Psychophysiologic abnormalities in schizophrenia: some implications for therapy

On the basis of several studies, some psychophysiological activation abnormalities in schizophrenia are explained. These abnormalities give rise to at least three therapeutic aims: (1) As some psychophysiological systems may be under- and others overaroused in schizophrenic patients compared to normal controls, therapeutic interventions should approach the systems selectively. (2) The ability to modulate the psychophysiological activation, which is diminished in schizophrenic patients, should be improved. (3) Schizophrenic patients need a more differentiated perception of their own state of activation. These aims contrast somewhat with past therapeutic studies, which tried to change activation for the purpose of tension reduction. It seems advisable to link basic psychophysiological research more closely to the development of therapies.     

"An analysis-of-variance model for intrasubject replicaiton design": some additional comments

The fixed effects ANOVA procedure utilized by Gentile, Roden, and Klein (1972) for single subjects is found inappropriate. Hartmann's proposal of a one-way fixed-effect ANOVA model is also considered. Time series analysis that takes serial correlation effects into account is recommended.     

Visual-perceptual abilities in healthy controls, depressed patients, and schizophrenia patients

Previous studies have suggested a right hemineglect in schizophrenia, however few assessed possible visual-perceptual implication in this lateralized anomaly. A manual line bisection without (i.e., lines presented on their own) or with a local cueing paradigm (i.e., a number placed at one or both ends of the line) and the Motor-free Visual Perceptual Test-Vertical format (MVPT-V) were used to assess the visual-perceptual abilities of healthy controls, schizophrenia and depressed patients. Whereas healthy controls and depressed patients showed a non-significant leftward bias in manual line bisection, schizophrenia patients bisected significantly to the left of the true centre of the line. Interestingly, the pattern of performances in response to the local cueing paradigm was similar in depressed and schizophrenia patients such that both groups demonstrated a significant change in their bisection performance only in response to a cue placed at the right extremity of the line (control performance was modified by cues at either end of the line). Finally, in the MVPT-V, schizophrenia patients were impaired relative to the other two groups, especially in the spatial working memory and visual closure categories. These results suggest that: 1/a deficit towards the right hemifield, consistent with a mild form of right hemineglect, can be observed in schizophrenia; 2/lateralized anomalies could also be observed in depression using an appropriate tool such as manual line bisection; 3/performances in the MVPT-V suggested that a simple visual-perceptual deficit could not explain the lateralized anomaly observed in the manual line bisection, as it is the case in the hemineglect syndrome.     

Family work for schizophrenia: some issues for Chinese immigrant families

This paper discusses some specific issues relevant to immigrant Chinese families in the context of family work for schizophrenia. The issues include shame and guilt, isolation and mistrust of officials, the importance of negotiation before details of problem-solving are worked out, high academic ambitions for children, and apparent ‘overprotectiveness’ in the Chinese culture. It is argued that cognitive-behavioural, goal-orientated family work could be adapted well for immigrant Chinese families with a member suffering from schizophrenia. A case study is presented to illustrate how such a family was helped.     

Mueller-Lyer illusion and size estimation performance in schizophrenics compared to normal controls

A size estimation (SE) paradigm and the Mueller-Lyer (ML) illusion were used to examine perceptual disturbances in schizophrenics. 35 reliably diagnosed (DSM III-R) schizophrenics were compared to 20 subjects with no history of psychiatric illness. Perceptual distortions found in previous studies of schizophrenics were only to a certain extent confirmed in the present results. More overestimators were found among the schizophrenics than among the normals on the SE task. The schizophrenics, first of all the chronic patients, also proved to be more prone to the Mueller-Lyer illusion. A reason why the very clear differences between schizophrenics and normals found in previous examinations were not confirmed in the present study, might be that a reliable diagnostic instrument was for the first time used in this kind of study.     

Psychometric deviance measured by MMPI in adoptees at high risk for schizophrenia and their adoptive controls

Psychometric deviance in personality traits as assessed by the Minnesota Multiphasic Personality Inventory (MMPI; Dahlstrom, Welsh, & Dahlstrom, 1982) was compared between adopted-away, high-risk (HR) offspring of schizophrenic biologic mothers and low-risk (LR) controls. A subsample of the Finnish Adoptive Family Study (Tienari et al., 2000) included 60 HR adoptees and 76 LR control adoptees who were tested by the MMPI before the onset of any psychiatric disorder at the mean age of 24 years. The HR group was found to be distinguishable based on deviant scores on the scales HOS and HYP, indicating emotional unresponsiveness, restricted affectivity, and decreased energy. These may also be considered possible premorbid and prodromal signs of future schizophrenia among the HR adoptees.     

Dichotic listening,executive functions and grey matter cortical volume in patients with schizophrenia and healthy controls

Schizophrenia is characterized by cognitive impairment, especially in relation to executive functions. Brain structural abnormalities are also often seen in schizophrenia although little is known of the relationship between cognitive impairment and structural brain changes. Our aim was therefore to investigate this relationship further using MRI and a dichotic listening (DL) task with simple speech sounds and with instructions to focus attention and report only from the left or right ear stimulus. When instructed to focus attention on the left ear syllable a cognitive conflict is induced requiring the allocation of executive resources to be resolved. Grey matter (GM) volume was measured with MRI from four volumes of interests (VOIs), left and right frontal and temporal cortex, respectively, and correlated with DL performance. The results showed significant differences between the groups in their ability to focus attention on and report the left ear stimulus, which was accompanied by reduced GM volume in the left frontal and right temporal lobe VOIs. There was also a significant positive correlation between left frontal GM volume and performance on the DL task, for the groups combined. The results did not support a conclusion that an impairment in cognitive function in schizophrenia was driven by an corresponding impairment in brain structure, since there were no significant correlations when the groups were analyzed separately. It is however concluded that patients with schizophrenia are impaired in executive functions and that they also show reduced GM volumes in left frontal and right temporal lobe areas, compared to healthy controls.