Relationship of negative symptom severity with cognitive symptoms and functioning in subjects at ultra-high risk for psychosis.

AIM: Negative symptoms and cognition are related with functioning in schizophrenia. However, it is not clear whether they have a similar effect in individuals at ultra-high risk (UHR) for psychosis. In this study, we aimed to explore relationship of negative symptoms with cognition and functioning cross-sectionally in people with UHR for psychosis. METHODS: In total, 107 people participated in this study. We assessed negative symptoms with Scale for Negative Symptoms (SANS). We applied a cognitive battery including seven tests. We evaluated functioning by using Global Assessment of Functioning Scale and work/study status as an indicator of role functioning. RESULTS: SANS scores were correlated to global functioning cross-sectionally. SANS total score was correlated to cognitive test scores related to cognitive flexibility and attention. Only Trail Making Test B (TMT B) was negatively correlated to global functioning. SANS-affective blunting and SANS-avolition scores were independently related to global functioning. There was a significant indirect effect of the TMT B and composite attention scores on global functioning through negative symptoms indicating a complete mediation. CONCLUSION: Our findings suggest that negative symptoms, particularly avolition have an impact on functioning and the association of cognition with functioning was mediated by negative symptoms in UHR.

Reliability and validity of the Turkish version of comprehensive assessment of at risk mental states.

AIMS: To perform the validation of the Comprehensive Assessment at Risk Mental State (CAARMS) in Turkish. METHODS: Sixty-five volunteers (15-24 years) were enrolled in this study. Concurrent validity was performed with Spearman's Correlation Test using Brief Psychiatric Rating Scale (BPRS). Median scores of the groups were compared using Mann-Whitney U Test. Interrater reliability was assessed by intragroup correlation coefficient method. Internal consistency was studied by the calculation of Cronbach Alfa Coefficient. RESULTS: The correlation of the severity scores of the CAARMS with unusual thought content, suspiciousness, hallucinations and conceptual disorganization items of the BPRS showed that the concurrent validity was good. ROC analysis revealed that CAARMS could discriminate between individuals with UHR and healthy volunteers well. We found a good correlation between the raters. Internal consistency was at very high level. CONCLUSION: Analyses of concurrent validity, criterion validity, interrater reliability and internal consistency indicate that the Turkish version is valid and reliable.

A Survey Focusing on Lucid Dreaming, Metacognition, and Dream Anxiety in Medical Students.

INTRODUCTION: The aim of this study was to examine the level of lucidity and its relation with metacognitive beliefs and dream anxiety in medical students. METHODS: Nine hundred sixteen medical students were enrolled in the study. The participants were assessed with the Lucidity and Consciousness in Dreams Scale (LuCiD), the Metacognition Questionnaire-30 (MCQ-30), and the Van Dream Anxiety Scale (VDAS). RESULTS: There was no significant difference in mean total lucidity score between females and males, but there were some significant sex differences in subscales of lucidity, and control was significantly higher in male students, while realism, thought, and dissociation were significantly higher in female students. In addition, females had more dream anxiety levels, higher total MCQ-30 scores, and higher cognitive confidence and uncontrollability scores according to Metacognition Questionnaire-30 than males. We also found that the mean lucidity level was positively correlated with the mean total metacognition score and the mean total dream anxiety level. DISCUSSION: Our results suggest that female medical students tend to have more realistic dreams (p=0.018), have more logical thoughts during dreaming (p=0.011), and have a more dissociative experience during dreaming (p=0.028), while male medical students have more controlled dream events (p=0.002). There seem to be differences according to lucidity features between sexes, and the relationship between subdomains of lucidity and metacognition might lead to new therapeutic approaches to several psychiatric disorders such as anxiety disorders.

History of childhood physical trauma is related to cognitive decline in individuals with ultra-high risk for psychosis.

The aim of this study was to investigate the relationship between childhood trauma (CT) and cognitive functioning in individuals with ultra-high risk for psychosis (UHR). Fifty-three individuals at UHR for psychosis were administered a neurocognitive battery that assessed attention, processing speed, verbal learning, memory, working memory, interference inhibition, and sustained attention. The CT was assessed using the short-version Childhood Trauma Questionnaire (CTQ). We dichotomized the sample by using cut-off scores for the presence of emotional, physical and sexual trauma, and physical and emotional neglect. Those with a history of physical trauma performed worse on the Digit Span Forward test, Trail making B (time), Stroop test (difference between color and word reading times), and completed categories of the Wisconsin Card Sorting Test (WCST). Physical trauma scores were correlated with WCST-completed categories, Digit Span Forward and Stroop test scores. Physical neglect scores were negatively correlated with Digit Span Forward Test scores. Most of the significant dose­response relationships between cognitive impairment and different subtypes of CT were found only in men. There was no difference between those with and without other kinds of childhood abuse or neglect in terms of cognitive impairment. Our findings suggest that a history of physical trauma has a negative impact on cognitive function in individuals at UHR for psychosis.