Social anxiety and the shame of psychosis: a study in first episode psychosis

Social anxiety disorder (SaD) or social phobia is a co-morbid affective disorder in schizophrenia, present in up to one in three individuals. We employ 'social rank' theory to predict that one pathway to social anxiety in schizophrenia is triggered by the anticipation of a catastrophic loss of social status that the stigma of schizophrenia can entail. A group of 79 people with a first episode of psychosis were assessed for social anxiety: hypotheses were tested comparing 23 socially anxious and 56 non-anxious patients on measures of cognitive appraisals of shame/stigma of psychosis and perceived social status, controlling for depression, psychotic symptoms and general psychopathology. Participants with social anxiety experienced greater shame attached to their diagnosis and felt that the diagnosis placed them apart from others, i.e., socially marginalised them and incurred low social status. We propose a stigma model of social anxiety that makes testable predictions about how the shame beliefs may contaminate social interaction and thereby exacerbate and maintain social phobia.     

Improving psychological adjustment following a first episode of psychosis: A randomised controlled trial of cognitive therapy to reduce post psychotic trauma symptoms

There are few evaluated psychological interventions or theoretical approaches which are specifically aimed at reducing problems related to adjustment and adaptation following a first episode of psychosis. The present study tests the efficacy of a form of CBT (Cognitive Recovery Intervention; CRI) in reducing trauma, depression and low self esteem following a first episode of psychosis, in a single-blind randomised controlled trial. A total of 66 patients who had recently experienced a first episode of psychosis were randomly assigned to CRI or treatment as usual (TAU) and followed up at 6 and 12 months. People receiving CRI tended to have lower levels of post-intervention trauma symptoms and demonstrated greater improvement than those receiving TAU alone. This was especially the case at 6 months for those with high pre-treatment levels of trauma. There was, however, no advantage for the CRI group with regards to reduced depression or improved self esteem. In conclusion, CRI appears to be an effective intervention to help young people adapt to the traumatic aspects of a first episode of psychosis although further evaluation in a larger study is warranted.     

Premorbid personality indicators of schizophrenia-related psychosis in a hypothetically psychosis-prone college sample

Bolinskey, P. K. & Gottesman, I. I. (2010). Premorbid personality indicators of schizophrenia-related psychosis in a hypothetically psychosis-prone college sample. Scandinavian Journal of Psychology, 51, 68–74.
Research into psychosis proneness has established the Chapman Psychosis Proneness Scales (CPPS), certain personality disorders, certain response patterns on the MMPI-2, and social withdrawal as being valid indicators of liability. The current study extends our understanding of premorbid indicators of schizophrenia-related psychosis (SRP) by examining whether individuals identified as hypothetically psychosis prone (HPP) by virtue of their CPPS scores also show differences on other premorbid indicators of SRP. Results indicate that HPP individuals evidence more deviancy in the schizophrenic direction. By providing additional construct validity for the CPPS and other endophenotypic indicators of premorbid processes, strategies for understanding the development of SRP are enhanced.     

The role of cognitive variables in psychological functioning after the death of a first degree relative

The present study sought to explore the relationship between negative cognitions and emotional problems after bereavement, with a group of 329 adults who had suffered the loss of a first degree relative. The following cognitions were assessed: global negative beliefs, cognitions about self-blame, negative cognitions about other people's responses after the loss, and negative cognitions about one's own grief reactions. Results showed that each of these cognitive variables was significantly related to the severity of symptoms of traumatic grief, depression and anxiety, even when background and loss-related variables that were initially found to influence symptom severity, were statistically controlled. When the shared variance between the cognitive variables was controlled, it was found that global negative beliefs about life, the world, and the future, and threatening interpretations of grief reactions each explained a unique proportion of variance in traumatic grief symptom severity. Global negative beliefs about life, the self and the future, and threatening interpretations of grief explained most variance in depression, while negative beliefs about the self and threatening interpretations of grief explained most variance in anxiety. Overall, the findings are in support of cognitive theories of grief, and suggest that effective treatment of problematic grief will need to address negative cognitions.     

Premorbid behavioral and psychosocial adjustment of children with traumatic brain injury

The premorbid adjustment of 85 six- to sixteen-year-old children with traumatic brain injury was assessed by means of standardized rating forms that were completed by the children's parents and teachers. Parents and teachers were in moderate agreement when rating children's premorbid functioning. Less than 11% of the children appeared to have premorbid disturbances. Premorbid adjustment did not appear to be clearly related to injury severity or to type of injury. It is concluded that premorbid behavioral and psychosocial factors are not strongly related to the incidence of traumatic brain injury in a sample of children with predominantly relatively severe injuries.The author gratefully acknowledges the assistance of Amy Herrema, Kevin Hogeterp, and Mary Jeanne Lynch in the data collection process.     

Dimensions of premorbid functioning in schizophrenia: a review of neuromotor, cognitive, social, and behavioral domains

After a brief discussion of methods for studying the premorbid period in schizophrenia, the authors review relevant experimental literature to assess the validity of current theories. A critical review is provided that includes representative empirical investigations on premorbid functioning in schizophrenia in the domains of neuromotor, intellectual, academic, cognitive, social, emotional, and behavioral functioning. Limitations of past research, such as lack of specificity to schizophrenia populations, high incidences of false positives, questionable definitions of the premorbid period, inconsistent measures of premorbid functioning, and problems with the current method of DSM classification are discussed. Alternative approaches to studying early functioning in schizophrenia are highlighted.     

Differential cerebral involvement in the cognitive functioning of bilinguals

The cognitive processing strategies of two groups of French-English bilinguals were studied by means of an auditory Stroop test designed to evaluate cerebral hemispheric involvement. An “early bilingual” group were bilingual before the age of 5, and a “late bilingual” group were bilingual after the age of 10. Stimuli were words uttered in pitches that were related to word meanings either congruently (as in the word “high” uttered in a high pitch) or incongruently (the word “haute” uttered in a low pitch). In one condition, subjects were to differentiate low from high pitches, disregarding meaning, while in a second condition, they were to disregard pitch and respond to word meanings. Measures of field independence were also taken. Results of data analyses suggest that male early bilinguals—the most field independent subgroup—process meaning efficiently in both cerebral hemispheres, but process pitch better in the right hemisphere. However, male late bilinguals and female bilinguals, both early and late, process meaning more rapidly in the right cerebral hemisphere and pitch equally rapidly in both hemispheres. The findings are interpreted as reflecting hemisphere-based strategy and sex differences in information-processing by the two bilingual groups.     

The role of cognitive stimulation on the relations between age and cognitive functioning

To make a convincing argument that cognitive stimulation moderates age trends in cognition there must be (a) a negative relation between age and level of cognitive stimulation, (b) a positive relation between level of cognitive stimulation and level of cognitive functioning, and (c) evidence of an interaction between age and cognitive stimulation in the prediction of cognitive functioning. These conditions were investigated in a study in which 204 adults between 20 and 91 years of age completed an activity inventory and performed a variety of cognitive tasks. Only the 1st condition received empirical support, and, thus, the results of this study provide little evidence for the hypothesis that cognitive stimulation preserves or enhances cognitive functioning that would otherwise decline.     

Changes in behavioral problems and prosocial functioning in child treatment

Decreasing emotional and behavioral problems and increasing prosocial functioning are two ares of interest in child treatment. The present study examined the extent to which changes in deviant behavior were associated with changes in prosocial functioning. Three separate samples of children (N = 393, ages 6–13) referred to inpatient or outpatient services were evaluated by parents and teachers on three separate assessment occasions spanning 1–2 years. The major findings indicated that behavioral problems and prosocial functioning and changes in behavioral problems and prosocial functioning over time showed low to moderate negative correlations for parent and teacher evaluations. These relations were consistent across separate time periods, samples of children, and parent and teacher ratings. The magnitude of the correlations between behavioral problems and prosocial functioning indicated that these domains are related but represent relatively independent spheres of child functioning. The importance of assessing both domains of functioning in evaluating children and treatment outcome is discussed.     

Bridging the schism between behavioral and cognitive analyses

A major schism in modern scientific psychology has occurred between behavior analysts and cognitive psychologists. The two groups speak in different languages, but the languages can be translated so that they are mutually understandable; when either language is translated into the other, similarities emerge from seeming differences. We draw an analogy between the basic units of behavior analysis (the operant and the establishing operation) and cognitive psychology (the production). We argue that both units describe behavior as a function of motivative and discriminative antecedents. In addition, the two perspectives account in analogous ways for ongoing changes in motivation and for control by verbal statements. Adherents of the two perspectives have experimentally analyzed some of the same problems and fashioned similar solutions for applied problems. We conclude that many of the commonly cited differences between the two perspectives are the result of misunderstanding, and that the real differences need not preclude communication and collaboration. The schism can be bridged.     

Gender processes in school functioning and the mediating role of cognitive self-regulation

The catalysts for gender discrepancies across developmental outcomes are widely debated. This study examines cognitive self-regulation (CSR) as a mechanism for understanding gender differences in scholastic performance—both subjective school functioning and objective standardized achievement. Utilizing a national sample from the NICHD SECCYD (n = 1364), not only does CSR (i.e., attention and executive function) in 3rd grade mediate the relation between early mother–child interactions (at 54 months) and scholastic outcomes (in 5th grade), but it also predicts gender discrepancies favoring girls in grades, work persistence and socio-emotional development. Additional exploratory evidence suggests quality mother–child interactions may be more meaningful for girls' CSR; however, for boys, CSR is more predictive of school functioning. Both school functioning and standardized achievement were utilized in this study and highlight that gender differences in development and learning are nuanced and not readily discernible across all measures of scholastic performance. Implications for future research, intervention, and practice are discussed.     

Neuromodulation of behavioral and cognitive development across the life span

Among other mechanisms, behavioral and cognitive development entail, on the one hand, contextual scaffolding and, on the other hand, neuromodulation of adaptive neurocognitive representations across the life span. Key brain networks underlying cognition, emotion, and motivation are innervated by major transmitter systems (e.g., the catecholamines and acetylcholine). Thus, the maturation and senescence of neurotransmitter systems have direct implications for life span development. Recent progress in molecular genetics has opened new avenues for investigating neuromodulation of behavioral and cognitive development. This special section features 6 selected reviews of recent cognitive genetic evidence on the roles of dopamine and other transmitters in different domains of behavioral and cognitive development, ranging from temperament, executive control, and working memory to motivation and goal-directed behavior in different life periods.     

Training the brain: fact and fad in cognitive and behavioral remediation

Putatively safe and effective for improving cognitive performance in both health and disease, products purported to train the brain appeal to consumers and healthcare practitioners. In an increasingly health-centered society, these applications constitute a burgeoning commercial market. Sparse evidence coupled with lack of scientific rigor, however, leaves claims concerning the impact and duration of such brain training largely unsubstantiated. On the other hand, at least some scientific findings seem to support the effectiveness and sustainability of training for higher brain functions such as attention and working memory. In the present paper we provide a tectonic integration and synthesis of cognitive training approaches. Specifically, we sketch the relative merits and shortcomings of these programs, which often appeal to parents who must choose between side-effect-laden medication and other less conventional options. Here we examine how neuroplasticity allows the healthy as well the impaired to benefit from cognitive training programs. We evaluate the evidence and consider whether brain training can be a stand-alone treatment or an adjunct to pharmacotherapy, outline promising future prospects, and highlight what training outcomes are plausible in line with available data. Future research would determine whether the field of brain training realizes its potential to revolutionize education and rehabilitation or withers away engulfed in controversy.