Social Disconnection in Schizophrenia and the General Community.

Social disability is a defining characteristic of schizophrenia and a substantial public health problem. It has several components that are difficult to disentangle. One component, social disconnection, occurs extensively in the general community among nonhelp-seeking individuals. Social disconnection is an objective, long-standing lack of social/family relationships and minimal participation in social activities. It is associated with negative health effects, including early mortality, and is distinct from subjective loneliness. These 2 topics, social disability in schizophrenia and social disconnection in the general community, have generated entirely distinct research literatures that differ in their respective knowledge gaps and emphases. Specifically, the consequences of social disability in schizophrenia are unknown but its determinants (ie, nonsocial cognition, social cognition, and social motivation) have been well-examined. Conversely, the health consequences of social disconnection in the general community are well-established, but the determinants are largely unknown. Social disconnection is a condition that presents substantial public health concerns, exists within and outside of current psychiatric diagnostic boundaries, and may be related to the schizophrenia spectrum. A comparison of these 2 literatures is mutually informative and it generates intriguing research questions that can be critically evaluated.

Expression of schizophrenia-spectrum personality traits in daily life.

The present study examined the expression of the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) schizotypal, schizoid, and paranoid personality disorder (PD) traits in daily life using experience sampling methodology in 206 nonclinically ascertained Spanish young adults oversampled for risk for schizophrenia-spectrum psychopathology. This study examined the overlap and differentiation of pathological personality traits in daily life settings, according to both diagnostic and multidimensional models. Daily life outcomes differentiated among schizophrenia-spectrum disorders. The assignment of Cluster A personality traits to positive, negative, paranoid, and disorganized dimensions provided an alternative to the traditional PD diagnoses. Positive, disorganized, and paranoid schizotypy were associated with elevated stress reactivity, whereas negative schizotypy was associated with diminished reactivity in daily life. The current diagnostic model is limited by the considerable overlap among the PD traits. Nonetheless, experience sampling methodology is sensitive enough to detect differences in day-to-day impairment and can be a powerful research tool for the examination of dynamic constructs such as personality pathology. (PsycINFO Database Record

Un abordaje genómico del alcoholismo / A genomic aproach to alcoholim

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[Neuropsychological syndromes of non-psychotic mental disorders of youthful age].

Seventy male patients with non-psychotic mental disorders of youthful age (mean age 19.2±3.7), were studied using A.R. Luria neuropsychological syndrome analysis. Patients were stratified into 3 groups by diagnosis: cyclothymia (20 patients), pubertal decompensation of schizoid personality disorder (30 patients) and schizotypal personality disorder (20 patients). It has been shown that the neuropsychological changes indicate the dysfunction of the amygdale/temporal region in patients of the first group and frontal/thalamic/parietal connections in the patients of two other groups. There were interhemispheric differences between patients with personality disorder and schizotypal personality disorder: left hemisphere dysfunction was characteristic of schizotypal disorder and right hemisphere deficit (neurocognitive deficit) was found in patients with personality disorder.

Neural processing of social rejection: the role of schizotypal personality traits.

A fear of being rejected can cause perceptions of more insecurity and stress in close relationships. Healthy individuals activate the dorsal anterior cingulate cortex (dACC) when experiencing social rejection, while those who are vulnerable to depression deactivate the dACC presumably to downregulate salience of rejection cues and minimize distress. Schizotypal individuals, characterized by unusual perceptual experiences and/or odd beliefs, are more rejection sensitive than normal. We tested the hypothesis, for the first time, that individuals with high schizotypy also have an altered dACC response to rejection stimuli. Twenty-six healthy individuals, 14 with low schizotypy (LS) and 12 with high schizotypy (HS), viewed depictions of rejection and acceptance and neutral scenes while undergoing functional MRI. Activation maps in LS and HS groups during each image type were compared using SPM5, and their relation to participant mood and subjective ratings of the images was examined. During rejection relative to neutral scenes, LS activated and HS deactivated the bilateral dACC, right superior frontal gyrus, and left ventral prefrontal cortex. Across both groups, a temporo-occipito-parieto-cerebellar network was active during rejection, and a left fronto-parietal network during acceptance, relative to neutral scenes, and the bilateral lingual gyrus during rejection relative to acceptance scenes. Our finding of dACC-dorso-ventral PFC activation in LS, but deactivation in HS individuals when perceiving social rejection scenes suggests that HS individuals attach less salience to and distance themselves from such stimuli. This may enable them to cope with their higher-than-normal sensitivity to rejection.

Does change in temperament predict change in schizoid personality disorder? A methodological framework and illustration from the Longitudinal Study of Personality Disorders.

Personality disorders (PDs) have been thought historically to be enduring, inflexible, and set in psychological stone relatively firmly; however, empirical findings from recent prospective multiwave longitudinal studies establish otherwise. Nearly all modern longitudinal studies of personality disorder have documented considerable change in PDs over time, suggesting considerable flexibility and plasticity in this realm of psychopathology. The factors and mechanisms of change in the PDs remain essentially opaque, and this area of PD research is just beginning to be probed using candidate predictors of change, such as personality systems. In this report, we investigate whether change in temperament dimensions (emotionality, activity, and sociability) predicts change in schizoid personality disorder. We present a latent growth framework for addressing this question and provide an illustration of the approach using data from the Longitudinal Study of Personality Disorders. Schizoid personality disorder was assessed using two different methodologies (structured psychiatric interview and self-report) and temperament was assessed using a well-known psychometric measure of temperament. All constructs were measured at three time points over a 4-year time period. To analyze these panel data, we fitted a covariance structure model that hypothesized simultaneous relationships between initial levels and rates of change in temperament and initial levels and rates of change in schizoid personality disorder. We found that rates of change in the core temperament dimensions studied do not predict rates of change in schizoid personality over time. We discuss the methodological advantages of the latent growth approach and the substantive meaning of the findings for change in schizoid personality disorder.

Dual-task information processing in schizotypal personality disorder: evidence of impaired processing capacity.

Working memory theories heavily rely on the concept of processing resources and the their efficient deployment. Some recent work with schizophrenia-spectrum patients has suggested that many associated cognitive impairments may be reduced to deficits in working memory, possibly related to reductions in information-processing capacity resources. In this study, 38 patients with schizotypal personality disorder (SPD), 22 patients with other personality disorders, and 14 healthy comparison participants performed a dual-task processing assessment that was designed specifically for use in this type of study. Participants recalled lists of digits at their predetermined maximum digit span and performed box-checking tests, first alone and then in a dual-task format. Instructions included equal prioritization of both tasks. SPD patients had significantly shorter digit spans, and they also showed more deterioration on both tasks. Performance operating characteristics curves indicated that SPD patients' reduced performance was not due to abnormal resource allocation strategies leading to strategic failures. The authors discuss the implications of these processing capacity limitations for understanding both the signature of cognitive impairment within the schizophrenia spectrum and general abnormalities in working memory.

Reduction of caudate nucleus volumes in neuroleptic-naïve female subjects with schizotypal personality disorder.

BACKGROUND: The caudate nucleus might contribute to the psychopathological and cognitive deficits observed in schizotypal personality disorder (SPD), a schizophrenia spectrum disorder. Here we focused on female patients, because this group is underrepresented in studies of SPD and schizophrenia, and we might learn more about the caudate and clinical and cognitive impairments that are unique to female patients diagnosed with SPD. METHODS: Magnetic resonance imaging scans, obtained on a 1.5-T magnet with 1.5-mm contiguous slices, were used to measure the caudate in 32 neuroleptic-naïve women with SPD and in 29 female normal comparison subjects. Subjects were group-matched for age, parental socioeconomic status, and intelligence quotient. RESULTS: We found significantly reduced left and right caudate relative volume (8.3%, 7.7%) in female SPD subjects compared with normal comparison subjects. In female SPD subjects, we found significant correlations between smaller total caudate relative volume and worse performance on the Wisconsin Card Sorting test (nonperseverative errors) and on the California Verbal Learning Test (verbal memory and learning), and significant correlations between smaller total caudate relative volume and both positive and negative symptoms on the Structured Interview for Schizotypy. CONCLUSIONS: These findings demonstrate that, for female SPD subjects, smaller caudate volume is associated with poorer cognitive performance and more schizotypal symptomatology.

A neuropsychiatric developmental model of serial homicidal behavior.

Serial sexual homicide has been the object of intensive study from forensic psychiatric, criminological, developmental, and sociological perspectives. In contradistinction to these approaches, neuropsychiatric concepts and methods have received relatively little attention in this area. In this article we adopt a neuropsychiatric developmental perspective and undertake a review of the psychiatric literature on violence and autism spectrum disorders. Our analysis of this literature suggests the presence of an association between autism spectrum psychopathology and serial homicidal behavior. Recommendations for further research to help clarify the nature of this association are briefly discussed.

Nightmares and schizotypy.

In order to explore the proposed relationship between nightmare occurrence and schizotypy, 30 frequent-nightmare subjects (at least one occurrence per week) and 30 low-nightmare controls, all of whom were female college students, were compared on several converging measures of schizotypal signs and behaviors. Consistent with previous research, frequent nightmare subjects demonstrated greater deviance on psychometric scales of schizotypy, and reported significantly greater schizotypal symptomatology on a structured clinical interview, than controls did. In addition, nightmare subjects produced similar electrodermal habituation patterns to auditory orienting stimuli as those that have been documented in schizophrenia-spectrum disorders. The results suggest that nightmare experience may be a useful conjoint behavioral indicator for the early detection of schizophrenia-spectrum psychopathology.

Smooth pursuit eye movements to extraretinal motion signals: deficits in relatives of patients with schizophrenia.

BACKGROUND: Although mounting evidence supports the idea that smooth pursuit abnormality marks the genetic liability to schizophrenia, the precise ocular motor mechanism underlying the abnormality remains unknown. Based on recent findings in schizophrenia, we hypothesize that subtle deficits in the ability to hold online and/or use extraretinal motion information underlie the pursuit abnormality in vulnerable individuals. METHODS: The hypothesis was tested in 69 first-degree, biological relatives of probands with schizophrenia; 26 relatives had schizophrenia spectrum personalities (SSP). Subjects recruited from the community (n=71; 29 with SSP), without a known family history of psychosis, constituted the comparison groups. The traditional smooth pursuit gain measure, which is a ratio of smooth pursuit eye velocity in response to both retinal and extraretinal motion signals and the target velocity, was obtained. In addition, newly developed measures of predictive smooth pursuit (ie, in the presence of only extraretinal motion signals) were obtained. The latter measures were evaluated after the current retinal motion signals were made unavailable by briefly making the target invisible. RESULTS: Relatives, particularly those with SSP, showed significantly poorer predictive pursuit response to extraretinal motion signals (F(2,136)=6.51, P<.005), compared with the community subjects. However, the traditional smooth pursuit gain in response to both retinal and extraretinal motion signals was not different between groups. CONCLUSIONS: These results suggest that relatives of patients with schizophrenia, particularly those with SSP, have specific deficits in predictive pursuit based on only extraretinal motion signals. Normal smooth pursuit gain in response to both retinal and extraretinal motion signals is likely due to compensation based on retinal motion information. The latter suggests normal retinal motion processing and smooth pursuit motor output.

Low body weight in male children and adolescents with schizoid personality disorder or Asperger's disorder.

This study explored the hypothesis that body weight is reduced in male children and adolescents with schizoid personality disorder or Asperger's disorder. The body weights of 33 consecutively admitted male subjects with one of these disorders were retrospectively assessed with percentiles for the body mass index (BMI). The mean percentile (+/- SD) for the BMI was 31.6 +/- 27.6 and differed significantly from the expected value of 50 (P<0.001). Ten subjects had a BMI of < or = 10th age percentile. Post hoc comparisons revealed that BMI percentiles were (a) reduced to a similar extent in patients with schizoid personality disorder and Asperger's disorder and (b) reduced to a greater extent in patients with abnormal eating behaviour. During childhood and adolescence both diagnoses are associated with an increased risk of being underweight. Population-based BMI percentiles are useful for detecting associations between specific psychopathological syndromes and body weight.

Failure to inhibit irrelevant information in non-clinical schizotypal individuals.

The present study compared negative priming performance in a non-clinical sample of individuals based on their schizotypal personality scale (STA) scores. There were 13 High STA and 19 Low STA individuals. High, but not Low, STA individuals displayed deficient negative priming, replicating previous findings. Converging evidence for this claim was observed in the correlation between negative priming and STA score, r = -.64, p < .01, supporting the notion that individuals with high STA scores exhibit an inability to adequately inhibit irrelevant information. Both groups did not differ on a simple reaction time control task, ruling out the possibility that observed negative priming differences across groups were the result of a simple motor reaction time difference.

[The characteristics of the cognitive defect in patients with different variants of late paranoia]. / Osobennosti kognitivnogo defitsita u bol'nykh s raznymi variantami pozdnego paranoida.

Evoked cortical activity in response to acoustic stimuli (oddball paradigm) was studied in patients with different paranoid disorders. The analysis covered the N150 negative wave and positive complex P300. In patients with paranoid schizophrenia and paranoid form of involutional psychosis cortical responses to the stimuli and cortex effects were not recorded. Such cognitive deficiency is believed to be typical for schizophrenia.

"Schizoid" personality in childhood: auditory P300 and eye tracking responses at follow-up in adult life.

The auditory P300 response and smooth pursuit eye tracking were recorded from a group of 23 male adult subjects who had been diagnosed in childhood as having schizoid personality. No differences were found in these physiological measures between the study group, their matched controls of other child psychiatric patients, and a group of population controls. The essentially negative findings are discussed in the light of abnormalities of these psychophysiological responses previously found in schizophrenic patients, in some of their biological relatives, and in other groups of psychiatric patients, including autistic children and adults with a diagnosis of borderline and schizotypal personality disorder. Results suggest that "schizoid" children, despite their high scores on a measure of schizotypy, do not have schizophrenia spectrum disorder or that schizotypy is a heterogeneous condition.

Canonical correlation of a temporal lobe signs scale with schizoid and hypomania scales in a normal population: men and women are similar but for different reasons.

The relationships between four relevant Minnesota Multiphasic Personality Inventory variables and temporal lobe signs and symptoms were determined separately for 70 university men and 86 women. Canonical correlations were similar in magnitude (0.55 to 0.60) but indicated sex-specific construction of the roots. For men the significant variables were the schizoid and complex partial epileptic-like signs; for women the significant variables were hypomania and all three temporal lobe clusters: complex partial seizure experiences, interictal-like signs, and religious/psi phenomenology.

Eye tracking, schizophrenic symptoms, and schizotypal personality disorder.

Schizophrenic patients and patients with schizotypal personality disorder were significantly more likely than normal controls to demonstrate impaired eye tracking performance. Fifteen of 27 schizophrenics and 15 of 27 schizotypals had impaired eye tracking, compared with 11 of 39 normal controls. In the schizophrenic group, including 10 out-patients in a stable state of relative remission, impaired eye tracking was associated with more severe formal thought disorder and more time spent in psychiatric hospitals. Among stable schizophrenic out-patients, poor eye tracking was related to more severe formal thought disorder and greater overall psychopathology. This pattern of results suggests a possible relation between eye tracking impairment and more severe enduring symptoms across the spectrum of schizophrenic and schizophrenia-related disorders.

Schizoid personality, inter-hemispheric transfer, and left hemisphere over-activation.

This study assesses the external validity of schizoid personality against multiple measures of cerebral laterality designed to distinguish between left hemisphere (LH) over-activation, LH damage and inter-hemisphere transfer deficit interpretations of schizotypy. Questionnaire measures of schizoid personality were assessed in an undergraduate population and related to laterality measures of both verbal and nonverbal dichotic listening, haptic inter- and intra-manual matching, employment of left and right hemisphere strategies during the haptic task, lateral eye-movements, and left and right ear auditory thresholds. A high score on a composite index of schizoid personality was significantly related to greater asymmetry (right ear advantage) in verbal dichotic listening, the use of LH strategies, and lower right ear thresholds, an overall pattern of results indicating LH over-activation in schizoids. It is suggested that studies comparing schizophrenic patients with normal controls minimize the likelihood of obtaining group differences if they fail to take into account schizoid personality in the controls.