Emotional awareness and delusions in schizophrenia and schizoaffective disorder.

BACKGROUND AND OBJECTIVES: Emotion plays a significant role in schizophrenia. Emotional awareness (i.e., attention to and clarity of emotions) is associated with a wide range of outcomes. Given that individuals with schizophrenia and schizoaffective disorder differ in the significance of their mood symptoms, the present research examined whether the association between emotional awareness and delusions differs for these two groups of patients. METHODS: Emotional awareness (i.e., attention to and clarity of emotions) was measured with self-report in a sample of 44 individuals diagnosed with either schizophrenia or schizoaffective disorder. Clinical ratings of delusions were made using the Scale for the Assessment of Positive Symptoms. RESULTS: For the sample as a whole, individuals with higher levels of attention to emotion tended to have more severe delusions. In addition, diagnostic group significantly moderated the relation between emotional clarity and delusions. LIMITATIONS: Conclusions regarding causality cannot be drawn due to the cross-sectional design. Replication is particularly important given the small sample sizes. CONCLUSIONS: The present research indicates that emotional awareness is associated with delusions. The results raise the possibility that the emotional factors that contribute to delusional beliefs among individuals with schizophrenia differ in at least some ways from the emotional factors that contribute to delusional beliefs among individuals with schizoaffective disorder.

Delivering group treatment via videoconference to individuals with traumatic brain injury: a feasibility study.

The objective was to assess the feasibility of delivering a group treatment to improve emotional regulation via videoconferencing to individuals with traumatic brain injury (TBI). A pre-post feasibility study was undertaken. Seven individuals with TBI were recruited at a brain injury research centre in an urban medical centre. The main measures were therapist assessment of session-by-session progress and feasibility, Difficulties in Emotion Regulation Scale (DERS), Brain Injury Rehabilitation Trust Regulation of Emotions Questionnaire (BREQ), Satisfaction with Therapy and Therapist Scale (STTS), and exit interview. Attendance across sessions and participants was over 90%. Adequate skill acquisition and ease of use of the technology were demonstrated. Self-reported satisfaction with treatment was high. Participants noted several benefits in terms of the treatment delivery modality. There was no change is self-reported emotional dysregulation. This is the first study to report the use of videoconferencing for the delivery of group treatment to individuals with TBI. The exceptional compliance and self-reported satisfaction suggest that this treatment delivery option could be a viable alternative for increasing access to healthcare in this population. The findings of the study supported the development of a large clinical trial to assess treatment effectiveness.

Depression and cognitive deficits in geriatric schizophrenia.

OBJECTIVE: Past reports have found patients with comorbid depression and schizophrenia spectrum disorders exhibit greater deficits in memory and attention compared to schizophrenia spectrum disorder patients without depressive symptoms. However, in contrast to younger schizophrenia patients, the few past studies using cognitive screens to examine the relationship between depression and cognition in inpatient geriatric schizophrenia have found that depressive symptomatology was associated with relatively enhanced cognitive performance. In the current study we examined the relationship between depressive symptoms and cognitive deficits in geriatric schizophrenia spectrum disorder patients (n=71; mean age=63.7) on an acute psychiatric inpatient service. METHOD: Patients completed a battery of cognitive tests assessing memory, attention and global cognition. Symptom severity was assessed via the PANSS and Calgary Depression Scale for Schizophrenia. RESULTS: Results revealed that geriatric patients' depression severity predicted enhancement of their attentional and verbal memory performance. Patients' global cognitive functioning and adaptive functioning were not associated with their depression severity. CONCLUSION: Contrary to patterns typically seen in younger patients and non-patient groups, increasing depression severity is associated with enhancement of memory and attention in geriatric schizophrenia spectrum disorder patients. Also, diverging from younger samples, depression severity was unassociated with patients adaptive and global cognitive functioning.

Bullying and discrimination experiences among Korean-American adolescents.

The bullying experiences of Korean-American adolescents (N = 295) were explored in relation to discrimination and mental health outcomes. Bullying experiences were assessed by the Bully Survey (Swearer, 2005), discrimination by the Perceived Ethnic and Racial Discrimination Scale (Way, 1997) and depression by the Center for Epidemiological Studies - Depression Scale (CES-D). Those who reported being bullied (31.5%) as well as those who reported both being bullied and bullying others (15.9%) experienced a higher level of depression, which was elevated beyond the clinically significant level of CES-D. The results of a LISREL model suggest that the experiences of bullying among Korean/Asian-American adolescents and their related mental health issues need to be addressed in a comprehensive context of their discrimination experiences, acculturation, family and school environments.

Ethnicity and symptom expression in patients with acute schizophrenia.

Chinese patients have been largely ignored in the literature examining ethnic differences in schizophrenia. This study examined demographics and symptom profiles of Euro-, African-, Chinese-American, and Latino inpatients with schizophrenia. Chinese-American patients had fewer symptoms, hospitalizations, and least amount of education compared to other groups. Cultural and clinical implications are discussed.

Cognitive status changes based on time of day in nursing home patients with and without dementia.

BACKGROUND: Changes in behavior and cognition have been observed with disruption of the circadian rhythm. METHODS: This study examined the effects of time of day (TOD) on administration of Mini-Mental State Examinations (MMSEs) in nursing home patients with dementia (patients) or functional psychiatric disorders (control), using repeated measures analyses of covariance (ANCOVAs). RESULTS: Controls (n = 34) scored significantly higher than patients (n = 38) on total MMSE and all subscales. Within the patients, men and women performed equally in the morning, but women performed marginally worse in the afternoon on total MMSE scores, orientation, and immediate recall and men performed significantly better in the afternoon. Within the control, no gender or time effects were detected. CONCLUSION: Results indicate that TOD had no significant impact on cognitive status in patients with dementia or patients with other psychiatric illnesses. No changes in activity timings are recommended in nursing home patients with dementia.