliness and various mental health difficulties in non-clinical young adults. Core schemas are suggested to be putative psychological mechanisms underlying their co-occurrence and even development.

Finding a positive me: Affective and neural insights into the challenges of positive autobiographical memory reliving in borderline personality disorder.

BACKGROUND: This study aimed to investigate whether people with borderline personality disorder (BPD) can benefit from reliving positive autobiographical memories in terms of mood and state self-esteem and elucidate the neural processes supporting optimal memory reliving. Particularly the role of vividness and brain areas involved in autonoetic consciousness were studied, as key factors involved in improving mood and state self-esteem by positive memory reliving. METHODS: Women with BPD (N = 25), Healthy Controls (HC, N = 33) and controls with Low Self-Esteem (LSE, N = 22) relived four neutral and four positive autobiographical memories in an MRI scanner. After reliving each memory mood and vividness was rated. State self-esteem was assessed before and after the Reliving Autobiographical Memories (RAM) task. RESULTS: Overall, mood and state self-esteem were lower in participants with BPD compared to HC and LSE, but both the BPD and LSE group improved significantly after positive memory reliving. Moreover, participants with BPD indicated that they relived their memories with less vividness than HC but not LSE, regardless of valence. When reliving (vs reading) memories, participants with BPD showed increased precuneus and lingual gyrus activation compared to HC but not LSE, which was inversely related to vividness. DISCUSSION: Women with BPD seem to experience more challenges in reliving neutral and positive autobiographical memories with lower vividness and less deactivated precuneus potentially indicating altered autonoetic consciousness. Nevertheless, participants with BPD do benefit in mood and self-esteem from reliving positive memories. These findings underline the potential of positive autobiographical memory reliving and suggest that interventions may be further shaped to improve mood and strengthen self-views in people with BPD.

A network analysis on the relationship between loneliness and schizotypy.

BACKGROUND: Schizotypy is a multidimensional personality trait related to the heightened risk for the development of schizophrenia spectrum disorders. While it has been suggested that loneliness may be associated with schizotypy in general, whether it relates to the specific schizotypal traits differentially remains unknown. Besides, as loneliness often co-occurs with depression and anxiety, it is important to delineate its relationship with schizotypy in consideration of these co-occurring emotional disturbances. METHODS: A demographically diverse sample of young people was obtained from multiple sources. The validated sample consisted of 2089 participants (68.4% female, age range: 18-30). The structural relationship between loneliness and schizotypy was modelled using a network analytic approach. The Gaussian graphical model with loneliness and nine schizotypal traits as nodes was first estimated without, and then with adjustment for the levels of depressive and anxiety symptoms. Edges were estimated as unique associations between nodes. RESULTS: 'Suspiciousness', 'odd beliefs or magical thinking', 'no close friends', 'constricted affect' and 'excessive social anxiety' were linked to loneliness directly. Loneliness was found to be more strongly associated with 'suspiciousness' and 'no close friends' than other schizotypal traits. After adjustment for the levels of depressive and anxiety symptoms, the above direct edges remained robust. LIMITATIONS: The use of cross-sectional data indicated only undirected associations between variables. CONCLUSIONS: Loneliness was more strongly linked to some schizotypal traits than others, with the relationships maintaining above and beyond the effects of anxiety and depression. These findings warrant further investigation of the specific relationships between loneliness and individual schizotypal traits.

Dissociation and Dissociative Disorders Reconsidered: Beyond Sociocognitive and Trauma Models Toward a Transtheoretical Framework.

For more than 30 years, the posttraumatic model (PTM) and the sociocognitive model (SCM) of dissociation have vied for attention and empirical support. We contend that neither perspective provides a satisfactory account and that dissociation and dissociative disorders (e.g., depersonalization/derealization disorder, dissociative identity disorder) can be understood as failures of normally adaptive systems and functions. We argue for a more encompassing transdiagnostic and transtheoretical perspective that considers potentially interactive variables including sleep disturbances; impaired self-regulation and inhibition of negative cognitions and affects; hyperassociation and set shifts; and deficits in reality testing, source attributions, and metacognition. We present an overview of the field of dissociation, delineate uncontested and converging claims across perspectives, summarize key multivariable studies in support of our framework, and identifyempirical pathways for future research to advance our understanding of dissociation, including studies of highly adverse events and dissociation.

The moderation of maternal parenting on the association of trauma, dissociation, and psychosis in depressive inpatients.

Background: The effect of dissociation and parenting style on the relationship between psychological trauma and psychotic symptoms has not previously been investigated. Objective: The aim of this study was to develop a moderated mediation model to assess whether the association between psychological trauma and psychotic symptoms is mediated by dissociation and moderated by parental maltreatment. Methods: Inpatients with major depressive disorder (MDD) and bipolar depression (BP) were recruited. Self-reported and clinical rating scales were used to measure the level of dissociation, psychotic symptoms, history of psychological trauma and parental maltreatment. The PROCESS macro in SPSS was used to estimate path coefficients and adequacy of the moderated mediation model. High betrayal trauma (HBT), low betrayal trauma (LBT), paternal maltreatment, and maternal maltreatment were alternatively entered into the conceptual model to test the adequacy. Results: A total of 91 patients (59 with MDD and 32 with BP) were recruited, with a mean age of 40.59 ± 7.5 years. After testing with different variables, the moderated mediation model showed that the association between LBT and psychotic symptoms was mediated by dissociation and moderated by maternal maltreatment. A higher level of maternal maltreatment enhanced the effect of LBT on dissociation. Conclusions: Healthcare workers should be aware of the risk of developing psychotic symptoms among depressive patients with a history of LBT and maternal maltreatment.

Antecedentes: El efecto de disociación y el estilo parental en la relación entre el trauma psicológico y los síntomas psicóticos no se han investigado previamente.Objetivo: El objetivo de este estudio fue desarrollar un modelo de mediación moderada para evaluar si la asociación entre trauma psicológico y síntomas psicóticos es mediada por la disociación y moderada por el maltrato de los padres.Métodos: Fueron reclutados pacientes hospitalizados con trastorno depresivo mayor (TDM) y depresión bipolar (DB). Se utilizaron escalas clínicas y de auto-reporte para medir el nivel de disociación, síntomas psicóticos, antecedentes de trauma psicológico y maltrato de los padres. La macro PROCESS en SPSS se utilizó para estimar los coeficientes de ruta y adecuación del modelo de mediación moderada. Alto exposición al trauma de traición (HET), baja exposición al trauma de traición (BET), maltrato paterno y maltrato materno fueron alternativamente ingresados en el modelo conceptual para probar la adecuación.Resultados: Se reclutaron un total de 91 pacientes (59 con TDM y 32 con DB), con una edad media de 40,59 ± 7,5 años. Después de probar con diferentes variables, el modelo moderado de mediación mostró que la asociación entre BET y síntomas psicóticos estuvo mediada por la disociación y moderada por el maltrato materno. Un nivel superior del maltrato materno aumentó el efecto de BET sobre la disociación.Conclusiones: Los trabajadores del área de la salud deben ser conscientes del riesgo del desarrollo de síntomas psicóticos entre los pacientes depresivos con antecedentes de BET y maltrato materno.

Longitudinal bifactor modeling of anxiety, depression and schizotypy - The role of rumination as a shared mechanism.

A bifactor model with a general (p) factor reflecting shared variance and specific factors reflecting additional variance in individual symptoms has been introduced to explain common co-occurrence among anxiety, depression and schizotypy. However, longitudinal evidence is lacking and the validity of bifactor modeling is debatable. The current study aimed to examine the presence of the p factor together with specific factors in accounting for relationships between anxiety, depression and schizotypy both cross-sectionally and longitudinally, and to investigate the relationship between these factors and rumination. A validated sample of university students were surveyed on levels of anxiety, depression, schizotypy and rumination at baseline (N = 2291), one year (N = 1833) and two years (N = 1656). Models were estimated using exploratory structural equation modeling (ESEM) and compared at each time point. Longitudinal invariance of the best-fitting model was examined and all potential within- and between-factor stability pathways were tested in an SEM framework. A bifactor model with a p factor and four specific factors (representing residual information of composite anxiety and depression, cognitive-perceptual, interpersonal and disorganized schizotypy respectively) consistently outperformed a correlated-factors model. The bifactor structure appeared longitudinally stable. Within-factor stabilities were moderate, and between-factor pathways reflected a few significant interactions, mostly involving the p factor. Rumination was independently associated with p and four specific factors at each time point. Therefore, there is a p factor accounting for concurrent and sequential co-occurrence of anxiety, depression and schizotypy. Rumination explained partly the p and specific factors. Transdiagnostic interventions should target rumination.

Relational self-evaluations in dissociation: Implicit self-rejection?

OBJECTIVE: Schematic self-knowledge consists of internal representations that shape perceptions of how the self is related to one's surroundings and other people. These representations may include dysfunctional implicit self-evaluations, such as associations of the self with negative attributes like shame, in trauma-spectrum disorders. The current study examines whether a negative relational self-association, that is, linking the self with rejection, characterizes dissociation. METHOD: One hundred six community participants with diverse early interpersonal experiences and mental health outcomes were recruited. Implicit relational self-evaluation was assessed by single-target implicit association tests. Dissociation and common psychopathological and psychosocial correlates such as anxiety, depression, self-esteem, and adverse interpersonal experiences were measured using standardized scales. RESULTS: Individuals with more dissociative symptoms responded faster when pairing self-pronouns with rejection-related words than with acceptance-related words. The correlation between dissociation and this self-rejection association remained significant when statistically controlling for adverse interpersonal experiences and for depression, anxiety, and self-esteem. CONCLUSION: A self-association with being rejected characterized individuals prone to dissociation. This dysfunctional implicit self-evaluation may bias perceptions of other people's attitudes toward themselves, prompting maladaptive social behaviors that can hinder the development and maintenance of relationships in dissociative people. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Dissociation of posture remapping and cognitive load in level-2 perspective-taking.

Visuospatial perspective-taking is the foundation for inferring the mental state of another person during social interaction. Although research has shown that dual processes are involved in self-judgment when an avatar is present on screen, it is unknown whether dual independent processes also underlie perspective-taking. During the three experiments in the present study, the participants made laterality judgments according to the perspective of a seated or standing avatar. The angular disparity between the egocentric and altercentric perspectives was manipulated so that the two perspectives led to congruent or incongruent responses. While performing the task, the participants were seated or standing (Experiment 1), seated and subjected to different response deadlines (Experiment 2), or seated and subjected to different mental workloads (Experiment 3). The analysis based on the process-dissociation-procedure framework showed that automatic processing was reduced when the participants stood on their feet and took the perspective of a seated avatar. Posture remapping did not influence controlled processing or behavioral outcomes. Conversely, time pressure and working memory load reduced controlled processing and impaired perspective-taking, but did not affect automatic processing. Thus, dual independent processes are involved in taking another person's perspective. Reduction of the automatic component may help to lower self-bias in preparation to act when posture remapping is required during social interactions, while cognitive load may impair the controlled processing of spatial alignment and response selection during visuospatial perspective-taking.

Absence of negative associations of insular and medial frontal gray matter volume with dissociative symptoms in schizophrenia.

BACKGROUND: Dissociative symptoms have been constantly found in schizophrenia (SCZ). Traumatic experience seems to relate to dissociative symptoms and brain volume alterations in SCZ. The current study aimed to clarify the inter-relations of dissociative symptoms, traumatic experience, and brain volume in SCZ. METHODS: We employed voxel-based morphometry to compare the distributions of gray matter volumes (GMV) in 37 SCZ patients and 26 healthy volunteers (HV). All participants underwent T1-weighted images on a 1.5 T MRI system. Traumatic experience was examined by the Brief Betrayal Trauma Survey. Pathological and non-pathological dissociation were measured by the Dissociative Symptoms Scale and the Dissociative Experiences Scale, respectively. RESULTS: A GMV reduction was found in SCZ patients in the right thalamus. Importantly, a significant group by pathological dissociation interaction was observed in the medial frontal cortex (MFC), bilateral anterior insular area, and precuneus. A negative correlation between MFC/insular GMV and pathological dissociation was observed in HV; higher non-pathological dissociation and smaller volume in MFC/insula were associated with pathological dissociation. In contrast, higher traumatic experience, higher non-pathological dissociation, and larger volume in MFC/insula were associated with pathological dissociation in SCZ. CONCLUSION: The negative association between MFC/insula GMV and pathological dissociation in HV was not observed in SCZ patients. The absent negative association in SCZ suggests a unique neural underpinning in SCZ with dissociative pathology, in which medial frontal and temporal regions play crucial roles.

Visuospatial perspective shifting and relational self-association in dispositional shame and guilt.

Although dispositional shame and guilt have been distinguished by perceptions of the self and behavioral responses, the underlying information processing patterns remain unclear. We hypothesized that an ability to contemplate alternatives to perceptions of the current environment, i.e., flexibility in perspective shifting, may be essential to both dispositions. Dispositional shame may additionally relate to negative relational knowledge that involves a self-representation of being rejected. One hundred and six community participants rated the two dispositions, and had their flexibility in perspective shifting and internalized self-association with rejection assessed. Regression analysis indicated that a lower cost of perspective shifting was observed with dispositional guilt and shame. Yet, unlike a direct association with perspective shifting for dispositional guilt, it was an interaction between perspective shifting and negative relational knowledge that accounted for dispositional shame. The association of dispositional shame with perspective shifting was contingent upon the tendency to pair the self with rejection.

Altered cortico-striatal functional connectivity in people with high levels of schizotypy: A longitudinal resting-state study.

PURPOSE OF THE RESEARCH: Cortico-striatal functional connectivity has been implicated in the neuropathology of schizophrenia. However, the longitudinal relationship between the cortico-striatal connectivity and schizotypy remains unknown. We examined the resting-state fMRI connectivity in 27 individuals with a high level of schizotypy and 20 individuals with a low level of schizotypy at baseline and 18 months later. Correlations between changes in cortico-striatal connectivity and changes in schizotypy scores over time were examined. PRINCIPAL RESULTS: We found both increased and decreased cortico-striatal connectivity in individuals with a high level of schizotypy at baseline. Over time, these individuals showed improvement in both the negative and positive schizotypal domains. Changes in striatal-insula connectivity were positively correlated with changes in positive schizotypy from baseline to follow-up. MAJOR CONCLUSIONS: Our results suggested impaired cortico-striatal connectivity in individuals with a high level of schizotypy. The dysconnectivity mainly involves the dorsal striatum. The connectivity between the dorsal striatum and the insula may be a putative marker for temporal changes in positive schizotypy.

A pilot study on the effectiveness of low-intensity cognitive behavioural therapy (LiCBT) for common mental disorders in Hong Kong.

BACKGROUND: To cope with the rising demand for psychological treatment, evidence-based low-intensity cognitive behavioural therapy (LiCBT) delivered by trained para-professionals was introduced internationally. AIMS: This pilot study aimed at examining the effectiveness of LiCBT in Hong Kong. METHOD: This study was of an uncontrolled pre- and post-treatment design, testing LiCBT at a local community mental health centre in Hong Kong. Two hundred and eighty-five Chinese adult help-seekers to the centre attended two or more sessions of LiCBT delivered by trained para-professionals. These participants also rated their depression and anxiety on the Patient Health Questionnaire-9 (PHQ-9) and Generalised Anxiety Disorder Scale-7 (GAD-7), respectively, at pre- and post-treatment. RESULTS: Comparison of the pre- and post-treatment PHQ-9 and GAD-7 scores of 285 participants indicated significant improvements in depression and anxiety with large effect sizes (depression: d = 0.87; anxiety: d = 0.95). For those participants reaching the clinical level of either depression and/or anxiety at pre-treatment (n = 229, 80.4%), they reported even larger effect sizes (depression: d = 1.00; anxiety: d = 1.15). The recovery rate was 55.9% with a reliable improvement rate of 63.9%. An average of 5.6 sessions was offered to the participants with each session spanning a mean of 42 minutes. The baseline clinical conditions and participants' educational level were predictive of post-treatment recovery. CONCLUSIONS: The results supported the effectiveness and cost-efficiency of LiCBT for depression and anxiety at a Hong Kong community mental health centre. The effect sizes and the recovery and reliable improvement rates achieved were comparable to those reported from countries such as the UK and Australia.

Risk perception in paranoia and anxiety: Two investigations across clinical and non-clinical populations.

OBJECTIVES: It is common, among clinical and non-clinical populations alike, for paranoia and anxiety to co-occur. It has been suggested that anxiety and its related appraisal styles may contribute to development of paranoia. We aimed to evaluate different aspects of risk perception in relation to paranoia and anxiety and to identify specific aspects that may differentiate paranoia from anxiety. This paper consists of two inter-related studies. METHODS: Study 1 compared 30 patients with persecutory delusions, 21 patients with generalized anxiety disorder and 52 healthy controls. Study 2 compared 30 non-clinical individuals with high levels of paranoia and anxiety, 28 individuals with high anxiety only and 36 healthy controls. Within each study, the two symptomatic groups were matched on level of anxiety. Four dimensions of risk perception (i.e. likelihood, harm, controllability, and intentionality) were compared across groups, as measured by the locally validated Risk Perception Questionnaire. RESULTS: In both studies, the paranoia and the anxiety groups reported an elevated perceived likelihood of negative events than controls respectively. Only the paranoia groups reported an elevated perceived harm of neutral events than controls. In Study 2, the two at-risk groups attributed more harm and intentionality to negative events than controls. CONCLUSION: Although perception of negative events was characteristic in anxiety (with or without paranoia), a biased perception of neutral events as risky was unique to the addition of paranoia. Implications to the transdiagnostic and continual view of psychopathology, and mechanism-based interventions were discussed.