Towards a scalable approach to assess speech organization across the psychosis-spectrum -online assessment in conjunction with automated transcription and extraction of speech measures.

Automatically extracted measures of speech constitute a promising marker of psychosis as disorganized speech is associated with psychotic symptoms and predictive of psychosis-onset. The potential of speech markers is, however, hampered by (i) lengthy assessments in laboratory settings and (ii) manual transcriptions. We investigated whether a short, scalable data collection (online) and processing (automated transcription) procedure would provide data of sufficient quality to extract previously validated speech measures. To evaluate the fit of our approach for purpose, we assessed speech in relation to psychotic-like experiences in the general population. Participants completed an 8-minute-long speech task online. Sample 1 included measures of psychometric schizotypy and delusional ideation (N = 446). Sample 2 included a low and high psychometric schizotypy group (N = 144). Recordings were transcribed both automatically and manually, and connectivity, semantic, and syntactic speech measures were extracted for both types of transcripts. 73%/86% participants in sample 1/2 completed the experiment. Nineteen out of 25 speech measures were strongly (r > 0.7) and significantly correlated between automated and manual transcripts in both samples. Amongst the 14 connectivity measures, 11 showed a significant relationship with delusional ideation. For the semantic and syntactic measures, On Topic score and the Frequency of personal pronouns were negatively correlated with both schizotypy and delusional ideation. Combined with demographic information, the speech markers could explain 11-14% of the variation of delusional ideation and schizotypy in Sample 1 and could discriminate between high-low schizotypy with high accuracy (0.72-0.70, AUC = 0.78-0.79) in Sample 2. The moderate to high retention rate, strong correlation of speech measures across manual and automated transcripts and sensitivity to psychotic-like experiences provides initial evidence that online collected speech in combination with automatic transcription is a feasible approach to increase accessibility and scalability of speech-based assessment of psychosis.

The positive dimension of schizotypy is associated with self-report measures of autobiographical memory and future thinking but not experimenter-scored indices.

ABSTRACTThe ability to remember our past and to imagine the future are critical to our sense of self. Previous research has indicated that they are disrupted in schizophrenia. However, it is unclear (i) whether this is found when examining experimenter-scored indices of content and/or participants' self-report of phenomenological characteristics, and (ii) how these abilities might be related to symptoms. This study sought to address these questions by taking a dimensional approach and measuring positive and negative schizotypal experiences in healthy people (n = 90). Participants were given cue words. For some, they remembered an event from the past and for others they generated an event in the future. No significant relationships were found with any aspect of schizotypy when participants' descriptions were scored by the experimenter according to a standardised episodic content measure. In contrast, several significant positive correlations were observed for past memory and future thinking when examining the positive dimension of schizotypy and participants' ratings, particularly to sensory characteristics of the experience and mental pre- or reliving. These results indicate enhanced subjective experiences of autobiographical memory and future thinking in those who report delusional and hallucinatory-like occurrences, which might be linked to mental imagery or metacognitive alterations.

Moral learning and positive schizotypy: Social cognitive mechanisms in psychosis- proneness.

BACKGROUND: Delusional thoughts such as paranoia and conspiratorial thinking reflect beliefs in others' intentions to do harm. Given the integral role of harm evaluation in moral cognition, a better understanding of how psychosis-prone individuals process others' moral characters may provide insights into social cognitive mechanisms of these types of delusions. METHODS: An online sample of 293 participants was drawn from the general population, using Amazon Mechanical Turk. Participants performed a moral inference task, where they predicted and judged the binary choices of two fictitious agents ("good" or "bad") to impose harm under different levels of financial incentives. An investment game involving the same agents then examined participants' trust behavior. Psychosis-proneness was measured with the Multidimensional Schizotypy Scale Brief Edition. RESULTS: A set of multiple regressions showed that positive schizotypy was associated with a lower yet more confident pre-experimental expectation of the agent's moral character, lower prediction accuracy of the agent's harm preferences, less belief revision, and undifferentiated perception of the good and bad agents' characters. Positive schizotypy was also related to higher expectations for reciprocity in the investment game, regardless of agent characters. CONCLUSION: Our findings suggest that inflexible beliefs associated with psychosis-proneness extend beyond negative prior expectations, also reflecting difficulties in moral learning. The resulting undifferentiated moral impressions might contribute to undue suspicion of benevolent individuals and increased gullibility to malicious ones, potentially further strengthening conspiratorial beliefs.

Quantifying the effects of practicing a semantic task according to subclinical schizotypy.

The learning ability of individuals within the schizophrenia spectrum is crucial for their psychosocial rehabilitation. When selecting a treatment, it is thus essential to consider the impact of medications on practice effects, an important type of learning ability. To achieve this end goal, a pre-treatment test has to be developed and tested in healthy participants first. This is the aim of the current work, which takes advantage of the schizotypal traits present in these participants to preliminary assess the test's validity for use among patients. In this study, 47 healthy participants completed the Schizotypal Personality Questionnaire (SPQ) and performed a semantic categorization task twice, with a 1.5-hour gap between sessions. Practice was found to reduce reaction times (RTs) in both low- and high-SPQ scorers. Additionally, practice decreased the amplitudes of the N400 event-related brain potentials elicited by semantically matching words in low SPQ scorers only, which shows the sensitivity of the task to schizotypy. Across the two sessions, both RTs and N400 amplitudes had good test-retest reliability. This task could thus be a valuable tool. Ongoing studies are currently evaluating the impact of fully deceptive placebos and of real antipsychotic medications on these practice effects. This round of research should subsequently assist psychiatrists in making informed decisions about selecting the most suitable medication for the psychosocial rehabilitation of a patient.

Can you believe your eyes? Positive schizotypy is associated with increased susceptibility to the Müller-Lyer illusion.

BACKGROUND AND HYPOTHESIS: Visual illusions provide a unique opportunity to understand cognitive and perceptual alterations in schizophrenia-spectrum conditions. Schizophrenia patients often exhibit increased susceptibility to the Müller-Lyer illusion. Here, we investigate susceptibility to the Müller-Lyer visual illusion in the general population with different levels of schizotypy. STUDY DESIGN: We assessed a population-based convenience sample (N = 263) on an online platform. In addition to basic demographics, participants completed the Müller-Lyer illusion, the Cardiff Anomalous Perceptions Scale (CAPS) to measure perceptual anomalies, and the Multidimensional Schizotypy Scale - Brief (MSS-B) for schizotypic traits. To evaluate what predicts susceptibility to the illusion, we fitted a large set of multilevel logistic regression models and performed model averaging over the coefficients. STUDY RESULTS: We found support for increased illusion susceptibility among individuals with high positive schizotypy. However, we did not find a comparable effect for anomalous perceptions alone, or for negative or disorganized schizotypy. CONCLUSIONS: The increased Müller-Lyer effect in positive schizotypy might be specific to delusion-like beliefs and magical ideation. Further research is needed to clarify how a hierarchical Bayesian formulation of brain function (e.g. imbalances between bottom-up perceptual processing and substantial reliance on prior expectations) can account for the Müller-Lyer effect in schizophrenia-spectrum conditions.

The role of the differential outcomes procedure and schizotypy in the recognition of dynamic facial expressions of emotions.

Emotional facial expression recognition is a key ability for adequate social functioning. The current study aims to test if the differential outcomes procedure (DOP) may improve the recognition of dynamic facial expressions of emotions and to further explore whether schizotypal personality traits may have any effect on performance. 183 undergraduate students completed a task where a face morphed from a neutral expression to one of the six basic emotions at full intensity over 10 s. Participants had to press spacebar as soon as they identified the emotion and choose which had appeared. In the first block, participants received no outcomes. In the second block, a group received specific outcomes associated to each emotion (DOP group), while another group received non-differential outcomes after correctly responding (NOP group). Employing generalized linear models (GLMs) and Bayesian inference we estimated different parameters to answer our research goals. Schizotypal personality traits did not seem to affect dynamic emotional facial expression recognition. Participants of the DOP group were less likely to respond incorrectly to faces showing Fear and Surprise at fewer intensity levels. This may suggest that the DOP could lead to better identification of the main features that differentiate each facial expression of emotion.

Schizotypy Moderates the Relationship Between Sleep Quality and Social Cognition.

ABSTRACT: Poor sleep quality has been tied to worse social cognition. Social cognitive deficits have been noted in those with high schizotypy. Yet, no study has assessed whether schizotypy moderates the relationship between sleep quality and social cognition, which may be vital to our understanding of contributors to social functioning. We conducted a cross-sectional analysis of associations of sleep quality and social cognition, with potential moderation by schizotypy. Participants ( n = 906) completed self-report measures of schizotypy, sleep quality, and social cognition. Levels of schizotypy significantly moderated some of the relationships between sleep and social cognition. For participants low in total or interpersonal schizotypy, worse sleep quality was associated with worse theory of mind scores. For participants low in total, disorganized, or cognitive perceptual schizotypy, worse sleep quality was associated with worse self-reported cognitive empathy. For those high in these facets of schizotypy, worse sleep quality was associated with better self-reported cognitive empathy. These results suggest that the individual facets of schizotypy provide additional information and, therefore, are important to assess when examining social cognition and sleep.

Childhood Schizotypy and Adolescent Mental Disorder.

BACKGROUND AND HYPOTHESIS: Schizotypy provides a framework for understanding the developmental nature of psychotic disorders and a means of identifying "at-risk" individuals early in the lifespan. However, there is a lack of prospective longitudinal research examining the relationship between schizotypy in childhood and later psychotic and other mental disorders. We hypothesized that distinct profiles of schizotypy in childhood would be differentially associated with psychotic and other mental disorders emerging later in adolescence. STUDY DESIGN: In a large population cohort of Australian young people (n = 26 837), we prospectively examined the relationship between person-centered profiles of schizotypy identified in middle childhood (age ~11 years) and adolescent diagnoses (age ~13-18 years) across 7 types of mental disorders using multinomial logistic regression. RESULTS: Membership in any of 3 childhood schizotypy profiles (true schizotypy, affective schizotypy, or introverted schizotypy) was associated with an increased likelihood of being diagnosed with any type of mental disorder in adolescence; effects were strongest for the true schizotypy group (aOR = 3.07, 95% CI = 2.64, 3.57), followed by the introverted (aOR = 1.94, 95% CI = 1.75, 2.15) and affective (aOR = 1.29, 95% CI = 1.13, 1.47) schizotypy groups. Six of the 7 types of mental disorders measured (including psychotic disorders) were associated with at least 1 schizotypy group. CONCLUSIONS: Schizotypy in middle childhood is an important correlate of mental disorders in adolescence; however, it does not appear to be specifically associated with psychotic disorders in this age group.

Co-occurrence of borderline and schizotypal personality disorders: a scoping review.

BACKGROUND: The historical concept of borderline conditions refers to the pathology on the border between neurosis and psychosis. In DSM-III the conditions were divided into specific but also somewhat overlapping diagnostic criteria for Borderline Personality Disorder (BPD) and Schizotypal Personality Disorder (SPD). This phenomenological overlap, which results in co-occurrence of the two diagnoses, remains a clinical challenge to this day. METHODS: To address this issue we examined the co-occurrence of SPD and BPD according to the established DSM-IV/-5 diagnostic criteria. A literature search was conducted including studies that employed a structured interview with defined BPD and SPD criteria. RESULTS: Studies from 20 samples were included (i.e. 15 patients, 3 community and 2 forensic samples). For patients diagnosed primarily with BPD, 1-27% also met the criteria for SPD and for patients diagnosed primarily with SPD, 5 - 33% showed co-occurrence with BPD. In the forensic samples, co-occurrence for primary BPD was 10% and 67 - 82% for primary SPD. In the community samples, co-occurrence for primary BPD was 29% and 50% for primary SPD. The pattern of co-occurrence across community samples was particularly heterogeneous. CONCLUSION: The identified co-occurrences for BPD and SPD were considerably sample-dependent, and samples and measurements were generally too heterogeneous for a precise meta-analysis. Forensic and community samples generally showed higher co-occurrences, but these findings were characterized by potential methodological limitations.

Cold executive function processes and their hot analogs in schizotypy.

OBJECTIVE: To examine cold (based on logical reasoning) versus hot (having emotional components) executive function processes in groups with high individual schizotypal traits. METHOD: Two-hundred and forty-seven participants were administered the Schizotypal Personality Questionnaire and were allocated into schizotypal (cognitive-perceptual, paranoid, negative, disorganized) or control groups according to pre-specified criteria. Participants were also administered a battery of tasks examining working memory, complex selective attention, response inhibition, decision-making and fluid intelligence and their affective counterparts. The outcome measures of each task were reduced to one composite variable thus formulating five cold and five hot cognitive domains. Between-group differences in the cognitive domains were examined with repeated measures analyses of covariance. RESULTS: For working memory, the control and the cognitive-perceptual groups outperformed negative schizotypes, while for affective working memory controls outperformed the disorganized group. Controls also scored higher compared with the disorganized group in complex selective attention, while both the control and the cognitive-perceptual groups outperformed negative schizotypes in complex affective selective attention. Negative schizotypes also had striking difficulties in response inhibition, as they scored lower compared with all other groups. Despite the lack of differences in fluid intelligence, controls scored higher compared with all schizotypal groups (except from cognitive-perceptual schizotypes) in emotional intelligence; the latter group reported higher emotional intelligence compared with negative schizotypes. CONCLUSION: Results indicate that there is no categorical association between the different schizotypal dimensions with solely cold or hot executive function processes and support impoverished emotional intelligence as a core feature of schizotypy.

Relationship between theta/beta ratio and mind wandering in schizotypy.

Negative association was found between the frontal theta/beta ratio and mind wandering in participants with high schizotypal traits, while no such association was found in participants with low schizotypal traits. These findings provide insights into the neural mechanism of mind wandering in individuals with high schizotypal traits.

A systematic evidence map of the association between cannabis use and psychosis-related outcomes across the psychosis continuum: An umbrella review of systematic reviews and meta-analyses.

While the legal status and public perception of cannabis are currently changing in many countries, one of the important considerations from a public health viewpoint is its potential association with adverse health outcomes such as the development of psychosis. We conducted an umbrella review of systematic reviews and meta-analyses using the AMSTAR-2 to assess the quality of included reviews. We further created an evidence map to visualize and facilitate the overview of the published evidence synthesis on the association between cannabis use and all psychosis-related outcomes and risk moderators in healthy, high-risk, and clinical populations. Overall, we found 32 systematic reviews and meta-analyses. Based on a synthesis of current evidence, cannabis use is associated with subclinical psychosis states (psychotic-like experiences) and traits (schizotypal personality) in the healthy population, as well as earlier onset and development of psychosis. An association with the clinical-high-risk state for psychosis, attenuated psychosis symptoms and transition to psychosis in this population could not be confirmed. An association between cannabis use and psychosis outcomes in patients with psychotic disorder could solely be confirmed regarding relapse. Whether causal effects underlie those associations has not sufficiently been addressed in the evidence synthesis to date.

[Psychopathological correlates of depression with non-suicidal self-harm in non-psychotic mental illnesses of adolescence]. / Psikhopatologicheskie korrelyaty depressii s nesuitsidal'nymi samopovrezhdeniyami pri nepsikhoticheskikh psikhicheskikh zabolevaniyakh yunosheskogo vozrasta.

OBJECTIVE: To determine the main clinical and psychopathological features of the relationship between depressive states and non-suicidal self-injury (NSSI) in mental illnesses of the non-psychotic register in adolescence. MATERIAL AND METHODS: Clinical data of 128 patients (77 males and 51 females), who presented with depressive states and NSSI in non-psychotic mental disorders during adolescence, were analyzed. The patients were examined at the Clinic of the Mental Health Research Center during the period 2020-2023. The mean age of the patients was 19±4.1 years. RESULTS: Based on the data from studying depression and NSSI in adolescence, we developed a typology, identifying three variants of affect and auto-aggressive activity interactions. The affect-dominant type (25.8%) was characterized by a predominance of affective pathology (p<.05), with the occurrence of impulsive NSSI (45.5%) and demonstrative NSSI (30.3%) (p<0.05). The personality-dominant type (43.0%) was based on pathocharacterological abnormalities (60.0%), where NSSI were represented by impulsive (25.5%), depersonalizing (27.3%), and addictive variants (32.7%) (p<0.05). The reciprocal type (31.3%) exhibited pronounced polymorphism, combining high affect variability with a tendency towards auto-aggressive behavior of varying severity and manifestations of NSSI (p<0.05). In terms of nosological distribution, schizotypal disorder predominated (45.0%) followed by predominantly borderline personality disorder (30.0%) and bipolar affective disorder (25.0%) (p<0.05). In terms of nosological distribution, schizotypal disorder predominated (45.0%), followed by predominantly borderline personality disorder (30.0%) and bipolar affective disorder (25.0%) (p<0.05). CONCLUSION: Three types of correlation between depression and NSSI were identified, the formation of which was due to the pathoplastic influence of the age factor, nosological affiliation and a certain, including pathological personality structure. Statistically significant regularities between variants of NSSI and types of their interrelation were revealed. The results can be considered as differential diagnostic and prognostic markers of their further trajectories and, therefore, contribute to the creation of new therapeutic strategies, timely diagnosis and earlier intervention.

Measurement invariance of brief forms of the Schizotypal Personality Questionnaire across convenience versus random samples.

Schizotypy, a multifaceted personality construct that represents liability for schizophrenia, is generally measured with self-report questionnaires that have been developed and validated in samples of undergraduate students. Given that understanding schizotypy in non-clinical samples is essential for furthering our understanding of schizophrenia-spectrum psychopathologies, it is critical to test whether non-clinically identified undergraduate and other convenience samples respond to schizotypy scales in the same way as random samples of the general population. Here, 651 undergraduates, 350 MTurk workers, and two randomly selected high school samples (n = 177, n = 551) completed brief versions of the Schizotypal Personality Questionnaire (SPQ-BR or SPQ-BRU). Multigroup confirmatory factor analysis was used to test whether measurement invariance was present across samples. Tests were made for all samples together and for each pair of samples. Results showed that a first-order nine-factor model fit the data well, and this factor structure displayed configural and metric invariance across the four samples. This suggests that schizotypy has the same factor structure, and the SPQ-BR/BRU is measuring the same construct across the different groups. However, when all groups were compared, results indicated a lack of scalar invariance across these samples, suggesting mean comparisons may be inappropriate across different sample types. However, when randomly selected high school students were compared with undergraduate students, scalar invariance was present. This suggests that factors such as culture and form type may be driving invariance, rather than sampling method (convenience vs general population).

[Depressive disorders in adolescents in outpatient psychiatric practice]. / Depressivnye rasstroistva u podrostkov v ambulatornoi psikhiatricheskoi praktike.

OBJECTIVE: To clarify the clinical features of depressive states in adolescent boys and girls (taking into account age and sex) seeking help from primary care specialists in outpatient psychiatric care. MATERIAL AND METHODS: The study included 158 patients (89 boys and 69 girls), aged 15-17, with depressive pathology of various genesis, observed in the adolescent office of one of the Moscow psychoneurological dispensary in 2015-2020. The main research methods were clinical-psychopathological, clinical-follow-up, statistical. RESULTS: An analysis of the data demonstrated that adolescent depression can be observed within different diagnostic categories. Most often they were noted in patients with affective disorders (43%, n=68), emerging personality disorders (29%, n=46), schizotypal disorder (13%, n=21). The nosological affiliation of depression and its severity were associated with sex. In young men, depressive states were more often detected in the structure of emerging personality disorder (59.6%) and schizotypal disorder (15.7%), depressive states within affective disorders were detected in 22.5% of cases. In girls, most of the depressive episodes (69.6%) developed in the structure of affective disorders, less often in personality disorders (20.3%), and schizotypal disorder (10.1%). Depressive episodes in girls were predominantly of moderate severity, in boys the most common were mild depressions. CONCLUSION: Adolescent depressions are a nosologically heterogeneous group of affective disorders, differing in clinical phenomenology and prognosis. They are noted within the pathology of the affective spectrum, affective phases and psychogenic reactions acting in the dynamics of emerging personality disorders, within the framework of psychopathological diathesis, schizotypal disorder. The influence of sex on the development of depressive disorders is determined by the nosological framework of the condition.

[Non-suicidal self-injurious behavior in conduct disorders and schizotypal disorder]. / Nesuitsidnye samopovrezhdeniya pri rasstroistvakh povedeniya i shizotipicheskom rasstroistve.

OBJECTIVE: To compare the methods and motives of non-suicidal self-injurious behavior (NSIB) in conduct disorders and schizotypal disorder. MATERIAL AND METHODS: The main group consisted of 91 patients (77.8%), aged 13-24 years, with behavioral disorders and NSIB, who completed questionnaires using the self-harm statements questionnaire. The younger subgroup consisted of 54 patients under the age of 18 with a diagnosis of «Behavior Disorders¼ (ICD-10 F91), the older subgroup included 37 patients aged 18 years or more with a diagnosis of Emotionally Unstable Personality Disorder (F60.3). The comparison group consisted of 100 patients, aged 13-41 years with a diagnosis of schizotypal disorder (F21) and NSIB. We used clinical-psychopathological, standardized and statistical methods. RESULTS: Significant differences were revealed in the sexual preference for NSIB (p=0.0001), a number of leading types of NSIB, and the absence of differences in the motives of self-injurious behavior in patients of the compared groups. In the comparison group, cuts and cauterization prevailed as the leading type of NSIB, in patients with behavioral disorders prevailed obstacles to wound healing, which is hypothetically associated with the influence of obsessive psychopathological mechanisms, since pathological excoriation has the same nature as obsessive-compulsive disorder and is included with it in the same DSM-5 category. The impulsive subtype of NSIB observed in this situation usually arises due to an increasing sense of tension and is associated with the motive of intrapersonal self-regulation. CONCLUSION: The study showed that the difference between the compared nosological groups according to the methods and motives of self-harming actions is determined not so much by intergroup differences as by sex and age patterns within each of the compared groups. This allows us to talk about the proximity of the mechanisms of self-harm in various mental disorders, and the phenomenon of NSIB itself should be considered rather as a nosologically nonspecific psychopathological phenomenon.

[Teraligen in the complex treatment of anxiety-phobic, behavioral and depressive syndromes in children and adolescents with schizotypal disorder]. / Teralidzhen v kompleksnoi terapii trevozhno-fobicheskikh, povedencheskikh i depressivnykh narushenii u detei i podrostkov s shizotipicheskim rasstroistvom.

OBJECTIVE: To determine the frequency of prescribing and the main therapeutic targets of Teraligen in the treatment of Schizotypal disorder (STD) in childhood and adolescence. MATERIAL AND METHODS: The sample consisted of 151 patients aged 7 to 16 years with a diagnosis of STD (F 21), of which 31.1% (n=47) of female patients and 68.9% (n=104) of male patients who received inpatient or outpatient treatment at the FSBI NCPZ from 2008 to 2020. The study was conducted by clinical-psychopathological, clinical-catamnestic, and statistical methods. RESULTS: Teraligen was prescribed by psychiatrists to patients with STD in 74.2% of cases, of which in 46.4% of cases patients received Teraligen even before the diagnosis of STD in connection with complaints of neurotic disorders (anxiety, fears and sleep disorders) (n=30), as well as in connection with autistic-like behavior (n=22). At the time of follow-up, 55% (n=83) of patients received Teraligen, of which 63.9% (n=53) of patients were prescribed it for the first time. The applied schemes of prescribing Teraligen for the treatment of anxiety-phobic, depressive and behavioral syndromes within the framework of the STD in a relatively age-related aspect are presented. CONCLUSION: The high frequency of prescribing Teraligen by psychiatrists and neurologists to children and adolescents with STD at different stages of observation is shown, which reflects the confidence of specialists in this drug. Teraligen has demonstrated a multidimensional pharmacological effect, including a mild antipsychotic effect, providing reduction of a wide range of psychopathological symptoms, with good tolerability and drug interaction. The study of the possibilities of Teraligen, both for monotherapy and for augmentation of the treatment of mental pathology in childhood, remains relevant.

Positive schizotypy and Motor Impulsivity correlate with response aberrations in ventral attention network during inhibitory control.

Inhibitory control (IC) aberrations are present in various psychopathologies, including schizophrenia spectrum and personality disorders, especially in association with antisocial or violent behaviour. We investigated behavioural and neural associations between IC and psychopathology-related traits of schizotypy [Oxford-Liverpool Inventory of Feelings and Experiences (O-LIFE)], psychopathy [Triarchic Psychopathy Measure (TriPM)], and impulsivity [Barratt Impulsiveness Scale (BIS-11)], using a novel Go/No-Go Task (GNG) featuring human avatars in 78 healthy adults (25 males, 53 females; mean age = 25.96 years, SD = 9.85) and whole-brain functional magnetic resonance imaging (fMRI) in a separate sample of 22 right-handed healthy individuals (7 males, 15 females; mean age = 24.13 years, SD = 5.40). Behaviourally, O-LIFE Impulsive Nonconformity (impulsive, anti-social, and eccentric behaviour) significantly predicted 16 % of variance in false alarms (FAs). O-LIFE Unusual Experiences (positive schizotypy) and BIS-11 Motor Impulsivity predicted 15 % of d prime (d') (sensitivity index) for the fastest (400 ms) GNG trials. When examined using fMRI, higher BIS-11 Motor Impulsivity uniquely, and also together with Unusual Experiences, was associated with lower activity in the left lingual gyrus during successful inhibition (correct No-Go over baseline). Additionally, higher Impulsive Nonconformity was associated with lower activity in the caudate nucleus and anterior cingulate during No-Go compared to Go stimuli reactions. Positive schizotypy, motor, and antisocial-schizotypal impulsivity correlate with some common but mostly distinct neural activation patterns during response inhibition in areas within or associated with the ventral attention network.

Treatment of schizotypal disorder: a protocol for a systematic review of the evidence and recommendations for clinical practice.

INTRODUCTION: Schizotypal disorder is associated with a high level of disability at an individual level and high societal costs. However, clinical recommendations for the treatment of schizotypal disorder are scarce and based on limited evidence. This review aims to synthesise the current evidence on treatment for schizotypal disorder making recommendations for clinical practice. METHODS AND ANALYSIS: This systematic review protocol follows the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. A systematic literature search will be performed in PsychArticles, Embase, Medline and Cochrane Central Register of Controlled Trials. Additionally, we will search for relevant articles manually. Inclusion criteria are published studies including individuals diagnosed with schizotypal personality disorder according to Diagnostic and Statistical Manual of Mental Disorders (DSM) criteria, or schizotypal disorder according to International Classification of Diseases (ICD) criteria. We will include interventional studies comprising any pharmacological and non-pharmacological treatment trials for patients with schizotypal disorder, and all relevant outcome measures will be reported. Risk of bias will be assessed by Cochrane risk-of-bias tools. Data will be synthesised using narrative or thematic analysis and, if suitable, through meta-analysis. ETHICS AND DISSEMINATION: No original data will be collected as part of this study and ethics approval is, therefore, not applicable. The results will be disseminated through peer-reviewed publication and presented at international scientific meetings. We will aim at submitting the final paper for publication within 4 months of completion of analyses. Furthermore, this systematic review will inform clinicians and researchers on the current state of evidence on treatment for schizotypal disorder. Findings may guide proposals for further research and potentially guide recommendations for clinical practice using the Grading of Recommendations Assessment, Development and Evaluation. PROSPERO REGISTRATION NUMBER: CRD42022375001.

Conceptualizing a less paranoid schizophrenia.

Schizophrenia stands as one of the most studied and storied disorders in the history of clinical psychology; however, it remains a nexus of conflicting and competing conceptualizations. Patients endure great stigma, poor treatment outcomes, and condemnatory prognosis. Current conceptualizations suffer from unstable categorical borders, heterogeneity in presentation, outcome and etiology, and holes in etiological models. Taken in aggregate, research and clinical experience indicate that the class of psychopathologies oriented toward schizophrenia are best understood as spectra of phenomenological, cognitive, and behavioral modalities. These apparently taxonomic expressions are rooted in normal human personality traits as described in both psychodynamic and Five Factor personality models, and more accurately represent explicable distress reactions to biopsychosocial stress and trauma. Current categorical approaches are internally hampered by axiomatic bias and systemic inertia rooted in the foundational history of psychological inquiry; however, when such axioms are schematically decentralized, convergent cross-disciplinary evidence outlines a more robust explanatory construct. By reconceptualizing these disorders under a dimensional and cybernetic model, the aforementioned issues of instability and inaccuracy may be resolved, while simultaneously opening avenues for both early detection and intervention, as well as for more targeted and effective treatment approaches.