Temperament and Character Inventory-R (TCI-R) and Big Five Questionnaire (BFQ): convergence and divergence.

This study evaluated the correspondence between measures of two competing theories of personality, the five-factor model as measured by the Big Five Questionnaire (BFQ), and Cloninger's psychobiological theory measured by the Temperament and Character Inventory-Revised (TCI-R). A sample of 900 Italian participants, balanced with respect to sex (393 men and 507 women), and representative of the adult population with respect to age (range 18 to 70 years; M = 39.6, SD = 15.7) completed the TCI-R and the Big Five Questionnaire. All TCI-R personality dimensions except Self-Transcendence were moderately correlated with one or more of the Big Five dimensions (from r = .40 to .61), and the two instruments showed areas of convergence. However, the differences outweighed the similarities, indicating that these current conceptualizations and measures of personality are somewhat inconsistent with each other.

How much stress is needed to increase vulnerability to psychosis? A community assessment of psychic experiences (CAPE) evaluation 10 months after an earthquake in L'Aquila (Italy).

Since severe stress can induce mental disorder symptoms that interact with vulnerability factors, the Community Assessment of Psychic Experiences (CAPE) was evaluated in a population of 419 young adults who survived an earthquake; results were compared to a database of 1,057 'non-exposed' subjects. Unexpectedly, earthquake survivors showed lower CAPE scores for 'small' to 'medium' effect size. Post-trauma positive changes or re-appraisal for successful adaptation may explain these findings.

Deconstructing theory of mind in schizophrenia.

First- and second-order theory of mind (ToM) abilities seem to form a hierarchy of mind states within the same construct. If so, no ability in higher comprehension of intentionality would be possible when the previous one is failing. The purpose of the study is to investigate this hierarchy in a sample of schizophrenic subjects. Insofar as ToM defines processes involved in a multi-level social cognitive processing, they could be part of a scenario of specialized areas performing different parallel computations. Therefore, we further investigated the relationship of ToM scores to metacognitive indexes, widely demonstrated to be involved in social cognition, symptomatology and global functionality, in two independent samples of subjects with schizophrenia. Thirty-eight subjects with schizophrenia were preliminarily examined for first- and second-order ToM, using only one story in each order. Cross-tabulation of subjects according to their answers revealed that 13.2% of subjects gave incorrect answers to ToM I but correct answers to ToM II. A more extensive examination of first- and second-order ToM in a sample of 42 subjects with schizophrenia was then performed. The results confirmed the existence of a group of subjects (11.9%) scoring incorrectly at ToM I but correctly at ToM II, which is unexplainable if the hierarchical hypothesis were true. While both ToM scores were highly correlated with metacognitive scores on the Positive and Negative Syndrome Scale (PANSS), for both positive and negative clusters, and only second-order ToM was correlated with scores on the Global Assessment of Function (GAF). On the other hand, meta-cognitive indexes were correlated with both PANSS and GAF scores. First-order ToM was found to play an essential role in determining clinical severity. ToM I and II order scores share a minor part of variance. Instead of hierarchically ordered mind states, first- and second-order intentionality can represent different constructs. The ability to 'understand others', i.e. ToM, can be dissociable, suggesting the existence of an interconnected network of different constructs deputed to an adequate understanding and management of the social world complexity.

Patterns of structural MRI abnormalities in deficit and nondeficit schizophrenia.

Negative symptoms of schizophrenia have generally been found in association with ventricular enlargement and prefrontal abnormalities. These relationships, however, have not been observed consistently, most probably because negative symptoms are heterogeneous and result from different pathophysiological mechanisms. The concept of deficit schizophrenia (DS) was introduced by Carpenter et al to identify a clinically homogeneous subgroup of patients characterized by the presence of primary and enduring negative symptoms. Findings of brain structural abnormalities reported by magnetic resonance imaging (MRI) studies focusing on DS have been mixed. The present study included 34 patients with DS, 32 with nondeficit schizophrenia (NDS), and 31 healthy comparison subjects, providing the largest set of MRI findings in DS published so far. The Schedule for the Deficit Syndrome was used to categorize patients as DS or NDS patients. The 2 patient groups were matched on age and gender and did not differ on clinical variables, except for higher scores on the negative dimension and more impaired interpersonal relationships in DS than in NDS subjects. Lateral ventricles were larger in NDS than in control subjects but were not enlarged in patients with DS. The cingulate gyri volume was smaller in NDS but not in DS patients as compared with healthy subjects. Both groups had smaller dorsolateral prefrontal cortex and temporal lobes than healthy subjects, but DS patients had significantly less right temporal lobe volume as compared with NDS patients. These findings do not support the hypothesis that DS is the extreme end of a severity continuum within schizophrenia.

The effect of verbalization strategy on Wisconsin Card Sorting Test performance in schizophrenic patients receiving classical or atypical antipsychotics.

BACKGROUND: A number of reports showed en encouraging remediation in some patients' executive deficits thanks to the use of 'information processing strategies'. Moreover the impact of antipsychotics on cognitive functions of the schizophrenics is an important issue, especially if an integrated psychosocial treatment is needed. The aim of this paper is to evaluate different executive performance and response to verbalization, a strategy of the Wisconsin Card Sorting Test (WCST) remediation, in subjects on classical vs atypical antipsychotic (AP) treatment. METHODS: Sixty-three schizophrenic subjects undertook the WCST under standard and modified (verbalization) administration. Subjects were stratified by the kind of WCST response (i.e. good, poor and remediable) and AP treatment (i.e. atypical vs. classical). RESULTS: Subjects on atypical APs showed a better performance than those on classical ones. More poor performers who did not remediate were seen in the sample with classical Aps while subjects who remediated the performance were seen in the subgroup with atypical APs only. An increase of perseverative and total errors was seen in poor performers subjects on classical APs. CONCLUSION: Subjects on atypicals showed a better cognitive pattern in terms of WCST performance. Since the naturalistic assignment of medication we cannot draw conclusions about its effect on cognitive performance and its interaction with cognitive remediation potential. However the data lead us to hypothesize that subjects with potential room for remediation did so with the atypical APs.

Predictors of social cognition in patients with schizophrenia.

The goal of this study is to explore neurocognitive, clinical and community functioning variables in order to predict "social reasoning" in a sample of patients with a diagnosis of schizophrenic disorder. Cognitive and community functioning, and social reasoning have been evaluated, together with the Positive and Negative Syndromes Scale (PANSS) and DSM-IV Global Assessment of Functioning (GAF), in a sample of 46 patients who met the DSM-IV criteria for schizophrenia. Our findings show that global functioning as reflected by GAF is the strongest predictor of the social reasoning as evaluated by the Wason's Selection Task (WST). Other community functioning variables such as the Life Skills Profile (LSP) sub-scores do not provide significant prediction of social reasoning. Similarly, neurocognitive measures, in terms of attention and contextual reasoning, have no predictive effect on social reasoning. Our findings show that social cognition should be considered as an additional cognitive domain more related to functional outcome.

The contribution of temperament and character to schizotypy multidimensionality.

Schizotypy could be viewed either as an underlying "personality organization" that includes the "liability" to schizophrenia, i.e., as a hypothetical latent construct, or it could be referred to the phenotypic manifestations of a particular personality organization. The psychobiologic model of the structure of personality accounts for dimensions of both temperament and character. This study examined the covariances between Temperament and Character Inventory (TCI) scores and aspects of Schizotypal Personality Questionnaire (SPQ) scores in a nonclinical sample. The results showed the relationship between the number of schizotypal phenotypic traits, as quantified by SPQ measures, and a specific configuration of character, namely, high self-transcendence (ST), low self-directedness (SD), and low cooperativeness (C). Data suggested that the unique combination of high ST, low SD, and low C seems to lead to a special risk for schizotypy. In particular, ST is a predictor either of psychosis proneness or mature, effective adapted and self-satisfied personalities, depending on its interaction with other TCI dimensions, both temperament and character.

Relationship of good and poor Wisconsin Card Sorting Test performance to illness duration in schizophrenia: a cross-sectional analysis.

The authors investigated whether schizophrenic patients with good and poor performance on the Wisconsin Card Sorting Test (WCST) showed cognitive modifications related to duration of illness. Of the 154 patients evaluated with the WCST, 56 subjects had normal or mildly impaired performance and 98 showed impairment on the basis of the number of categories achieved (0-3 categories = poor performance). These subsamples were then cross-sectionally divided into three subsamples depending on length of illness (< 5 years, 6-10 years, > 10 years). The inclusion of 69 healthy controls allowed the effect of age to be taken into account. The schizophrenic group as a whole and the group of poor performers did not show differences in any of the WCST indices related to length of illness. Good performers instead showed improvement on the intermediate length-of-illness group (6-10 years of illness), and then decline in the third one (> 10 years). Good performers only showed a positive significant correlation between age, age at onset, educational level and successful WCST performance. Results for the poor performers support the hypothesis of no progressive 'deteriorating' course of schizophrenia, while good performers show an unstable pattern of cognitive functions. These data support the hypothesis that cognitive deficits associated with schizophrenia cannot be considered a unitary trait, but emerge along different hypothetical trajectories.

Insight and neuropsychological function in patients with schizophrenia and bipolar disorder with psychotic features.

OBJECTIVES: This study investigates the pattern of association between patient unawareness of illness and neuropsychological tests of frontal lobe function in subjects with schizophrenia and bipolar disorder (BD) with psychotic features. METHOD: We administered the Wisconsin Card Sort Test (WCST) and a shortened version of the Scale to Assess Unawareness of Mental Disorder (SUMD) to a sample of 64 patients with psychosis (42 with schizophrenia and 22 with BD). RESULTS: None of the correlations between WCST scores and insight scores were statistically significant, either in the total group or in each group analyzed separately. Further, no differences were seen in insight scores between sexes and between the diagnostic groups. CONCLUSIONS: The 3 insight dimensions (that is, awareness of mental disorder, awareness of social consequences of mental disorder, and awareness of the benefits of medication) do not appear to be associated with frontal impairment, as measured by the WCST.

Wisconsin Card-Sorting Test performance does not discriminate different patterns of premorbid behavioral abnormalities in schizophrenic patients.

It is well documented that premorbid behavior abnormalities precede the onset of schizophrenia in a large number of patients. The research findings suggest that there are differences in the type and severity of these premorbid dysfunctions. Another research field has shown impairment of preschizophrenic patients in several cognitive domains. The present study reports retrospective childhood and adolescence neurobehavioral assessment in 31 patients with schizophrenia by the Child Behavior Checklist (CBCL) and current Wisconsin Card-Sorting Test (WCST) evaluation in order to investigate whether specific behavioral abnormality (BA) patterns are related to executive function as evaluated by the WCST. Cluster analysis was conducted on the childhood premorbid behavior ratings for the schizophrenic patients and two subgroups emerged: (i) Cluster I with an initial low level of BA that increased over the years; and (ii) Cluster II with a high level of BA that remained relatively stable until early adulthood. Furthermore, Cluster II showed more severe current negative and total symptoms, but the two groups did not differ in WCST performance. Our results show that the patterns and severity of CBCL upon retrospective evaluation are not related to WCST performance, which seems to be a feature inherent to the disease process. Different factors could be responsible for cognitive and behavioral disturbances in schizophrenia.

Historical, psychopathological, neurological, and neuropsychological aspects of deficit schizophrenia: a multicenter study.

OBJECTIVE: This multicenter study aimed to verify whether the historical and psychopathological characteristics of a large group of patients with deficit schizophrenia were consistent with those reported in previous studies. The authors also tested the hypothesis that neurological and neuropsychological indices sensitive to frontoparietal dysfunction, but not those sensitive to temporal lobe dysfunction, are more impaired in patients with deficit schizophrenia than in those with non-deficit schizophrenia. METHOD: For each patient with deficit schizophrenia enrolled in the study, a matched subject with non-deficit schizophrenia was recruited. Historical, psychopathological, neurological, and neuropsychological evaluations were carried out for all patients. RESULTS: Patients with deficit schizophrenia, compared with patients with non-deficit schizophrenia, had a similar severity of positive symptoms and disorganization and less hostility. They had poorer premorbid adjustment during childhood and early adolescence and exhibited more impairment in general cognitive abilities. The deficit state was associated with impairment in sequencing of complex motor acts, which suggests frontoparietal dysfunction. CONCLUSIONS: Previous reports of differences in historical, psychopathological, and neuropsychological characteristics between patients with deficit schizophrenia and those with non-deficit schizophrenia were mostly supported by the present findings. Neurological findings suggest that frontoparietal functioning is more impaired in patients with deficit schizophrenia. Deficit schizophrenia might represent a neurodevelopmental subtype of schizophrenia in which significant behavioral and cognitive impairment since childhood compromises the development of basic capacities relevant to subsequent cognitive and social functioning.

Schizotypal dimensions in normals and schizophrenic patients: a comparison with other clinical samples.

Schizotypy is usually referred to as a "liability" to schizophrenia, but it could also be more generally referred to as nonspecific "psychosis-proneness". This study examined the structure of schizotypy in a normal sample and in a sample of schizophrenics through the administration of the Schizotypal Personality Questionnaire (SPQ). Within a "fully dimensional" approach to psychiatric disorders, this study also compared SPQ scores in clinical samples of subjects with bipolar, unipolar and obsessive-compulsive (OCD) disorders. The results suggested that the disorganized three-factor model, Cognitive-Perceptual, Interpersonal Deficits and Disorganization, underlies individual differences across samples of normal and schizophrenic patients. Furthermore, the SPQ measures discriminated schizophrenia and bipolars from major depression but not from OCD.