Association between Parents' Relationship, Emotion-Regulation Strategies, and Psychotic-like Experiences in Adolescents.

This study aimed to examine the association between the psychotic-like experiences (PLEs) and emotion-regulation (ER) strategies of adolescents and their parents' relationship, and we hypothesized that the parents' relationship moderates the link between ER strategies and PLEs. We recruited a total of 2708 first-year college students (1659 males and 1049 females) aged 15-20 years (mean = 17.9). Participants completed assessments of PLEs, their use of ER strategies, and reported their parents' relationship as harmonious, conflicting, or divorced. Regression analyses indicated that the lower the use of the emotion-reappraisal strategy, the greater the use of the emotion-suppression strategy and that parental conflict or divorce predicted the number of PLEs endorsed and the level of distress from the PLEs. The parents' relationship moderated the association between ER strategies and distress from PLEs. Among those who reported parental conflict or divorce, their lower use of the reappraisal strategy predicted their experiencing higher levels of distress from their PLEs. This study suggested the direct and interactive influence of the parents' relationship and ER strategies on the presence of PLEs and PLE-related distress levels among adolescents, which may represent potential intervention targets.

The Relationship Between Big Five Personality Traits and Psychotic Experience in a Large Non-clinical Youth Sample: The Mediating Role of Emotion Regulation.

Objective: Despite a long history of interest in personality traits and psychosis, the association between personality traits and psychotic experiences in the general population is not yet well understood. One possible factor that could influence the degree of distress from psychotic experiences is emotion regulation. The purpose of this study was to explore whether the association between personality and psychotic symptoms is already apparent in non-clinical youth as well as the mediating role of emotion regulation strategies between personality traits and psychotic experiences. Methods: Three thousand one hundred and forty seven college students were surveyed via self-report questionnaires measuring the Five-Factor model of personality, emotion regulation strategies, and psychotic experiences. Results: Neuroticism was found to be significantly positively correlated with psychotic experiences, while Extraversion, Openness, Agreeableness, and Conscientiousness were found to be significantly negatively correlated. Both the suppression and reappraisal strategies mediated the relationship between personality traits and psychotic experiences. Conclusion: Our findings suggest that youth with certain personality traits are more likely to have psychotic experiences. The reappraisal emotion regulation strategy could serve as a protective factor against the distress of psychotic experiences.

Systemic Therapy for Youth at Clinical High Risk for Psychosis: A Pilot Study.

Psychosocial intervention trials for youth at clinical high risk (CHR) for psychosis have shown promising effects on treating psychotic symptoms but have not focused on psychosocial functional outcomes, and those studies have been conducted among help-seeking patients; there is a lack of research on non-clinical young CHR individuals. Systemic therapy (ST) is grounded in systemic-constructivist and psychosocial resilience theories. It has a number of advantages that makes it attractive for use with CHR individuals in non-clinical context. The present study evaluated the effect of ST for students at CHR on reducing symptoms and enhancing psychosocial function. This was a single-blind randomized controlled trial for CHR young people comparing ST to supportive therapy with a 6-month treatment. Psychotic and depressive symptoms (DS) as well as self-esteem and social support (SS) were assessed at pre- and posttreatment. 26 CHR individuals were randomly divided into intervention group (n = 13) and control group (n = 13). There were no significant differences in severity of symptoms, level of SS and self-esteem at baseline between the two groups (P > 0.05). At posttreatment, significant improvements in positive and DS as well as SS and self-esteem were observed in the ST group (P < 0.05); in the control group, these improvements were not significant (P > 0.05). The findings indicated that systemic intervention for university students at CHR for psychosis may have a positive effect on symptoms and self-esteem as well as SS in short term. More long-term research is needed to further evaluate this intervention.

Comorbid Mental Disorders and 6-Month Symptomatic and Functioning Outcomes in Chinese University Students at Clinical High Risk for Psychosis.

BACKGROUND: High rates of non-psychotic psychopathological symptoms have been observed in clinical population at clinical high risk (CHR) for psychosis. These comorbid disorders affected the baseline functional level of CHR patients. However, little is known about the comorbid mental disorder in CHR individuals in non-clinical adolescent population. This study aimed to investigate the comorbid mental disorder in non-clinical CHR adolescents and the impact on attenuated psychosis symptoms (APS) as well as clinical outcome. METHODS: The sample consisted of 32 CHR students, who were screened from 2,800 university students. CHR status was evaluated with the Structured Interview of Prodromal Syndromes, comorbid mental disorder diagnoses with the International Neuropsychiatric Interview. RESULTS: In the CHR sample, 46.9% was found at least one non-psychotic comorbid mental disorder. The CHR participants presenting comorbid mental disorder had significantly more severity of APS than those without comorbid mental disorders, and the remission rate at 6-month follow-up is significantly higher in the individuals without comorbid mental disorders at baseline. CONCLUSION: In the non-clinical sample of individuals at CHR, non-psychotic comorbid mental disorders are common and anxiety disorder is most frequent. Copresence of anxiety and/or depression is related to higher level of attenuated psychotic symptoms and unfavorable clinical outcome at 6-month follow-up. Assessment and intervention in anxiety and depression for non-clinical CHR adolescents are suggested.

Family Function and Self-esteem among Chinese University Students with and without Grandparenting Experience: Moderating Effect of Social Support.

This study examines the association between family function and self-esteem of Chinese university students with grandparenting experience, and explores the moderating effects of social support in this link. Two thousand five hundred thirty university students (1372 males and 1158 females) from a Chinese university completed the Perceived Social Support Scale, the Rosenberg's Self-esteem Scale, and the Family Assessment Device (FAD). Six hundred and forty-five (25.69%) students reported grandparenting experience and they reported lower scores on self-esteem and social support than the students raised only by their parents. The grandparenting group scored higher on such dimensions of family functioning as Communication, Role, Affective Involvement, Affective Responsiveness, and General Family Function (GF) than their counterpart group. For both groups, self-esteem scores were positively correlated with social support scores, while negatively correlated with FAD all sub-scale scores. Hierarchical regression analysis showed that for the students with grandparenting experience the social support moderated the relationship between GF and self-esteem. When students reported a high level of social support, those with low GF score reported higher scores in self-esteem than those with low self-esteem. However, in case of low social support, there were no differences in self-esteem between groups with high and low GF scores. These findings suggest that social support plays a positive role to relieve the adverse impact of poor family function on self-esteem of the adolescents with grandparenting experience. In addition, the significance and limitations of the results will be discussed.

Protective factors in Chinese university students at clinical high risk for psychosis.

The role of protective factors in symptom formation and prognosis in schizophrenia has been shown in many studies, but research in the early phases of psychosis is limited, particularly among the nonclinical subjects. Protective factors associated with the severity of symptoms and clinical outcomes might be meaningful to the establishment of prevention systems and to the development of optimal psychosocial interventions prior to the onset of psychosis. The present study compares self-reported levels of self-esteem, social support and resilience of 32 university students at clinical high risk for psychosis (CHR) and 32 healthy controls in a longitudinal study design. Associations between protective factors with symptoms of psychosis were assessed in the CHR group. Individuals at CHR showed significantly lower self-esteem, social support and resilience compared to healthy controls. In the CHR group, lower social support and lower self-esteem were associated with more severe positive, negative and depressive symptoms. Multiple regression analyses revealed that self-esteem was the only significant determinant for negative, depressive symptoms and global functioning. In addition, we found that subjects who were fully recovered at a 6-month follow-up survey were greater resilient and showed lower depressive symptoms at baseline. The result implied that resilience intervention could be effective on early prevention of the onset of psychosis. Moreover, implications and limitations of this study will be discussed.

Family Perception and 6-Month Symptomatic and Functioning Outcomes in Young Adolescents at Clinical High Risk for Psychosis in a General Population in China.

BACKGROUND AND AIMS: Given the difficulty of treating schizophrenia and other forms of psychosis, researchers have shifted focus to early detection and intervention of individuals at clinical high risk (CHR) for psychosis. Previous studies have shown that elements in family functioning could predict symptom outcome in CHR individuals. However, associations between self reported family functioning and symptom or functioning outcome of CHR individuals was rarely reported. Our study aimed to investigate the characteristics and the role of family functioning in the development of CHR individuals among young adolescents. METHODS: A sample of 32 CHR individuals was recruited from 2800 university students. The characteristics of family perception were evaluated by both Family Assessment Device (FAD) and Family cohesion and adaptability evaluation Scale II (FACES II). 6 month follow up data was available with 25 of the recruited CHR individuals. Baseline socio-demographic characteristics and family functioning were compared between CHR and control group. We also measured the associations between different dimensions of perceived family functioning and both severity of prodromal symptoms and global functioning at baseline and 6-month follow up. RESULTS: CHR individuals showed more maladaptive family functioning compared to control in nearly all of the dimensions of FAD and FACES II except for Affective Involvement. Better Problem Solving and Affective Responsiveness predicted less severe positive and negative symptoms respectively. Family cohesion and adaptability were not only correlated with the baseline severity of general symptoms, but also positively associated with the general and disorganized symptom outcome. CONCLUSIONS: This study contributed preliminary evidence towards the associations between family perception and symptom outcome of CHR individuals. It also provided evidence for the importance of family interventions on CHR individuals.

Differential pattern for regulating insulin secretion, insulin resistance, and lipid metabolism by osteocalcin in male and female T2DM patients.

BACKGROUND: Osteocalcin has been reported to be relevant to glucose and lipid metabolism, indicating it may stimulate insulin secretion and improve insulin resistance. Yet the difference between male and female patients is still not clear. We aimed to investigate the difference in serum osteocalcin, and its association with glucose, lipid metabolism, pancreatic function, insulin sensitivity, and resistance in male and female middle-aged and elderly type 2 diabetic (T2DM) patients. MATERIAL AND METHODS: 739 T2DM patients were included. After measurement of body mass index (BMI), the levels of fasting plasma glucose (FPG), insulin (FINS), C peptide (FC-P), 2-h post-OGTT plasma glucose (2h-PG), HbA1C, and osteocalcin were determined. Homeostasis model assessment of ß-cell function (HOMA-%B), homeostasis model assessment of insulin sensitivity (HOMA-%S), and homeostasis model assessment of insulin resistance (HOMA-IR) were calculated. RESULTS: Females had higher osteocalcin concentration than males (P<0.05). In males, serum osteocalcin was negatively correlated with HbA1C, FPG, and 2-h PG (P<0.05), but positively with 2-h post-OGTT C peptide (2hC-P), 2-h post-OGTT serum insulin (2h-INS), and HOMA-%B (P<0.05). In females, serum osteocalcin was negatively correlated with HbA1C, FPG, triglyceride (TG), and HOMA-IR (P<0.05), but positively with 2-h C-P, 2-h INS, HOMA-%B, HOMA-%S, and high-density lipoprotein (HDL) (P<0.05). In all subjects, serum osteocalcin was inversely correlated with HbA1C, FPG, and 2-h PG (P<0.05), but positively with 2-h C-P, 2-h INS, HDL, and HOMA-%B (P<0.05). CONCLUSIONS: Osteocalcin might improve glucose metabolism through enhancing insulin secretion in males, and through increasing insulin secretion and improving insulin resistance in females with T2DM. Osteocalcin probably also plays an important role in lipid metabolism.