Prospective memory,working memory,planning, and attention in schizophrenia and bipolar disorder: A comparative study

There is a need to study prospective memory (PM) and its relationship with aspects of frontal lobe functioning in schizophrenia and bipolar disorder. The study aims to investigate event‐based (EB) and time‐based (TB) PM functioning in the two groups, and its association with working memory, planning, and attention. A word categorisation task was developed to assess PM functioning among 90 participants (schizophrenia, bipolar disorder, and a control group). Frontal lobe functioning was assessed using Tower of London, N‐Back test, and triads test. Mean comparisons revealed significantly higher impairment in TB PM in comparison to EB PM in both the clinical groups. Significant relationship between PM and frontal lobe impairment was found. Relationship between PM and frontal lobe deficits in the clinical groups emphasises the need to include its assessment at an early stage and to develop PM rehabilitation strategies to improve the quality of living.     

Factor solutions of the Social Phobia Scale (SPS) and the Social Interaction Anxiety Scale (SIAS) in a Swedish population

Culturally validated rating scales for social anxiety disorder (SAD) are of significant importance when screening for the disorder, as well as for evaluating treatment efficacy. This study examined construct validity and additional psychometric properties of two commonly used scales, the Social Phobia Scale and the Social Interaction Anxiety Scale, in a clinical SAD population (n?=?180) and in a normal population (n?=?614) in Sweden. Confirmatory factor analyses of previously reported factor solutions were tested but did not reveal acceptable fit. Exploratory factor analyses (EFA) of the joint structure of the scales in the total population yielded a two-factor model (performance anxiety and social interaction anxiety), whereas EFA in the clinical sample revealed a three-factor solution, a social interaction anxiety factor and two performance anxiety factors. The SPS and SIAS showed good to excellent internal consistency, and discriminated well between patients with SAD and a normal population sample. Both scales showed good convergent validity with an established measure of SAD, whereas the discriminant validity of symptoms of social anxiety and depression could not be confirmed. The optimal cut-off score for SPS and SIAS were 18 and 22 points, respectively. It is concluded that the factor structure and the additional psychometric properties of SPS and SIAS support the use of the scales for assessment in a Swedish population.     

Patient preferences for medicine administration for acute agitation: results from an internet-based survey of patients diagnosed with bipolar disorder or schizophrenia in two Nordic countries

The objective was to elicit patient preferences for medicine administration method in the management of acute agitation episodes among patients diagnosed with bipolar disorder or schizophrenia. The patients’ experiences of acute agitation episodes and their management of episodes were also explored. Data were collected via an anonymous, internet-based survey of residents in Denmark or Sweden with schizophrenia or bipolar disorder (October 2014 to December 2014). Inclusion criteria were having a diagnosis of schizophrenia or bipolar disorder, and being above 18 years of age. The questionnaire included questions about preferences for medication attributes, experiences with pharmacological treatment for agitation and involvement in treatment plans. A total of 237 diagnosed patients (61 with schizophrenia; 176 with bipolar disorder) completed the questionnaire. Agitation episodes were experienced by 90% of the respondents. In total, 83% of the respondents reported having received treatment with tablets. When patients were presented with the attributes of an inhalation method, respondents stated that the fast onset of action, low risk of adverse reactions and least invasive form of drug delivery were positive attributes of treatment with inhalation. Inhalation is a new delivery route for treatment of acute agitation in patients diagnosed with bipolar disorder or schizophrenia. Inhalation is the preferred treatment method for acute agitation among Danish and Swedish patients with bipolar disorder or schizophrenia.     

Psychometric properties of the Norwegian version of the Dysfunctional Attitude Scale (Form A)

The present study reports the reliability and validity of the Norwegian version of the Dysfunctional Attitude Scale in non‐clinical and clinical populations. The participants were 344 young male military recruits, 41 healthy controls and 142 psychiatric outpatients. All the participants completed the Dysfunctional Attitude Scale, the Beck Depression Inventory and the Automatic Thoughts Questionnaire. The analysis of the Dysfunctional Attitude Scale revealed a Cronbach's alpha of 0.85, indicating satisfactory reliability. Evidence for the construct validity was obtained by the correlation between the Dysfunctional Attitude Scale and the Beck Depression Inventory (r?=?0.47) and the Dysfunctional Attitude Scale and the Automatic Thoughts Questionnaire (r?=?0.47). Finally, the Dysfunctional Attitude Scale significantly discriminated between clinically depressed, non‐depressed psychiatric patients and healthy controls. The results showed that the Norwegian version of the Dysfunctional Attitude Scale possess satisfactory psychometric properties suggesting that this instrument is appropriate for use as a cognitive measure in a Norwegian cultural context.     

Comparing neurocognitive impairment in schizophrenia and bipolar I disorder using the Screen for Cognitive Impairment in Psychiatry Scale

The purpose of this study was to compare the psychometric properties of the Screen for Cognitive Impairment in Psychiatry (SCIP) when applied to patients diagnosed with schizophrenia (n = 126) or bipolar I disorder (n = 76), and also to compare the cognitive impairment in both samples of patients and a control group (n = 83) using the SCIP and a complete neuropsychological battery. The SCIP is a scale intended to quickly and easily assess cognitive impairment in patients with severe psychiatric disorders. The results showed firstly that, in terms of internal consistency, temporal stability, dimensional structure, and criterion-referenced validity, the SCIP provides reliable and valid scores at an equivalent level in both schizophrenia and bipolar I disorder samples. Secondly, it showed that differential cognitive impairment between the two patient groups occurs only in verbal memory, although the effect size of the difference is small. Finally, compared with the control group, cognitive impairment was present at all levels in both groups of patients using both the SCIP and the neuropsychological battery, which indicates that the SCIP is a good screening tool for cognitive deficits in schizophrenia and bipolar and useful in clinical practice for healthcare professionals.     

Fast screening of eating disorders among patients with bipolar disorder: Validation of the French version of BEDS questionnaire

IntroductionThe prevalence and morbidity of eating disorders (ED) is high in patients with bipolar disorder (BD). Simple tools are necessary to easily and rapidly screen for ED in bipolar patients.ObjectiveThe aim of this study was to validate the French version of Bipolar Eating Disorder Scale (BEDS-F).MethodED and BD diagnoses were established with a structured-interview in 80 patients according to the DSM-IV criteria. The BEDS was translated into French using appropriate methods. Patients were administered the following scales: BEDS-F, SCOFF, Bulimic Investigatory Test Edinburgh (BITE) and Eating Disorder Inventory-two (EDI-2).ResultsBEDS-F score were significantly higher in bipolar patients with ED. The BEDS-F showed high feasibility (no omission response), excellent discriminating abilities (ROC AUC = 0.97) with a sensibility of 98% and specificity of 85% for BEDS ≥ 11, high internal consistency (Cronbach's alpha coefficient = 0.86) and test-retest reliability (ICC = 0.99). No floor/ceiling effect was observed. The BEDS-F sensitivity was equivalent to that of the BITE and EDI-2 subscale B. The BEDS-F specificity was slightly lower than that of the EDI-2 subscale B, but equivalent to that of BITE.ConclusionThe BEDS-F is a valid scale for fast ED screening in patients with bipolar disorder, and easier to administer than other currently used scales.     

Religion and spirituality in the context of bipolar disorder: a literature review

Religion and spirituality (R/S) may play an important role for individuals with bipolar disorder (BD) by providing a means of coping with, and an explanatory model for, their disorder. We conducted a systematic review of empirical studies that have explored R/S in individuals with BD or samples that explicitly delineate individuals with BD. Only six studies met our inclusion criteria. Findings from these studies suggest that R/S strategies may be important for some people in the management of BD. Religion and spirituality thus become relevant concerns for a therapeutic regime that seeks to develop wellness within a bio-psycho-social model. However, the limited body of research and methodological shortcomings of existing research make it difficult to draw relevant conclusions about how this might be accomplished. The authors propose a need for longitudinal, prospective, mixed methods research in order to inform evidence-based practice.     

National Norms and Life-Event Frequencies for the Revised Social Readjustment Rating Scale

The revised 51-event Social Readjustment Rating Scale (SRRS) was administered to a representative national sample of 5,000 in order to construct and interpret norms for overall scale scores and life-event frequencies. Directions asked for the frequency of each life-event during the previous 12 months. Life-event frequencies for each subject were multiplied by previously determined stressfulness ratings to produce an overall scale score. Norms for overall scale scores and life-event frequencies were calculated. A total of 3,399 completed surveys were returned (68%). The distribution of overall scale scores had a mean of 278, standard deviation of 422, and marked positive skewness of 4.12. Five of the top 10 most frequently occurring life-events were directly related to work. The normative information concerning overall scores on the revised Social Readjustment Rating Scale can be invaluable in understanding and interpreting individual scores, as well as diagnosing or identifying at-risk individuals with high scores who would likely benefit from stress management interventions.     

Validation of the German version of the Driver Skill Inventory (DSI) and the Driver Social Desirability Scales (DSDS)

The psychometric properties of the new German versions of the Driver Skill Inventory (DSI) and the Driver Social Desirability Scales (DSDS) were examined. The DSI is a self-report measure assessing perceptual-motor skills and the safety motive as two important aspects of driving behavior. Self-report measures, however, are susceptible to socially desirable responding (SDR) which is why both general and specific driving-related SDR scales have been developed: Based on the Balanced Inventory of Desirable Responding (BIDR), the DSDS taps Driver Impression Management and Driver Self-Deception as two important aspects of SDR. In two validation studies with less experienced (N = 130) and experienced drivers (N = 1199), both inventories showed the expected two-factor structure and satisfactory internal consistency. In Study 1, self-ratings were compared with and confirmed by peer-ratings. In both studies, we accumulated evidence of convergent and discriminant validity for the German version of the DSI by correlating it with demographic, driving-specific, and personality measures, including the Big Five, Type A behavior, and sensation seeking. The DSI seemed to be only marginally contaminated by SDR.     

The Relationship Between the Child and Adolescent Functional Assessment Scale (CAFAS) and Indicators of Functioning

We investigated the relationship between scores on the Child and Adolescent Functional Assessment Scale (CAFAS) and several indicators of functioning assessed in the national evaluation of the demonstration grants funded by the Center for Mental Health Services System of Care Initiative. The sample included 3187 youths, ranging in age from 4 to 23, with serious emotional disturbance (SED) who were evaluated at intake. At 6 month post-intake, 873 of these youths were re-evaluated. As predicted, higher CAFAS scores were associated with previous psychiatric hospitalization, more serious psychiatric diagnoses, and more restrictive living arrangements. Youths in residential inpatient settings were significantly more impaired than youths living in their own home or in regular foster care. Below average school performance, poor attendance, and contact with law enforcement personnel were also associated with greater impairment. Youth's total CAFAS scores decreased significantly from intake to 6 months. These results indicate that the CAFAS is a measure of functioning which has both statistical and clinical significance.     

Validation of the Preschool and Early Childhood Functional Assessment Scale (PECFAS)

Efforts to determine the prevalence of serious emotional disturbance in preschool-aged children have been hampered by the lack of a validated measure. The Preschool and Early Childhood Functional Assessment Scale (PECFAS) is a multi-dimensional measure that assesses the psychosocial functioning of children aged 3–7 years. The concurrent validity and reliability of the PECFAS were assessed in a sample of 30 preschool-aged children in a large Head Start program in Ventura, California. PECFAS ratings based on in-depth interviews were significantly related to parental ratings that the children had mental health problems, psychiatric diagnoses, teacher ratings of the child's need for mental health evaluations, teacher ratings of behavior problems on a standardized screening inventory (DIAL-R), and actual referrals for mental health evaluations. Interrater reliability for the total PECFAS score was high (r = .90) as was internal consistency of the five subscales (alpha = .86). Using the PECFAS scores as a standard, the weighted prevalence of serious emotional disturbance in this West Coast Head Start program was 17%, at the lower end of the current estimated rate of SED for older children in low income samples (18–26%).     

Social adjustment in the offspring of parents with bipolar affective disorder

The social adjustment of the adolescent offspring of parents with bipolar affective disorder (n=41) was compared to that of the offspring of parents with nonaffective psychiatric disorders (n=22) and the offspring of normal controls (n=26). In addition, the relationship between social adjustment and cyclothymia in offspring was determined. Social adjustment was assessed using the Life Activities Inventory, a new measure developed to assess social functioning in adolescents and young adults. Cyclothymia was assessed with the General Behavior Inventory. As a group, the offspring of bipolar parents did not differ significantly from either control group on social adjustment. However, the cyclothymic offspring of bipolar parents exhibited significantly poorer social adjustment than the noncyclothymic offspring of bipolars and the offspring of psychiatric and normal controls. These findings suggest that poor social functioning in the adolescent offspring of parents with bipolar illness may be associated with the early manifestations of affective disorder. In addition, these data indicate that despite its subsyndromal intensity, cyclothymia can result in significant social impairment.This study was supported in part by National Institute of Mental Health (NIMH) Research Grant MH-39782 to Daniel N. Klein and NIMH Grants MH-33083 and MH-37195 to Richard A. Depue.     

Stressful Life Events: A Revision and Update of the Social Readjustment Rating Scale

The widely used and cited Social Readjustment Rating Scale developed by Holmes and Rahe (1967) was comprehensively revised and updated. The new instrument, containing 51 major life events, was administered to a national sample of 5000. Respondents were asked to rate the stressfulness of each life event on a 1–100 scale. Completed surveys were returned by 3122 individuals (62.4%). Responses were analyzed using repeated measures MANOVA and profile analysis. Major results included: (a) statistically and practically significant differences in mean ratings for the 51 life events; (b) five overlapping themes in the top 20 rated life events—death and dying, healthcare, crime and the criminal justice system, financial/economic issues, and family-related issues; and (c) an amazing level of agreement concerning perceived life event stressfulness, regardless of gender, age, or income level.     

A New Scrupulosity Scale for the Dimensional Obsessive-Compulsive Scale (DOCS): Validation With Clinical and Nonclinical Samples

Scrupulous obsessions are a prominent presentation of obsessive-compulsive disorder (OCD). Previous conceptualizations of scrupulosity have indicated that it belongs to the unacceptable thoughts dimension, which pertains to sexual, violent, and religious obsessive themes. However, research suggests that scrupulous symptoms may differ from other unacceptable thoughts symptoms, necessitating the need for targeted and thorough assessment. We added a Scrupulous or Religious Thoughts subscale (DOCS-SR) to the Dimensional Obsessive-Compulsive Scale (DOCS) and tested its factorial structure, psychometric properties, and clinical correlates in a nonclinical and clinical sample. In the first study, nonclinical participants (N = 203) completed the DOCS-SR, which was subjected to an exploratory factor analysis. Analyses revealed that the DOCS-SR reflected a one-factor solution and possessed acceptable internal consistency, as well as strong convergent validity with clinical correlates of OCD. In the second study, we administered the DOCS, as well as the DOCS-SR to a clinical sample (N = 314). An exploratory factor analysis and confirmatory factor analysis both suggested that the four subscales and additional DOCS-SR represented a five-factor solution. Internal consistency and convergent validity were strong. The DOCS Unacceptable Thoughts subscale and the DOCS-SR shared a moderate correlation but evidenced differences in associations with other correlates. This suggested both convergent and divergent validity. Collectively, our results support the utility of examining the individual components of the unacceptable thoughts dimension of OCD for effective assessment and treatment planning.     

Designing a brief measure of social anxiety: Psychometric support for a three-item version of the Interaction Anxiousness Scale (IAS-3)

Although social situations are enjoyable for most people, they cause extreme anxiety in others. To better understand individual differences in social anxiety, researchers have designed scales, such as the 15-item Interaction Anxiousness Scale (IAS; Leary, 1983), to measure people’s anxiousness in social situations. Despite the importance of measuring social anxiety, many research settings that require time or space constraints (e.g., field, longitudinal, daily diary studies) cannot always accommodate a 15-item scale. To address this problem, the current research aimed to create and validate a three-item version of the IAS. Studies examined the psychometric properties of a three-item measure of social anxiety (IAS-3). After choosing the best three items using item response theory methods (Study 1), we examined the IAS-3’s (a) concurrent validity with the 15-item IAS in a student sample (Studies 1 and 2), (b) test–retest reliability across 4 months (Study 2), and (c) construct validity in a diverse international sample (Studies 3 and 4). Across all studies, the IAS-3 showed good reliability and validity, supporting its use in future research.     

Psychometric properties of the Norwegian version of the Dysfunctional Attitude Scale (Form A)

The present study reports the reliability and validity of the Norwegian version of the Dysfunctional Attitude Scale in non-clinical and clinical populations. The participants were 344 young male military recruits, 41 healthy controls and 142 psychiatric outpatients. All the participants completed the Dysfunctional Attitude Scale, the Beck Depression Inventory and the Automatic Thoughts Questionnaire. The analysis of the Dysfunctional Attitude Scale revealed a Cronbach's alpha of 0.85, indicating satisfactory reliability. Evidence for the construct validity was obtained by the correlation between the Dysfunctional Attitude Scale and the Beck Depression Inventory (r = 0.47) and the Dysfunctional Attitude Scale and the Automatic Thoughts Questionnaire (r = 0.47). Finally, the Dysfunctional Attitude Scale significantly discriminated between clinically depressed, non-depressed psychiatric patients and healthy controls. The results showed that the Norwegian version of the Dysfunctional Attitude Scale possess satisfactory psychometric properties suggesting that this instrument is appropriate for use as a cognitive measure in a Norwegian cultural context.     

Use of the Beck Scale for suicide ideation with psychiatric inpatients diagnosed with schizophrenia,schizoaffective, or bipolar disorders

To ascertain how useful the Beck Scale for Suicide Ideation (BSI; Beck & Steer, Manual for Beck Scale for Suicide Ideation (1991)) would be for assessing the severity of suicidal ideation in patients who were diagnosed with schizophrenia, schizoaffective, or bipolar disorders, 142 inpatients were asked to complete the BSI. Eight (6%) patients refused, and four patients (3%) were unable to complete the BSI because they were unable to concentrate. Of the 130 patients who completed the BSI, 53 (41%) had schizoaffective, 37 (28%) had paranoid schizophrenia, 30 (23%) had manic bipolar, and 10 (8%) had depressed bipolar disorders. The coefficient alpha for the BSI was .96, and its one-week test-retest reliability for a subsample of 15 inpatients was 0.88, p < 0.001. The BSI total scores were positively correlated with having ever attempted suicide, r = 0.46, p < 0.001. According to the BSI, 36 (28%) patients were classified as current suicide ideators. The results were discussed as supporting the use of the BSI with inpatients who are diagnosed with schizophrenia, schizoaffective, or bipolar disorders.     

An examination of the factorial dimensionality of the Marlowe Crowne Social Desirability Scale

Using a sample of 555 undergraduate students, the present study examined the factorial dimensionality of the Marlowe-Crowne Social Desirability Scale (MCSDS). In particular, using confirmatory factor analysis, the study explored the goodness of fit of both one and two factor models, the latter of which were based upon the work of Paulhus and Reid (1989). Findings indicate that while both one and two factor models demonstrate many features of adequate fit, the two factor model emerged as superior. The study concludes with a discussion of the meaning of the results and suggestions for future research.     

Social emotions and social cognition in the development of social anxiety disorder

ABSTRACT

Social anxiety disorder (SAD) is one of the most prevalent mental disorders with serious individual impairments and societal costs. Little is known about the mechanisms involved in SAD development. Here, I propose that dysregulated social emotions (social fear and shyness) are crucial for SAD development and that these dysregulated social emotions originate in the disturbances in socio-cognitive abilities. The research from our lab confirmed this. It showed that behavioural and physiological indices of social fear contribute to the development of SAD in toddlerhood and early childhood. Later in childhood, between ages 4.5 and 7.5, we found a new risk factor for SAD―dysregulated shyness. Specifically, we found that negative shy expressions and prolonged physiological blushing (temperature increase) contribute to SAD development. Whereas elevated fear may be rooted in deficits in socio-cognitive skills, dysregulated shyness may be rooted in advanced socio-cognitive abilities. These findings imply that dysregulated social emotions play an important role in SAD and should be explicitly targeted in clinical treatments of SAD.