Specific facial emotion recognition deficits across the course of psychosis: A comparison of individuals with low-risk, high-risk, first-episode psychosis and multi-episode schizophrenia-spectrum disorders.

Our study aimed to explore the recognition of specific emotions across the course of psychosis. A visual task representing the six basic emotions was used to assess facial emotion recognition (FER) in 204 healthy controls classified into 152 low-risk (LR) and 52 high-risk for psychosis (HR), following a psychometric risk approach; and 100 patients: 44 with first-episode psychosis (FEP) and 56 with multi-episode schizophrenia-spectrum disorders (MES). First, we performed a MANCOVA to compare the four conditions. Next, we conducted a logistic regression to explore whether specific FER deficits predicted the presence of psychosis. Finally, we investigated the relationships of FER with psychosis-like experiences (PLEs) and psychotic symptoms. Global FER, anger and fear recognition were impaired in HR, FEP and MES. No differences between HR and FEP appeared. Moreover, fear and anger correctly classified 83% of individuals into LR or psychosis. FER was associated with PLEs and psychotic symptoms. Concluding, FER is early impaired in HR individuals and increases along the psychosis continuum. However, fear recognition is similarly impaired throughout the illness, suggesting a possible vulnerability marker. Furthermore, deficits in anger and fear recognition predicted the presence of psychosis. Therefore, we suggest that FER may be essential in detecting psychosis risk.

Self-reported cognitive biases in psychosis: Validation of the Davos Assessment of Cognitive Biases Scale (DACOBS) in a Spanish sample of psychotic patients and healthy controls.

Cognitive biases have been demonstrated to be important in developing and maintaining psychosis. However, self-report measures for everyday clinical practice have been developed only recently. We aimed to study one of these instruments for assessing cognitive biases: the Davos Assessment of Cognitive Biases Scale (DACOBS). In a Spanish sample of 84 patients diagnosed with schizophrenia-spectrum disorders and 152 healthy controls, we examined a) the factor structure using Confirmatory Factor Analysis (CFA) to test the original one-, three- and seven-factor solutions, b) the reliability (Cronbach's alpha), c) the discriminative power (Multivariate Analysis of Covariance - MANCOVA) and d) the relationships of cognitive biases with positive psychotic-like experiences (PPLEs) in healthy individuals and with psychotic symptoms in schizophrenia-spectrum patients. The CFA revealed that the seven-factor solution achieved the best fit. The DACOBS overall scale (Cronbach's alpha = .92) and subscales obtained good internal consistencies. MANCOVA, controlling for age and education, demonstrated that all subscales differentiated between healthy controls and psychotic patients (Wilks' Lambda = 0.87; F7, 226 = 4.70; p < .000; partial eta squared = 0.13). In addition, the DACOBS showed high correlations with PPLEs (controls) and moderate correlations with positive and general symptoms (patients), demonstrating its predictive validity. Concluding, the DACOBS proved to be a psychometrically suitable instrument for assessing cognitive biases in psychosis and adequately differentiated between patients and healthy individuals within the Spanish population. Norm scores are provided.

A third hierarchical level of narrower traits for the Dimensional Assessment of Personality Pathology-Basic Questionnaire.

Current dimensional taxonomies of personality disorder show a stronger empirical grounding than categories, but may lack the necessary level of detail to make accurate predictions and case formulations. We need to further develop the lower levels of the hierarchy until reaching the building blocks of personality pathology. The Dimensional Assessment of Personality Pathology-Basic Questionnaire (DAPP-BQ) is well-suited to this purpose due to its multilayered structure and its agreement with the official dimensional classifications. We disaggregated the 18 DAPP-BQ mid-level facets through exploratory and confirmatory factor analysis in a sample of 3233 community subjects and outpatients. We obtained a set of 72 clinically relevant, narrower subfacets, which were reliable, well-fitted to the data, and invariant between clinical and community subjects and between the sexes. This third level of abstraction increases by 4.7% the capacity to predict DSM categorical personality disorders, gives a particular advantage in capturing dependent, histrionic, paranoid, obsessive, and schizoid features and can provide the detailed information that clinical decisions demand.

Mean-level change in pathological personality dimensions over 4 decades in clinical and community samples: A cross-sectional study.

Although normal personality traits change gradually with age, personality disorders have been reported to remit rapidly and completely in little more than 10 years. Such a benign prognosis is surprising and may be due in part to the combined use of categorical diagnoses, seriously ill patients, and longitudinal designs in the existing literature. This study examines, for the first time, the development of personality pathology across a life span by means of dimensional models, represented by the Dimensional Assessment of Personality Pathology-Basic Questionnaire and the Personality Inventory for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. We draw upon a cross-sectional design and four large clinical and community samples to avoid previous biases. We found that personality pathology declined by around 0.5 SD overall from age 20 to 60, though with noticeable differences between domains: Dissocial behavior and antagonism decreased by between two thirds and 1 SD; compulsivity increased at the same rate; disinhibition, negative affect, and psychoticism dropped by 0.5 SD; and detachment remained stable or rose slightly. In short, the changes in many clinically important traits are modest, occur at a slow pace, and roughly parallel the maturation effect found for normal personality traits. The resulting picture of personality disorder development is not as optimistic as previous studies would have us believe. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Personality disorders in obsessive-compulsive disorder: a comparative study versus other anxiety disorders.

OBJECTIVE: The purpose of this paper is to provide evidence for the relationship between personality disorders (PDs), obsessive compulsive disorder (OCD), and other anxiety disorders different from OCD (non-OCD) symptomatology. METHOD: The sample consisted of a group of 122 individuals divided into three groups (41 OCD; 40 non-OCD, and 41 controls) matched by sex, age, and educational level. All the individuals answered the IPDE questionnaire and were evaluated by means of the SCID-I and SCID-II interviews. RESULTS: Patients with OCD and non-OCD present a higher presence of PD. There was an increase in cluster C diagnoses in both groups, with no statistically significant differences between them. CONCLUSIONS: Presenting anxiety disorder seems to cause a specific vulnerability for PD. Most of the PDs that were presented belonged to cluster C. Obsessive Compulsive Personality Disorder (OCPD) is the most common among OCD. However, it does not occur more frequently among OCD patients than among other anxious patients, which does not confirm the continuum between obsessive personality and OCD. Implications for categorical and dimensional diagnoses are discussed.

[Involvement of the thalamic-cortical-striatal circuit in patients with obsessive-compulsive disorder during an inhibitory control task with reward and punishment contingencies]. / Implicación del circuito corticoestriadotalámico en pacientes con trastorno obsesivo-compulsivo durante una tarea de control inhibitorio con contingencias de recompensa y castigo.

INTRODUCTION: Recent neuroimaging studies conducted on obsessive-compulsive disorder (OCD) show alterations in the fronto-thalamic-striatal circuit, which would give rise to an executive dysfunction. This could be the neurocognitive substrate underlying the main symptoms of OCD, i.e. obsessions and compulsions. SUBJECTS AND METHODS: Both brain activity and behavioural performance of a group of 13 patients with OCD were compared with a control group of 13 healthy subjects by means of functional magnetic resonance imaging while performing an inhibitory control task with reward and punishment contingencies. The effects of medication were also analysed. RESULTS: The intra-group analyses showed a longer reaction time during the go/no go condition in both groups, although there were no differences between the groups in the performance of the task. With regard to this task, significant activation of large areas of the cerebellum and the occipital, temporal and parietal lobes was observed in the healthy subjects. In comparison with the controls, the obsessive patients showed lower activation in the right-side frontal medial and superior gyri, the anterior cingulate cortex and the caudate nucleus, and greater activation in the inferior parietal convolution and the fusiform gyrus. The effects of medication were found in the frontal cortex and basal structures. CONCLUSIONS: These results agree with the argument claiming that the dysfunction in the corticostriatal system in OCD is associated to diminished brain activity in response to cognitive tasks.

Implicación del circuito corticoestriadotalámico en pacientes con trastorno obsesivo-compulsivo durante una tarea de control inhibitorio con contingencias de recompensa y castigo / Involvement of the thalamic-cortical-striatal circuit in patients with obsessive-compulsive disorder during an inhibitory control task with reward and punishment contingencies

Introducción. Estudios recientes sobre neuroimagen en el trastorno obsesivo-compulsivo (TOC) muestran alteraciones en el circuito frontoestriadotalámico, lo que daría lugar a una disfunción ejecutiva. Éste podría ser el sustrato neurocognitivo de los síntomas principales del TOC: obsesiones y compulsiones. Sujetos y métodos. Se comparó tanto la activación cerebral como el rendimiento conductual de un grupo de 13 pacientes con TOC comparado con un grupo control de 13 sujetos sanos a través de resonancia magnética funcional durante la ejecución de una tarea de control inhibitorio con contingencias de recompensa y castigo. Los efectos de la medicación también se analizaron. Resultados. Los análisis intragrupo mostraron un tiempo de reacción más largo durante la condición de go/no go en ambos grupos, aunque no hubo diferencias entre los grupos en la ejecución de la tarea. En relación con dicha tarea, se observó, en los sujetos sanos, una activación significativa de grandes áreas del cerebelo y de los lóbulos occipital, temporal y parietal. En comparación con los controles, los pacientes obsesivos mostraron una activación reducida en los giros frontal medial y superior derechos, la corteza cingulada anterior y el núcleo caudado, y una mayor activación en la circunvolución parietal inferior y el giro fusiforme. Se encontraron efectos de la medicación en la corteza frontal y estructuras basales. Conclusiones. Estos resultados están de acuerdo con el argumento de que la disfunción en el sistema corticoestriado en el TOC se asocia a una disminución de la actividad cerebral en respuesta a tareas cognitivas (AU)

Introduction. Recent neuroimaging studies conducted on obsessive-compulsive disorder (OCD) show alterations in the fronto-thalamic-striatal circuit, which would give rise to an executive dysfunction. This could be the neurocognitive substrate underlying the main symptoms of OCD, i.e. obsessions and compulsions. Subjects and methods. Both brain activity and behavioural performance of a group of 13 patients with OCD were compared with a control group of 13 healthy subjects by means of functional magnetic resonance imaging while performing an inhibitory control task with reward and punishment contingencies. The effects of medication were also analysed. esults. The intra-group analyses showed a longer reaction time during the go/no go condition in both groups, although there were no differences between the groups in the performance of the task. With regard to this task, significant activation of large areas of the cerebellum and the occipital, temporal and parietal lobes was observed in the healthy subjects. In comparison with the controls, the obsessive patients showed lower activation in the right-side frontal medial and superior gyri, the anterior cingulate cortex and the caudate nucleus, and greater activation in the inferior parietal convolution and the fusiform gyrus. The effects of medication were found in the frontal cortex and basal structures. Conclusions. These results agree with the argument claiming that the dysfunction in the corticostriatal system in OCD is associated to diminished brain activity in response to cognitive tasks (AU)