Paranoia and Power Anxiety

Several previous studies of paranoid schizophrenia have provided only scattered support for Freud's notion that homosexual wishes and fears are the root of the difficulty. The present study was designed as a partial test of the broader theory that paranoid schizophrenia in men involves severe anxiety over aggression or assertion. The subjects were men and women in three categories: paranoid schizophrenic, nonparanoid schizophrenic, and people without any history of psychiatric trouble. Using a set of TAT cards portraying various situations of anger and aggression, it was found, as predicted, that paranoid schizophrenic men, and only paranoid schizophrenic men, show a defensive response. These findings are discussed in the context of traditional gender roles and other evidence about the paranoid style.     

Hemispheric processing deficits in patients with paranoid schizophrenia

The purpose of the present study was to investigate hemispheric deficits in individuals with paranoid schizophrenia on four kinds of tasks: dichoptic viewing tasks involving verbal and nonverbal visual stimuli, and dichotic listening tasks involving verbal and nonverbal auditory stimuli. As dependent measures, both accuracy and speed of (correct) responding were measured. The sample recruited for this study consisted of 18 patients with paranoid schizophrenia, 15 outpatients with anxiety disorders, and 20 controls with no history of psychiatric disorders. Results indicated that, relative to the controls, the paranoid schizophrenic patients were less accurate and less efficient on auditory-verbal tasks requiring right hemisphere processing. Unlike the controls the paranoid schizophrenic patients manifested a lateralized left hemisphere advantage.     

Hemispheric Processing Deficits in Patients with Paranoid Schizophrenia

The purpose of the present study was to investigate hemispheric deficits in individuals with paranoid schizophrenia on four kinds of tasks: dichoptic viewing tasks involving verbal and nonverbal visual stimuli, and dichotic listening tasks involving verbal and nonverbal auditory stimuli. As dependent measures, both accuracy and speed of (correct) responding were measured. The sample recruited for this study consisted of 18 patients with paranoid schizophrenia, 15 outpatients with anxiety disorders, and 20 controls with no history of psychiatric disorders. Results indicated that, relative to the controls, the paranoid schizophrenic patients were less accurate and less efficient on auditory-verbal tasks requiring right hemisphere processing. Unlike the controls, the paranoid schizophrenic patients manifested a lateralized left hemisphere advantage.     

Schizophrene Patienten der forensischen Psychiatrie im Vergleich zu schizophrenen Patienten der Allgemeinpsychiatrie

Background

The number of schizophrenic patients admitted to forensic hospitals according to section 63 of the German Criminal Code has increased continuously over the past years. Some researchers assume that these forensic patients form a group of patients with very complex mental disorders, a number of risk factors and insufficient pretreatment in general psychiatry. This study aimed to identify differences regarding the history of treatment of forensic and general psychiatric patients diagnosed with schizophrenia.

Method

The matched samples included 72 male patients from forensic wards and 72 male patients from general psychiatric institutions diagnosed with schizophrenia. The history of psychiatric treatment was reconstructed by interviewing the patients as well as outpatient psychiatrists and patients’ legal custodians and by analyzing patient medical records.

Results

In contrast to the general psychiatric patients, prior to admission forensic patients were less integrated into psychiatric care and showed a lower rate of treatment compliance. They also showed a higher rate of previous compulsory treatment because of aggressive behavior towards other persons as well as higher rates of treatment difficulties and violent behavior during previous inpatient treatment. Furthermore, forensic patients had a higher number of previous criminal convictions and had been convicted more often for violent offences. With regard to other relevant risk factors (e.g. comorbid substance abuse disorder, age, education, conduct disorder, antisocial personality disorder, previous exposure to violent and abusive behavior) the two patient groups were, however, comparable.

Conclusions

Regarding schizophrenic patients with comorbid substance abuse disorders, previous violent delinquency and violent behavior during previous inpatient treatment, an intensive outpatient aftercare should be arranged before they are discharged from general psychiatric institutions.     

Nonverbal Interactional Behavior in the Families of Persons with Schizophrenic and Bipolar Disorders

Whereas verbal interactional behaviors have been repeatedly found to distinguish the families of persons with and without major psychiatric disorders, there has been comparatively little examination of the discriminative value of nonverbal interactional behaviors. We developed the Nonverbal Interactional Coding System to measure “affiliative” and “distancing” nonverbal behaviors in 18 schizophrenic and 18 bipolar patients and their parents during 10-minute interactions conducted during a posthospital period. Bipolar patients and their parents displayed affiliative nonverbal behaviors (“illustrator gestures” or “prosocial behaviors”) for longer durations than schizophrenic patients and their parents. In contrast, parents of schizophrenic patients displayed distancing nonverbal behaviors (looking away) for longer durations than those of bipolar patients. The nonverbal interactional data added to the statistical strength of patients’ and parents’ verbal interactional data in distinguishing between these diagnostic groups. Nonverbal interactional behaviors are important variables to consider in interventions aimed at improving the communication skills of families coping with psychiatric disorders.     

Acoustic startle in maltreated children

We investigated the eyeblink component of acoustic startle reactions in maltreated children. Previous research indicates that acoustic startle is enhanced in adult males with posttraumatic stress disorders (PTSD) whereas findings on women with PTSD have been inconsistent. In accord with the only previous report for children with PTSD, we found that maltreated boys, particularly those who had been physically abused, responded to increases in startle probe loudness with smaller increments in amplitude of startle eyeblink and smaller reductions in blink latency than did comparison boys. Results for girls were inconsistent: younger maltreated girls had smaller startle amplitude and slower onset latency than controls, whereas older maltreated girls exhibited the opposite pattern.     

Preparation and motor potentials in chronic tic and Tourette syndromes

Many studies have found that people with tic disorder show more difficulty when inhibiting an automated than a controlled response. Furthermore, although normal motor threshold and excitability are present, but reduced or impaired, motor inhibition seems manifest in patients with tic. In order to localize this inhibition impairment in tic disorder the present study examine two response-locked ERPs: the Bereitschaft (preparation BP) and the motor potentials (MP). The simple tic group showed faster BP latency and smaller amplitude than control and complex tic group and did not show a corresponding change in values with practice or with automated or controlled condition. The MP amplitudes revealed that whereas both controls and complex tic disorder showed a decrease in amplitude during control condition for both blocks, simple tic showed larger amplitude. Our ERP results are in agreement with RT results of a previous study. The explanation could lie with modulation in motor excitation inhibition circuits and seems worse in simple tics where the movements are more automatic and nonvoluntary.     

Phenylthiocarbamide (PTC) tasting in paranoid and nonparanoid schizophrenic patients.

The present study reports on the association between Phenylthiocarbamide tasting for paranoid and nonparanoid schizophrenic patients. The incidence of PTC tasting is highly variable, and tasters and nontasters are frequently associated with some pathological states. 25 paranoid and 25 nonparanoid schizophrenic patients were examined for their PTC taste sensitivity. Frequency of paranoid tasters resembles the distribution of the normal population, whereas the nonparanoid patients are significantly different in their taste thresholds, with a higher incidence of nontasters. The members of this latter group have twice the incidence of psychiatric illness in their family histories as those of the former group. The significance of these findings is discussed as related to vulnerability for schizophrenia.     

What is perseverated in schizophrenia? Evidence of abnormal response plasticity in the saccadic system

Although perseveration is sometimes attributed to defective set switching, the authors have recently shown that set-switching is normal in schizophrenia. In this article, the authors tested for persistent states of the saccadic response system, rather than set perseveration. Schizophrenic and healthy subjects performed antisaccades and prosaccades. The authors analyzed for 3 carry-over effects. First, whereas the latency of the current saccade correlated with that of the prior saccade in both groups, the correlations under mixed-task conditions declined in healthy but not in schizophrenic subjects. Second, antisaccades in penultimate trials delayed upcoming saccades in schizophrenic but not in healthy subjects. Third, schizophrenic subjects were more likely to erroneously perseverate the direction of a prior antisaccade but not a prior prosaccade. The authors concluded that, in schizophrenia, the effects of correct antisaccades are persistent not weak. Saccades in schizophrenia are characterized by perseveration of antisaccade-induced changes in the saccadic response system rather than failures to switch task set.     

Differentiating between schizophrenic and manic inpatients by means of the MMPI

Forty-five psychiatric inpatients with DSM-III diagnoses of schizophrenia and 31 inpatients with DSM-III diagnoses of bipolar disorder (and currently manic) were compared on the MMPI. Results indicated that although the schizophrenic patients achieved significantly higher scores on several of the MMPI scales (F, Pt, Sc, Si), these findings were of questionable clinical significance. On the other hand, the schizophrenic group did produce a significantly greater percentage of MMPI high-point pairs containing Scale 8(Sc): that is, 64.4% versus 35.5%.     

Communication deviance in families of schizophrenic and manic patients

Levels of communication deviance (CD) distinguish parents of schizophrenic patients from parents of nonpsychotic patients, but the prevalence of intrafamilial CD in other psychotic disorders has not been examined. Levels of CD were compared across biological parents of schizophrenic (n = 39) and bipolar manic (n = 16) patients and across patients themselves. CD ratings were based on Thematic Apperception Test protocols (parents only) and family interactions (parents and patients). Total levels of CD did not distinguish between groups of parents or patients. However, instances of odd word usage were more frequent among parents of manic patients than among parents of schizophrenic patients on both CD measures. Also, during the interaction task, odd word usage was more frequent among manic patients, whereas schizophrenic patients made more ambiguous references. Results suggest that high levels of intrafamilial CD are not unique to schizophrenia.     

Regional cortical dysfunction in schizophrenic patients studied by computerized neuropsychological methods

18 RDC-diagnosed schizophrenic patients (11 men, 7 women) were compared to 84 normal men with three computerized neuropsychological methods, assumed to reflect lateralized and frontal cortical functions: (1) Bilateral Finger Tapping and Finger Alternation, (2) Bilateral Trail Making, and (3) passively perceived Necker cube reversals. Schizophrenics differed from normals by (1) inferior Tapping/Alternation but only in the right hand, (2) inferior Trail Making, most pronounced for Form B, and (3) lower frequency of Necker cube reversals. Patients with previous neuroleptic medication and prior psychiatric hospitalizations were inferior in Trail Making and had fewer Necker cube reversals. The findings were interpreted in line with recent models of schizophrenia involving a left-hemisphere dysfunction/over-activation and a frontal dysfunction.     

A comparison between the Grid Test of Schizophrenic Thought Disorder and diagnostic psychologicaI testing

Abstract.— Bannister and Fransella's Grid Test of Schizophrenic Thought Disorder based on Personal Construct Theory and the concept of "loosened construing", as measurable in the scores of Intensity and Consistency between intercorrelations, has been applied to a Scandinavian sample of psychiatric patients. The validity of the test was illustrated, and a significant difference was found between a group of schizophrenics and schizophrenic borderline states and a group without schizophrenic thought disorders. The Grid Test scores were found to agree with thought disorder manifestations as evaluated in qualitative terms on the basis of cognitive and projective tests, but they did not differentiate between developmental levels of thinking corresponding to con-creteness in organic impairment versus diffuseness in schizophrenia. Thus, the concept of "loosened construing" as applied in this thought disorder test seems too unspecific.     

Kinesthetic figural aftereffects in acute schizophrenia: a style of processing stimuli.

The Kinesthetic Figural Aftereffect test was administered to 106 psychiatric inpatients to assess styles of stimulus processing in schizophrenia. Three conditions were used: (1) standard stimulus conditions at the acute phase; (2) standard conditions, 7 wk. later, to evaluate stability over time; (3) reversed stimulus conditions to assess kinesthetic figural aftereffect generality under different stimulus conditions. Results indicated that: (1) schizophrenics reduced stimuli, but differences between patient groups were not significant. (2) Kinesthetic figural aftereffect stability over time was shown by nonschizophrenics (p less than .01) but not by schizophrenic and borderline patients. (3) All diagnostic groups reversed kinesthetic figural aftereffect responses under reversed stimulus conditions, e.g., former "augmenters" tended to reduce more under agumenting conditions, suggesting the importance of the specific stimulus conditions. (4) Acute schizophrenics showed a stimulus-governed style. (5) The results raise questions about kinesthetic figural aftereffects as a measure of response style.     

Orienting-reflex behavior and clinical psychopathology

The effects of diagnosis, sex, age and medication on the orienting-reflex behavior of 263 psychiatric patients and 58 normal subjects were studied. Significant differences between the normal and patient groups and within the patient groups in different diagnostic categories were found. In the patient populations, further variations by types of medication received were found, whereas sex and age did not affect the orienting reflex. On the basis of frequency of response only normal subjects and patients could be distinguished, whereas amplitude analysis revealed a continuum in which the highest responses were given by normal subjects and the lowest by patients with chronic organic brain damage. In all subgroups the amplitudes of the responses of patients receiving antidepressant medication were higher than those of patients receiving antipsychotic medication.     

Contours of equal perceived amplitude and equal perceived frequency for electrocutaneous stimuli

Previous measurements of equal-sensation contours for electrocutaneous stimuli consisting of repeated bursts of biphasic pulses have shown that stimulus frequency has little effect on perceived amplitude, and that stimulus amplitude has no effect on perceived frequency. These earlier contours, however, were measured over a very restricted range of amplitude and frequency or for a single perceived amplitude or perceived frequency. Contours of equal perceived amplitude and equal perceived frequency were measured in the present study for stimuli covering most of the useable range of amplitudes and frequencies: 3–12 dB SL and 4–64 Hz. Eight naive subjects generated contours of equal perceived amplitude at four reference amplitudes via Békésy tracking, and 8 additional subjects generated contours of equal perceived frequency at three reference frequencies. The contours of equal perceived amplitude declined slightly but significantly with increases in stimulus frequency, consistent with previous results. The shape of the contours was also slightly dependent on the amplitude of the reference stimulus. Contours of equal perceived frequency were unaffected by stimulus amplitude on the average, but the contour shape did vary modestly, though erratically, with reference frequency.     

执行功能与精神分裂症

执行功能障碍是精神分裂症最重要的认知功能障碍,与精神分裂症其它方面的障碍有着密不可分的关系。文章在相关的认知神经心理学和临床研究的基础上,分别综述了精神分裂症执行功能障碍的特点、研究方法、相关脑机制,执行功能与注意、记忆等一般认知功能间的关系,执行功能与精神症状间的联系及其在诊断、康复、判断预后方面的作用等。对精神分裂症执行功能障碍的认识有助于更深入地理解其病因机制,并有利于临床评价与防治     

Significance of latency and amplitude values of the visual evoked potential in children with early childhood brain damage

The latency and amplitude data of optically evoked potentials (unipolar from the vertex) were measured during the 50-200 ms interval in a group of normal boys (n = 26) and a group of boys with brain damage sustained during early childhood (n = 38). The latency periods were sometimes significantly longer and the amplitudes larger (flash stimulus) and smaller (pattern stimulus) respectively in the brain damaged than in the normal subjects. In view of the results of clinical, neurological and psychological examinations, these phenomena must be attributed to delayed maturation of the central nervous functional system.     

Self-focused attention in schizophrenic patients with and without auditory hallucinations and normal subjects: A comparative study

Self-focused attention has been implicated in a number of psychiatric disorders, but little research has examined this in schizophrenic subjects. In this study, a sample of schizophrenic patients experiencing auditory hallucinations, schizophrenic patients not experiencing auditory hallucinations and normal controls were asked to complete the private self-consciousness subscale of the Self Consciousness Scale. It was found that patients experiencing auditory hallucinations exhibited significantly higher levels of self-focus than those not experiencing hallucinations, although they did not differ from normal subjects. It was also shown that level of self-focus predicted whether or not subjects experienced hallucinations. These results, and their implications, are discussed with reference to the literature.     

The discriminative validity of the Whitaker Index of Schizophrenic Thinking

An attempt was made to assess the discriminative validity of the WIST with a sample of psychiatric inpatients. Through the use of a standardized structured interview and a diagnostic system for schizophrenia based on the use of discriminant function analysis with nonpathognomic symptom combinations, a reliable and valid system was used to establish the criterion diagnosis. Approximately 63% of patients reliably diagnosed as schizophrenic were detected via the WIST while only 14% of nonschizophrenic patients scored in the schizophrenic range on the WIST. The assets and liabilities of using the WIST to diagnose schizophrenia are discussed.