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.     

Development of social functioning in preschizophrenia children and adolescents: a systematic review

Schizophrenia is associated with severe deficits in social functioning. Similar deficits may be present prior to psychosis onset, in childhood and adolescence. If so, then prepsychosis social deficits could provide clues to the development of pathological processes in preschizophrenia children and could potentially improve early identification of the disorder and suggest targets for intervention. Evidence is reviewed from birth cohort, case- control, and familial high-risk studies within distinct periods of development to clarify the nature, timing, and specificity of social deficits in preschizophrenia children and adolescents. The results indicate that poor social functioning does differentiate preschizophrenia children and adolescents from their peers and can be a sensitive and potentially specific predictor of schizophrenia, not just psychopathology in general. Furthermore, age (but not sex) appears to be an important moderator of the strength and specificity of the association between particular social deficits (e.g., externalizing, internalizing) and later schizophrenia. Results are discussed in the context of current developmental theories of timing and pathophysiology of schizophrenia involving hypothalamic- pituitary-adrenal dysregulation. Implications for the early identification and treatment of preschizophrenia individuals are also considered.     

Cognitive and behavioral functioning in Coffin-Siris syndrome and epilepsy: a case presentation

The authors characterized the cognitive, adaptive, and behavioral sequelae of Coffin-Siris (CS) syndrome and epilepsy in a 7.5-year-old child. Little is known about the early neurobehavioral presentation of CS. Clinical features consistent with this genetic anomaly include underdeveloped tips and nails of the fifth fingers, extended infranasal depression, and craniofacial abnormalities. MRI findings often reveal callosal agenesis. The authors conducted a neuropsychological evaluation and obtained parental ratings of behavioral and adaptive functioning. Attentional abilities were limited. As assessed by the Mullen Scales of Early Learning, receptive language abilities (age equivalent [AE]: 3-3) were relatively stronger than expressive skills (AE: 1-4). Adaptive functioning was low across all domains (Vineland Adaptive Behavior Composite AE: 1-9). On the Behavior Assessment for Children (BASC-2), social skills dysfunction, stereotyped and self-stimulatory behaviors, restricted interests, ritualistic play, and inappropriate object usage were noted. No significant mood disturbances were endorsed. Study findings indicate a diffuse pattern of neurobehavioral deficits in a child with CS and epilepsy. Further clinical assessment and research should include multidimensional assessment techniques, including evaluation of adaptive behavior, in an effort to capture the full range developmental sequelae in children with CS.     

Substance abuse and panic-related anxiety: a critical review

The relationship between substance abuse and panic-related anxiety can be divided into two broad areas: the incidence of anxiety disorders in substance abuse patients and the incidence of substance abuse in patients with panic-related anxiety disorders. Studies indicate that approx. 10-40% of alcoholics have a panic-related anxiety disorder, and about 10-20% of anxiety disorder patients abuse alcohol or other drugs. The majority of patients with both an anxiety and alcohol disorder report that anxiety problems preceded alcohol problems. In some cases substance abuse (e.g. cocaine) triggers the onset of panic attacks. Most patients believe that self-medication is efficacious despite the fact that they appear to have a more serious clinical condition (e.g. higher rates of depression). Directions for future research are outlined, including the proposal for a study to examine the effects of an anxiety intervention procedure for anxious alcoholics to reduce relapse rates.     

Learning and production of movement sequences: behavioral, neurophysiological, and modeling perspectives

A wave of recent behavioral studies has generated a new wealth of parametric observations about serial order behavior. What was a trickle of neurophysiological studies has grown to a steady stream of probes of neural sites and mechanisms underlying sequential behavior. Moreover, simulation models of serial behavior generation have begun to open a channel to link cellular dynamics with cognitive and behavioral dynamics. Here we review major results from prominent sequence learning and performance tasks, namely immediate serial recall, typing, 2 x N, discrete sequence production, and serial reaction time. These tasks populate a continuum from higher to lower degrees of internal control of sequential organization and probe important contemporary issues such as the nature of working-memory representations for sequential behavior, and the development and role of chunks in hierarchical control. The main movement classes reviewed are speech and keypressing, both involving small amplitude movements amenable to parametric study. A synopsis of serial order models, vis-a-vis major empirical findings leads to a focus on competitive queuing (CQ) models. Recently, the many behavioral predictive successes of CQ models have been complemented by successful prediction of distinctively patterned electrophysiological recordings. In lateral prefrontal cortex, parallel activation dynamics of multiple neural ensembles strikingly matches the parallel dynamics predicted by CQ theory. An extended CQ simulation model--the N-STREAMS neural network model--exemplifies ongoing attempts to accommodate a broad range of both behavioral and neurobiological data within a CQ-consistent theory.     

Belongingness as a core personality trait: how social exclusion influences social functioning and personality expression

People have a fundamental need for positive and lasting relationships. This need to belong is rooted in evolutionary history and gave rise to the development of traits that enable individuals to gain acceptance and to avoid rejection. Because belongingness is a core component of human functioning, social exclusion should influence many cognitive, emotional, and behavioral outcomes and personality expression. This article summarizes recent evidence that social exclusion causes an assortment of outcomes, many of which depend on whether the excluded can gain acceptance or forestall possible distress. It highlights common overlap in physical and social pain systems and how a physical painkiller can reduce the pain of social exclusion. Finally, it shows how social exclusion moderates the effects of traits on cognition, emotion, and behavior. To appreciate personality processes in social contexts, scientists should consider how people respond to social exclusion and how the need to belong influences personality expression.     

Masculine traits and reports of social functioning: Evidence for a positivity bias

Sex Roles - Previous reviews have concluded that there is a significant positive relation between masculine traits and measures of adjustment, including social adjustment. It is suggested that this...     

Family functioning and the social adaptation of hearing-impaired youths

This study examined the associations between important aspects of family functioning and the adjustment of hearing-impaired youths. Participants were 75 hearing-impaired youths and their hearing parents. The dependent variables were mothers' and fathers' ratings of child behavior problems and social competence. Independent variables included parental symptomatology, parental ratings of family stress, and family members' perceptions of family cohesion and family adaptability. Demographic characteristics and the youth's degree of hearing loss and mode of communication were used as control variables. Results from multiple regression analyses showed that parental ratings of the youths' behavior problems were linked with parental symptomatology, and that maternal ratings of the youths' behavior problems were associated with low family adaptability. Parental ratings of the youths' social competence were predicted by family stress. Overall, key aspects of family functioning accounted for considerably more variance than did the control variables. The methodological and conceptual implications of the findings are discussed.     

Exposure to intimate partner violence and children's psychological adjustment,cognitive functioning,and social competence: A review

Research over the past 30 years has established that exposure to intimate partner violence poses significant risks to children's adjustment and functioning. It is also clear, however, that there is considerable variability in children's outcomes, and research in the past decade has increasingly focused on understanding this variability. This paper provides a review of recent research that examines relations between children's exposure to intimate partner violence and their psychological adjustment, cognitive functioning, and social competence. Emphasis is placed on studies that examine risk and protective factors for children's functioning in the context of exposure to intimate partner violence. In addition to highlighting strengths of recent studies, limitations of existing research and future directions are considered.     

Efficacy of the third wave of behavioral therapies: a systematic review and meta-analysis

During the last two decades a number of therapies, under the name of the third wave of cognitive behavior therapy (CBT), have been developed: acceptance and commitment therapy (ACT), dialectical behavior therapy (DBT), cognitive behavioral analysis system of psychotherapy (CBASP), functional analytic psychotherapy (FAP), and integrative behavioral couple therapy (IBCT). The purposes of this review article of third wave treatment RCTs were: (1) to describe and review them methodologically, (2) to meta-analytically assess their efficacy, and (3) to evaluate if they currently fulfil the criteria for empirically supported treatments. There are 13 RCTs both in ACT and DBT, 1 in CBASP, 2 in IBCT, and none in FAP. The conclusions that can be drawn are that the third wave treatment RCTs used a research methodology that was significantly less stringent than CBT studies; that the mean effect size was moderate for both ACT and DBT, and that none of the third wave therapies fulfilled the criteria for empirically supported treatments. The article ends with suggestions on how to improve future RCTs to increase the possibility of them becoming empirically supported treatments.     

A review of online social networking profiles by adolescents: implications for future research and intervention

This study explored content posted and interactions taking place on adolescent online social networking profiles. Although "blogging" continues to soar in popularity, with over half of teenagers online participating in some form, little research has comprehensively explored blog communication within the context of adolescent development. Content was qualitatively coded from 100 randomly selected profiles authored by adolescents between the ages of 16 and 18. Rich thematic elements were identified including family and social issues, risk behaviors, disclosure of personally identifiable information, and frequent peer interaction. Results indicate adolescent blogs frequently contain appropriate images, positive comments about parents and peers, athletics, a variety of risk behaviors, and sexual and profane language. In addition, school type was examined (public versus private, religious) as a potential factor in understanding the differences in content posted by adolescents; however, no significant differences were found. Implications for parental monitoring and intervention are discussed as well as direction for future research. Adolescents' online profiles contain a wealth of intimate, candid, and publicly available information on a wide range of social issues pertinent to adolescence that contribute to the understanding of adolescent development and well-being.     

Parent-adolescent relations and adolescent functioning: self-esteem, substance abuse, and delinquency

The present study examined parental support and monitoring as they relate to adolescent outcomes. It was hypothesized that support and monitoring would be associated with higher self-esteem and less risky behavior during adolescence. The diverse sample included 16,749 adolescents assessed as part of the National Educational Longitudinal Study. Both high parental support and parental monitoring were related to greater self-esteem and lower risk behaviors. The findings partially confirm, as well as extend, propositions in attachment theory.     

Courtesy stigma: the social implications of associating with a gay person

We investigated the operation of courtesy stigma with American male college students who reacted to a fictitious male student described as gay, rooming by choice with a gay male student, involuntarily assigned to room with a gay, or rooming with a male heterosexual. Among respondents who expressed strong intolerance of gays, the voluntary associate of a gay was perceived as having homosexual tendencies and as possessing the same stereotyped personality traits attributed to a gay. No such courtesy stigma was attached to the involuntary associate of a gay by these respondents. Relatively tolerant respondents engaged in no courtesy stigmatization at all. Thus, courtesy stigmatization occurred only under circumscribed conditions and appeared to depend more on the tendency of highly intolerant individuals to infer that a male student who apparently liked a gay individual was himself gay than on a motivation to maintain cognitive consistency.     

Variations in internet-related problems and psychosocial functioning in online sexual activities: implications for social and sexual development of young adults.

This survey of 760 university students examined differences in Internet-related problems and psychosocial functioning between four patterns of participation in online sexual information and entertainment activities. Students who did not participate in either online sexual activity were more satisfied with their offline life and more connected to friends and family. Those who engaged in both online sexual activities were more dependent on the Internet and reported lower offline functioning. Students who only sought sexual information maintained strong offline affiliations. Those who only sought entertainment did not report lower offline functioning. Respondents most deficient in offline social support did not report compensatory online support. Despite students' common participation in online sexual activities (OSA) as a venue for social and sexual development, those relying on the Internet and the affiliations it provides appear at risk of decreased social integration. The authors discussed the finding's implications for social and sexual development.     

Neuropsychological functioning and social functioning of survivors of pediatric brain tumors: evidence of nonverbal learning disability.

The purpose of the study was to examine if survivors of pediatric brain tumors exhibit a pattern of performance consistent with nonverbal learning disability (NVLD) and to explore the relationship between neuropsychological and social functioning in these children. A comprehensive neuropsychological battery and objective measures of psychosocial function designed to assess NVLD were administered to 15 survivors of brain tumors, ages 8-12 years. Despite the small sample size, a trend for better verbal skills compared to nonverbal skills was found using composite scores. Parents reported significant social deficits and a tendency for greater internalizing behavior problems as expected in NVLD. Additionally, there was a trend for a positive association between nonverbal scores and social function. Further research is needed to determine if the NVLD pattern observed is attributable to white matter damage of the right hemisphere. Routine neuropsychological and psychosocial assessment and intervention are indicated.