Creative personality in schizophreniform disorder.

This paper sets forth the contention that a schizophreniform disorder can enhance creativity. Given the usual brief duration of no more than six months, this disorder may enable the resilient ego of a creative person to descend temporarily into the symbolic sea of the unconscious. With such broadening of the person's symbolic experience in the unconscious, in the postpsychotic period the person may be able to forge symbols into novel concepts through a cohesive ego restored to homeostasis.     

Early maladaptive schemas of personality disorder subtypes.

This investigation attempted to examine the cognitive schemas of five distinct clusters that emerged from a cluster analysis of the personality disorder scales of the Millon Clinical Multiaxial Inventory-II (Millon, 1987). Specifically, the degree to which early maladaptive schemas, as measured by the Cognitive Schema Questionnaire-Short Form (Young, 1994), could correctly identify empirically derived patterns of personality disorders was examined. Between-cluster differences centered on five personality components and five schemas. Discriminant analyses revealed two significant functions composed of cognitive schemas, which correctly identified 61.2% of the entire sample in terms of cluster group membership. The total proportion of variance in the two significant functions associated with cluster group differences was 76.8%. Findings are discussed in relation to the domain theory of personality disorders posited by Millon and Davis (1996).     

Treatment of a biracial child with schizophreniform disorder: cultural formulation

Over the past several years, the field of psychiatry has shown a higher level of cultural sensitivity and an increasing interest in the role of cultural factors in mental health. This has been notably reflected in the incorporation of cultural considerations, such as an outline for cultural formulation and a glossary of culture-bound syndromes, in the Diagnostic and Statistical Manual of Mental Disorders (4th ed., DSM-IV; American Psychiatric Association, 1994). This case report is illustrative of the significance of considering cultural elements in diagnosing and treating a psychiatric disorder. It is also the first-known detailed case report on fakamahaki, a culture-bound syndrome from the Kingdom of Tonga. The syndrome is described in a child from the perspective of a child psychiatry fellow. To serve as a teaching case for clinicians in training as well as those in practice, the DSM-IV outline for cultural formulation has been used. This case can be helpful in educating others in the mental health field about the utility of a more comprehensive approach to understanding clients in contrast to the growing trend of very focused approaches.     

Diagnostic differences in social anhedonia: a longitudinal study of schizophrenia and major depressive disorder

This study examined the hypothesis that, in schizophrenia, elevated trait social anhedonia (SA) is a stable individual difference, whereas in depression, increased SA is a reflection of a current clinical state that will diminish with recovery. Differences in trait Negative Affect (NA) and Positive Affect (PA) were also examined. Individuals with schizophrenia (n = 55) and depression (n = 34) were evaluated at baseline during hospitalization and compared with nonpsychiatric control participants (n = 41). Participants were assessed again at a 1-year follow-up. At baseline, compared with control participants, individuals with schizophrenia and depression were both characterized by elevated SA, greater NA, and lower PA. In schizophrenic individuals, elevated SA remained stable over the follow-up. However, in recovered depressed patients, SA declined over the follow-up period. Group differences remained in NA and PA over the 1-year follow-up. These results support the view that elevated SA is enduring in schizophrenia but that elevated SA is transiently related to clinical status in depression.     

高风险婴儿前瞻性纵向研究与孤独症谱系障碍早期识别

孤独症谱系障碍(Autism Spectrum Disorder, ASD)早期识别有助于早期诊断和早期干预的实施, 对于改善ASD儿童发育结果至关重要。高风险前瞻性纵向研究以高风险婴儿(ASD儿童的年幼同胞, 入组年龄小于12个月)作为主要研究对象, 通过对ASD高风险婴儿(24至36个月之间诊断为ASD的高风险婴儿)的早期发育轨迹的描绘和核心症状早期表现的识别, 为ASD早期识别提供了重要依据。未来可以增加被试数量、延长观察时间并密集观察时间点、关注伴发障碍、综合考虑遗传、环境和文化因素影响, 并结合早期干预研究进行深入探索。未来在中国开展相关研究具有重要的科学价值和临床意义。     

Attributions and affective reactions of family members and course of schizophrenia.

The authors tested an attribution-affect model of schizophrenic relapse attending to the role of families' positive affect (warmth) and negative affect (criticism). Coders listened to interviews of 40 family members taken from C. E. Vaughn, K. S. Synder, S. Jones, W. B. Freeman, and I. R. Falloon (1984) and rated their attributions of controllability for the symptoms and behaviors of their relatives with schizophrenia. For family members not designated as emotionally overinvolved, perceptions that their ill relatives' symptoms and behaviors were under the patients' control were related to family members' warmth and criticism and to patients' clinical outcomes. Of the affective reactions, only criticism predicted outcome. In addition, patients' use of street drugs was related to attributions, criticism, and outcome. Together these findings suggest that families' attributions and criticism are important in understanding the relationship between family factors and course of illness.     

Social phobia: a comparison of specific and generalized subtypes and avoidant personality disorder.

The validity of the social phobia subtype distinction was examined in a large sample of carefully diagnosed social phobics (N = 89). Generalized and specific subtypes were diagnosed reliably, and the generalized subtype showed a consistent pattern of greater symptom severity than did the specific subtype. In addition, generalized social phobics with and without avoidant personality disorder were compared, and a difference was found for only 1 of 4 parameters. The results are discussed in terms of the validity of subtyping in social phobia and the diagnostic boundary between social phobia and avoidant personality disorder.     

Social support and the course of bipolar disorder

The current study prospectively examined the impact of social support on symptom severity and recovery from episodes in bipolar disorder, both as a direct influence and as a buffer of life events. Fifty-nine individuals with Bipolar I disorder were followed longitudinally with monthly symptom severity interviews. Social support was measured by the Interpersonal Support Evaluation List and the Interview Schedule for Social Interaction, and life events were assessed using the Life Events and Difficulties Schedule. Individuals with low social support took longer to recover from episodes and were more symptomatic across a 6-month follow-up. Results suggest a polarity-specific effect, in that social support influences depression but not mania. Discussion focuses on theoretical implications of a series of polarity-specific findings within the field.     

Cognitive discernible factors between schizophrenia and schizoaffective disorder

BackgroundSchizophrenia (SZ) and schizoaffective disorders (SA) are associated with cognitive deficits. Generally, a schizoaffective diagnosis is associated with better prognosis on the level of social integration. It is also well established that cognition is an important factor for good social outcome in schizophrenia. We hypothesized that, although patients suffering from SA share symptoms with SZ, they can be differentiated on the basis of neurocognitive function and that SA perform better in several domains.MethodPerformances of two groups SA (N = 13) and SZ (N = 44) were compared on several visual-motor tasks using CANTAB [Motor Screening (MOT), Reaction Time (RTI), Paired Associates Learning Task (PAL), and Stockings of Cambridge items (SOC)]. The two groups were matched for symptom severity. ANOVA with repeated measures was employed to determine whether any difference in cognitive scores during a 2-year period was significantly related to the diagnostic status.ResultsA significant and durable difference was observed between SZ and SA on motor screening and explicit memory tests where SA performed better.ConclusionNeurocognitive tests may be relevant for distinguishing schizoaffective from schizophrenia, chiefly via tests tapping into visuo-spatial and visuo-motor coordination abilities (e.g., paired associated learning and motor screening).     

Cognitive discernible factors between schizophrenia and schizoaffective disorder

BACKGROUND: Schizophrenia (SZ) and schizoaffective disorders (SA) are associated with cognitive deficits. Generally, a schizoaffective diagnosis is associated with better prognosis on the level of social integration. It is also well established that cognition is an important factor for good social outcome in schizophrenia. We hypothesized that, although patients suffering from SA share symptoms with SZ, they can be differentiated on the basis of neurocognitive function and that SA perform better in several domains. METHOD: Performances of two groups SA (N = 13) and SZ (N = 44) were compared on several visual-motor tasks using CANTAB [Motor Screening (MOT), Reaction Time (RTI), Paired Associates Learning Task (PAL), and Stockings of Cambridge items (SOC)]. The two groups were matched for symptom severity. ANOVA with repeated measures was employed to determine whether any difference in cognitive scores during a 2-year period was significantly related to the diagnostic status. RESULTS: A significant and durable difference was observed between SZ and SA on motor screening and explicit memory tests where SA performed better. CONCLUSION: Neurocognitive tests may be relevant for distinguishing schizoaffective from schizophrenia, chiefly via tests tapping into visuo-spatial and visuo-motor coordination abilities (e.g., paired associated learning and motor screening).     

Expressed emotion and sociocultural moderation in the course of schizophrenia

This study examined whether the sociocultural context moderates the relationship between families' expressed emotion (EE) and clinical outcomes in schizophrenia. In a sample of 60 Mexican American caregivers and their ill relatives, we first assessed whether EE and its indices (criticism, emotional overinvolvement [EOI], and warmth) related to relapse. Second, we extended the analysis of EE and its indices to a longitudinal assessment of symptomatology. Last, we tested whether bidimensional acculturation moderated the relationship between EE (and its indices) and both relapse and symptom trajectory over time. Results indicated that EOI was associated with increased relapse and that criticism was associated with increased symptomatology. Additionally, as patients' Mexican enculturation (Spanish language and media involvement) decreased, EE was increasingly related to relapse. For symptomatology, as patients' U.S. acculturation (English language and media involvement) increased, EE was associated with increased symptoms longitudinally. Our results replicate and extend past research on how culture might shape the way family factors relate to the course of schizophrenia.     

Visual event-related potentials in schizotypal personality disorder and schizophrenia

Schizophrenia (SZ) occurs among a spectrum of disorders with similar characteristics, including schizotypal personality disorder (SPD). Visual processing disturbances have been reported in both disorders, but it is not yet clear which processes are disturbed in both SZ and SPD, suggestive of a common endophenotype, and which appear only in SZ. In order to address this question, the authors evaluated visual event-related potentials (ERPs) elicited during a line-orientation discrimination task in control, SPD, and SZ participants. Visual ERPs allow specification of both the time course and physiological correlates of visual perception and cognition. SZ patients had smaller P100 and P300a amplitudes and prolonged P300b latency compared to the control group. SZ patients also had smaller N160, N200, P300a, and P300b amplitudes compared to the SPD group. SPD participants did not differ from control participants on any ERP measure. These data documented pervasive abnormalities in visual perception and attention in SZ but not in SPD, suggesting that these visual ERP disturbances may not represent a common endophenotype.     

Cognitive process-based subtypes of developmental coordination disorder (DCD)

The purpose of the study was to identify the cognitive subtypes demonstrated by children with developmental coordination disorder (DCD) using the Planning-Attention-Simultaneous-Successive Processing (PASS) theory and the Cognitive Assessment System (D-N CAS). Participants were 108 children aged 5- and 6-years old, 54 with DCD and 54 without DCD, all attending typical kindergartens. They were examined on 31 cognitive-motor variables. Hierarchical-agglomerative and iterative partitioning cluster analyses including 9 motor and 7 cognitive variables revealed the following six subtypes:

• oC1 = children at risk (having considerable difficulty with jumping and minor difficulty with manual dexterity and simultaneous coding);
• oC2 = children on the mean (all cognitive-motor scores close to the mean);
• oC3 = free from cognitive-motor problems (all scores above average);
• oC4 = manual dexterity, planning and simultaneous coding difficulties;
• oC5 = manual dexterity, dynamic balance, and planning difficulties;
• oC6 = generalized cognitive-motor dysfunction (all scores considerably below average).

It is well known that DCD is a heterogeneous condition. However, whenever cognitive processes were lower than average, cognitive-motor relationship was evident in subgroups C1, C4, C5 and C6. Early identification of task-specific cognitive-motor difficulties may be essential for early educational intervention practices in order to anticipate and improve learning, academic and performing difficulties.     

Differential effects of safety behaviour subtypes in social anxiety disorder

Clinical observations indicate that individuals with Social Anxiety Disorder (SAD) use a variety of safety behaviours; however, virtually no research has examined the functional effect of different safety-seeking strategies. Accordingly, we conducted two studies to address this issue. Study 1 measured global patterns of safety behaviour use in a large analogue sample. Factor analysis revealed two primary safety behaviour categories, avoidance and impression management. Study 2 assessed situational use of safety behaviours during a controlled social interaction in a clinical sample of 93 patients with Generalised SAD. Factor analysis again revealed support for avoidance and impression-management subtypes. Notably, the two types of safety behaviours were associated with different social outcomes. Avoidance safety behaviours were associated with higher state anxiety during the interaction and negative reactions from participants’ interaction partners. Impression-management strategies appeared to impede corrections in negative predictions about subsequent interactions. These findings suggest that it may be beneficial to consider the unique effects of different safety-seeking strategies when assessing and treating SAD.     

Developmental coordination disorder: a review of research on subtypes and comorbidities

The interest in Developmental Coordination Disorder (DCD) has grown considerably over the last decade. Nevertheless, its etiology and prognosis are still poorly understood. The idea is growing that DCD may not be a uniform disorder. This review summarizes research on DCD, with a particular focus on subtype and comorbidity studies. The main message of the paper is that, in order to understand the etiology and prognosis of DCD, we need to have a better understanding of its nature. This requires an awareness of the existence of subtypes and comorbidities. Current theories on comorbidity phenomena are discussed in terms of their possible merit for the development of the field. Particular attention is given to the Automatization Deficit Hypothesis, a theory based on research on dyslexia.     

Trauma and posttraumatic stress disorder in people with schizophrenia

This study evaluated the hypothesis that trauma and posttraumatic stress disorder (PTSD) severity would be positively associated with schizophrenia symptoms. Forty-seven clients with schizophrenia were assessed for schizophrenia severity and for lifetime trauma history and PTSD symptoms in 2 independent symptom interviews; 35 (74%) participants reported at least 1 event in which there was threat of harm or life threat and subjective distress, and 6 (13%) had current PTSD. Trauma across the life span was associated with greater severity of PTSD. Within the total sample, PTSD symptoms were associated with greater emotional distress, but not with schizophrenia-specific symptoms. Distress among clients with schizophrenia and PTSD suggests the need for routine assessment of PTSD and development of PTSD interventions in this population.     

Hemispheric processing of idioms in schizophrenia and autism spectrum disorder

Studies conducted on individuals with schizophrenia (SZ) and autism spectrum disorder (ASD) show that they find it difficult to comprehend figurative language, and have a tendency to interpret it literally. This study examines hemispheric processing of idioms in patients with SZ, in comparison to individuals with ASD. Seventeen adults with SZ and 18 adults with ASD participated in the study. The two clinical groups were matched in age, vocabulary scores and verbal executive function scores. Using the divided visual field paradigm, the participants performed a lexical decision task for a target word related to either a literal or a figurative interpretation of an idiom. Whereas SZ patients showed the typical right lateralisation for non-salient literal interpretations of idioms, adults with ASD showed atypical bilateral processing. These findings indicate different hemispheric lateralisation in idiom processing in the two clinical groups.