A between-subjects test of the lower-identification/ higher-priming paradox.

An under-recognised U-shaped model states that unconscious and conscious perceptual effects are functionally exclusive and that unconscious perceptual effects manifest themselves only at the objective detection threshold, when conscious perception is completely absent. We tested the U-shaped line model with a between-subjects paradigm. Angry, happy, neutral faces, or blank slides were flashed for 5.5 ms and 19.5 ms before Chinese ideographs in a darkened room. A group of volunteers (n = 84) were asked to rate how much they liked each ideograph and performed an identification task. According to the median identification score two subgroups were composed; one with 50% or < 50% identification scores (n = 31), and one with above 50% identification scores (n = 53). The hypothesised U-shaped line was confirmed by the findings. Affective priming was found only at the two extreme points: the 5.5 ms condition of the low-identification group (subliminal perception) and the 19.5 ms condition of the > 50% high-identification group (supraliminal perception). The two intermediate points (19.5 ms of the low-identification group and 5.5 ms of the high-identification group) did not correspond to significant priming effects. These results confirm that a complete absence of conscious perception is the condition for the deployment of unconscious perceptual effects.

Replication study and meta-analysis in European samples supports association of the 3p21.1 locus with bipolar disorder.

BACKGROUND: Common genetic polymorphisms at chromosome 3p21.1, including rs2251219 in polybromo 1 (PBRM1), have been implicated in susceptibility to bipolar affective disorder (BP) through genome-wide association studies. Subsequent studies have suggested that this is also a risk locus for other psychiatric phenotypes, including major depression and schizophrenia. METHODS: To replicate the association, we studied 2562 cases with BP and 25,439 control subjects collected from seven cohorts with either genome-wide association or individual genotyping of rs2251219 and tagging single nucleotide polymorphisms across the PBRM1 gene. Results from the different case-control groups were combined with the inverse variance weighting method. RESULTS: In our dataset, rs2251219 was associated with BP (odds ratio [OR] = .89, p = .003), and meta-analysis of previously published data with our nonoverlapping new data confirmed genome-wide significant association (OR = .875, p = 2.68 × 10(-9)). Genotypic data from the SGENE-plus consortium were used to examine the association of the same variant with schizophrenia in an overall sample of 8794 cases and 25,457 control subjects, but this was not statistically significant (OR = .97, p = .21). CONCLUSIONS: There is strong evidence of association of rs2251219 with BP. However, our data do not support association of this marker with schizophrenia. Because the region of association has high linkage disequilibrium, forming a large haplotype block across many genes, it is not clear which gene is causally implicated in the disorder.

Differentiating clinical groups using the serial color-word test (S-CWT).

The present study attempted to differentiate 11 diagnostic groups by means of the Serial Color-Word Test (S-CWT), using multivariate discriminant analysis. Two alternative scoring systems of the S-CWT were outlined. Asample of 514 individuals who had clinical diagnoses of various types and 397 controls who had no diagnostic findings comprised the sample. The first discriminant analysis failed to differentiate the groups adequately. The groups were consequently reduced to four (schizophrenia, bipolar disorders, temporo-mandibular joint pain dysfunction syndrome, and eating disturbances), which gave better reclassification findings for a clinical application of the test. This classification gave over 55% correct assignments. The final four groups had a statistically significant discrimination on the test, which remained stable also in a bootstrap procedure. Implications for treatment indications and outcomes as well as strategies for further studies using the S-CWT are discussed.

Referential failures and affective reactivity of language in schizophrenia and unipolar depression.

Reference failures, and their increase in affectively negative conditions (known as affective reactivity of speech), are more frequently observed in schizophrenia patients than in normal controls, but no information is available comparing schizophrenia with depression, ie, a mental disorder closely linked to the concept of affective reactivity. To address this gap in the literature, the present study compared 24 schizophrenia inpatients, 21 unipolar depression inpatients and 21 normal controls. Two 10-minute conversational speech samples (1 on negative and 1 on positive memories) were collected from each patient. The transcripts of the audiotaped interviews were analyzed blindly for frequencies of 6 types of referential failures, employing the Communication Disturbances Index, adapted for use with Italian. The schizophrenia patients made more frequent total reference failures and, specifically, more missing information references than the depression patients. The depression patients made more frequent reference failures than the normal controls, overall, and on most of the specific types of failures. Affective reactivity of speech was observed only for the schizophrenia sample and was greatest for missing information references. This study supports the viability of reference failure analysis as a measure of communication disturbance in a language other than English. The findings indicate that schizophrenia and depression both are associated with high levels of referential failures but that affective reactivity of speech is present only in schizophrenia and not in depression.

A comparative study of axis I antecedents before age 18 of unipolar depression, bipolar disorder and schizophrenia.

BACKGROUND: Despite a large scientific literature on early clinical precursors of schizophrenia, bipolar disorder and unipolar depression, few data are available on axis I disorders preceding the adult onset of these illnesses. SAMPLING AND METHODS: Disorders before the age of 18 years were retrospectively assessed with a structured interview in 3 groups of consecutive adult inpatients with DSM-IV diagnoses of schizophrenia (n = 197), major depressive disorder (n = 287) and bipolar disorder (n = 132). Only patients with adult onset of schizophrenia and of mania/hypomania were included. A sample of the general population served as control group (n = 300). RESULTS AND CONCLUSION: The clinical groups significantly outnumbered the control sample on the majority of early axis I diagnoses. Schizophrenia was significantly associated (1) with attention deficit hyperactivity disorder (ADHD), ADHD inattentive subtype, ADHD hyperactive subtype and primary nocturnal enuresis, compared to unipolar depression, and (2) with social phobia and ADHD inattentive subtype, compared to bipolar disorder. Oppositional defiant disorder was significantly associated with bipolar disorder, compared to the other clinical and control groups. The ADHD hyperactive subtype predicted the adult onset of bipolar disorder compared to unipolar depression. Externalizing disorders seem of special importance as regards the clinical pathways toward schizophrenia.

Early adverse experiences in schizophrenia and unipolar depression.

To study the prevalence of early adversities in schizophrenia and unipolar depression, 2 groups of consecutive adult-onset inpatients with DSM-IV diagnoses of schizophrenia (n = 173) and unipolar depression (n = 305) were compared with an unscreened control group of volunteers from the general population (n = 310), with respect to their association with 4 types of childhood abuse and with early parental adversities (discord, separation, death, psychiatric caseness). Compared with general population, most types of early adversities (except sexual abuse and parental death) were significantly associated with both clinical groups. Compared with depression, all early adversities with the same 2 exceptions were significantly associated with schizophrenia; both frequency of abuse and number of types of abuse increased the risk of schizophrenia in a dose-response pattern, suggesting causality. These findings stress the role of social developmental factors in the etiology of schizophrenia.

Personality differences between depressed melancholic and non-melancholic inpatients.

OBJECTIVE: The aim of the present study was to confirm that non-melancholic depression corresponds to a higher degree of personality dysfunction compared to melancholia. METHOD: A total of 188 inpatients, with a main DSM-IV diagnosis of major depressive disorder, were classified as melancholic and non-melancholic according to CORE system, DSM-IV, Research Diagnostic Criteria (RDC) Retarded Depression, and RDC Agitated Depression. Personality was assessed by means of the Temperament and Personality Questionnaire (T&P). Only patients at the nadir of their episode were included. RESULTS: Compared to non-melancholic depressives, patients with CORE melancholia scored lower on social avoidance and higher on effectiveness and cooperativeness; patients with RDC Retarded Depression scored lower on Anxious-Worrying and Cooperativeness; patients with RDC Agitated Depression scored lower on Social Avoidance, Rejection Sensitivity and Anxious-Worrying, and higher on Effectiveness; while patients with DSM-IV melancholia scored higher on Irritability and lower on Cooperativeness. Both CORE and RDC Agitated Depression were associated with higher scores of Perfectionism. CONCLUSIONS: The hypothesis of an association of melancholic depression with less marked personality dysfunction was confirmed for CORE melancholia and RDC Agitated Depression, and not supported for DSM-IV melancholia. Mixed evidence was obtained for RDC Retarded Depression. Personality of melancholic depressives seems to be characterized not only by less dysfunction but also by perfectionism, akin to the features of Tellenbach's typus melancholicus.

The defense mechanism test-separation theme in two anxiety disorders.

Two groups of 26 age- and sex-matched outpatients, with DSM-IV diagnoses of obsessive-compulsive disorder and panic disorder with agoraphobia, were compared on the Defense Mechanism Test-Separation Theme. A stimulus portraying a mother figure who is leaving a room where a baby lies alone on the floor was presented 22 times at increasing exposure durations in a single-view tachistoscope. Participants were asked to describe what they perceived at each step, according to the method of the Defense Mechanism Test. As predicted, reports of the mother seen as an inanimate object (phobic repression) were statistically significantly associated with agoraphobia, while reports of the mother entering the room or doing something other than leaving the baby (reaction formation) and reports of the baby as an angel (intellectualization) were associated with obsessive-compulsive disorder.

Patterns of adaptation in obsessive-compulsive disorder: multivariate indicators of greater variability and linear change compared to controls.

Patterns of adaptation to conflict in persons with Obsessive-Compulsive Disorder were assessed with the Serial Color-Word Test. Obsessive-Compulsive patients (n=50) were compared with an age- and sex-matched group of nonclinical volunteers. Measures of linear and nonlinear change in reading times during each of the five consecutive trials of the test were compared between groups by means of a multivariate model with doubly repeated measures. The multivariate analysis yielded a significant between-groups result (Wilks Lambda = .76, p < .001), mainly supported by higher values of nonlinear change in the Obsessive-Compulsive group. Thus, the discriminative ability of the Serial Color-Word Test was confirmed when individual differences were removed from the error term.

Signs of defense in obsessive-compulsive disorder: a validation study of the Defense Mechanism Test.

A group of 31 patients with Obsessive-Compulsive Disorder was compared with an age and sex-matched group of 31 nonclinical volunteers on the Defense Mechanism Test, a tachistoscopic paradigm which confronts the subject with anxiety-arousing stimuli at increasing durations from subliminal levels until complete recognition. It was hypothesized that distortions of the stimuli coded as Isolation or Reaction Formation would be more frequent in the obsessive-compulsive sample. Reaction Formation and one variant of Isolation (Barrier Isolation) were significantly associated with the obsessive-compulsive diagnosis.

Patterns of adaptation to conflict and schizoid personality scale scores.

A previous investigation gave no evidence of a significant relationship of patterns of adaptation to conflict, as measured with the Serial Color-Word Test, with the Schizoid Personality Scale of the Coolidge Axis II Inventory. As a new scoring algorithm has subsequently been proposed for the latter scale, a replication was done with the modified schizoid scale. A group of 75 consecutive nonpsychotic women outpatients was given the Serial Color-Word Test and Coolidge's inventory. Both multiple and logistic regressions selected two significant predictors of schizoid personality, corresponding to high values of linear change in reading times during Trials 3 and 5 of the Serial Color-Word Test, i.e., to an increasingly rigid and inflexible style of the adaptive process. A multivariate analysis of variance yielded an effect size of .22 (partial eta2).

Styles of adaptation in autoimmune thyroiditis and bipolar disorder: a pilot study.

BACKGROUND: A growing body of evidence suggests that styles of adaptation, assessed with the Serial Color-Word Test (S-CWT, a 5-trials Stroop task), are able to differentiate several mental and psychosomatic disorders. Recent findings have confirmed a very high rate of cases of autoimmune thyroiditis (so called Hashimoto disease) among bipolar patients, suggesting an etio-pathogenetic relatedness between the two ailments. Based on the latter relatedness, it was hypothesized that the same styles of adaptation, which are known to differentiate bipolar and control subjects are also characteristic of patients with autoimmune thyroiditis. METHODS: Three groups (autoimmune thyroiditis, fully remitted bipolar I, and nonclinical) of 40 women, matched on age and schooling, were administered the S-CWT. The following variables were considered: (a) early discontinuity (i.e. the summed nonlinear change of the first three trials), (b) late discontinuity (i.e. the summed nonlinear change of the last two trials), (c) across-trials discontinuity (i.e. the nonlinear change of the five measures of nonlinear change). RESULTS: The thyroiditis group had (1) higher values of early discontinuity (P=0.006) and of late discontinuity (P=0.004) compared with nonclinical controls, (2) lower values of early discontinuity (P=0.005) and of across-trials discontinuity (P=0.008) compared with the bipolar group. LIMITATIONS: The study did not include men patients and lacked a quantification of affective symptoms among clinical and nonclinical participants. CONCLUSION: A discontinuous style of adaptation is more marked among remitted bipolar than among thyroiditis patients, and more marked among the latter ones than among nonclinical controls, thus delineating a sort of adaptive continuum.

Self-defeating personality and memories of parents' child-rearing behavior: a replication.

A recent study of correlations of self-defeating personality and memories of parents' child-rearing behaviour has been replicated on a larger sample. Non-clinical volunteers (145 women and 114 men) were administered Schill's Self-defeating Personality Scale and a short version of the EMBU-Egna Minnen Beträffande Uppfostran (own memories of parental education) scale. Replicating previous findings, memories of rejecting or nonsupportive parents were significantly correlated with scores for the Self-defeating Personality Scale for both women (rejecting mother, r = 24; supportive mother, r = -.29; rejecting father, r = .23; supportive father, r = -.36) and men (rejecting mother, r = 40; rejecting father, r = .41; supportive father, r = -.28). Memories of an overinvolved parent were significantly correlated with self-defeating personality scores only among men (mother: r = .41; father: r = .36) as in the original study.

Patterns of adaptation and personality disorders.

Patterns of adaptation to conflict were explored with the Serial Color-Word Test, and personality disorders were assessed by means of the Coolidge Axis II Inventory in a group of 76 nonpsychotic women volunteers in the age range 18-50 yr. (M=29.1 yr., SD=8.3), who attended a psychiatric outpatients unit. Forward multiple regression analyses were performed to investigate whether patterns of adaptation were associated with personality disorders. 10 out of 13 personality scales, as measured by the Coolidge Axis II Inventory, were significantly predicted by adaptive variables. Some predictors were positive and others were negative. The variable R(AD) was a negative predictor of avoidant and dependent personalities, and a positive predictor of Extraversion, Aggressive personality, and Antisocial personality; this finding suggests that R(AD) may represent the regulative counterpart of a continuum from passive introversion to aggressive extraversion. The results encourage further research on nontrait laboratory correlates of personality disorders.

Styles of adaptation in panic disorder with and without agoraphobia.

Two groups of women with a main DSM-IV diagnosis of panic disorder, one with and one without agoraphobia (respectively, n = 26 and n = 14) were compared on several clinical variables. Forward logistic regressions were run for the presence of agoraphobia. Age of onset, duration of illness, presence of major depressions, and cluster classification on Axis II did not predict the criterion variable. Diagnosis and scores on avoidant personality disorder led, respectively, to 65% and 72.5% rates of correct classifications. Among panic symptoms, fear of going crazy and palpitations significantly predicted agoraphobia (75% of correct allocations). Three adaptive variables assessed by the Serial Color-Word Test (a serial version of the Stroop task) led to a 90% rate of correct classification. Agoraphobic patients were mainly characterized by an anxious or over-controlling style, which permitted a pseudo-objective mastery of the conflict situation. The findings seem to support the clinical relevance of the Serial Color-Word Test.

Self-defeating personality and memories of parents' child-rearing behaviour.

A group of 132 nonclinical volunteers was given the Self-defeating Personality Scale and a short version of the Egna Minnen Beträffande Uppfostran (EMBU) scale to explore correlations of scores for adults' self-defeating traits with memories of parents' child-rearing behaviours. For men, the recall of two rejecting parents and, for women, the memory of a nonsupportive father were significantly correlated with scores of self-defeating traits. The latter scores correlated positively with memories of both overinvolved mother and father for men, while no significant correlation was found among women.

A multivariate exploration of basic symptoms.

Little is known about the relationship between the different categories of basic symptoms (BS). Researchers of the Bonn School have accurately described the progression from second-level BS (relatively characteristic BS) to first-rank Schneiderian symptoms. Using a multiple regression model, the present study tried to investigate which kind of dynamic deficiencies (DDs; uncharacteristic first-level BS) mostly lead to each type of second-level BS. A group of 108 patients with a DSM-III-R diagnosis of schizophrenia completed an inventory on BS, with all items in strict accordance with those of the Bonn Scale. Five dependent variables (cognitive thought disorders, cognitive perception disorders, cognitive action disorders, increased impressionability, cenesthesias) and four independent variables (DDs with direct negative symptoms, DDs with indirect negative symptoms, affective DDs, relational DDs) were considered. Among the significant findings, a widespread contribution of DDs with indirect negative symptoms to most of the dependent variables, and the special role of DDs with direct negative symptoms as a predictor of cognitive thought disorders, must be emphasized. Suggestions for further multivariate studies in the field of BS are presented.

Clinicians' ratings and self-reports of basic symptoms.

A sample of 34 paranoid or undifferentiated schizophrenic outpatients were given the Rome Basic Disorders Scale, a self-rating questionnaire aimed to the assessment of basic symptoms, as defined by the Bonn Scale. These patients were then interviewed on the same 54 basic symptoms explored with the scale, by two independent clinicians blind to the outpatients' data. Self-ratings compared with clinicians' ratings by Student t for dependent samples yielded only one significant difference (p< .01) for the item measuring hypersensitivity to light. Present findings suggest that the Rome Basic Disorders Scale may be safely self-rated even by collaborative schizophrenic patients.

Sex differences on the serial color-word test.

The Serial Color-Word Test was administered to nonclinical volunteers of three age strata (17-29, 30-45, 46-65 yr.). Sex differences on the 17 variables of the test were explored for each age stratum. Only six significant intersex differences were found. In all age strata women scored significantly higher on linear regression of reading times in one of the last two subtests, i.e., R4 or R5.