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).     

Validation of the Norwegian version of the Social Functioning Scale (SFS) for schizophrenia and bipolar disorder

Hellvin, T., Sundet, K.,Vaskinn, A., Simonsen, C.,Ueland, T., Andreassen, O.A. & Melle, I. (2010). Validation of the Norwegian version of the Social Functioning Scale (SFS) for schizophrenia and bipolar disorder. Scandinavian Journal of Psychology 51, 525–533. Studies of social functioning in severe mental disorders are disadvantaged by the multitude of different assessment instruments in use. The present study aims to establish reliability and validity of the Norwegian version of the Social Functioning Scale (SFS) and to examine social functioning in bipolar disorder (BD) compared to schizophrenia (SZ) and healthy controls (HC). SFS, a 76 item questionnaire divided into seven subscales measuring various aspects of daily life functioning, was administered to samples diagnosed with BD (n = 100) or SZ (n = 100) and to HC (n = 100), recruited from the ongoing Tematic Organized Psychosis (TOP) study. Reliability analyses prove adequate psychometric properties both for the composite full scale score (α: 0.81) as well as for the seven subscale scores (α: 0.60–0.88). Principal component analysis of the subscales confirms a one‐component structure, explaining 59% of the variance. Although significantly correlated with the Global Assessment of Functioning, our results indicate that the SFS measures different aspects of social functioning, is less influenced by demographic and clinical characteristics, but differentiates at the same time significantly BD from SZ. Thus, SFS adds valuable information as a supplement to standard clinician‐rated assessment tools of social functioning, suited both for research and clinical work.     

Romantic competence,healthy relationship functioning,and well‐being in emerging adults

A skills‐based model of healthy relationship functioning—romantic competence (RC)—is described. Its association with relationship and individual well‐being was examined in three studies of emerging adults using the Romantic Competence Interview for Emerging Adults (RCI–EA), which measures competence as the interplay of three skill domains. Across studies (women [n = 102], women and men [n = 187], romantic couples [n = 89]), RC was associated with greater security, healthier decision making, greater satisfaction, and fewer internalizing symptoms. The RCI–EA skill domains formed a latent factor and were associated with self‐reports reflective of RC, supporting the construct's validity. The RC construct may thus provide a theory‐driven, overarching way to characterize healthy romantic functioning that can reduce negative outcomes.     

Therapeutic Factors Contributing to Change in Cognitive-Behavioral Group Therapy for Older Persons with Schizophrenia

The contributions of homework, therapy participation, cognitive insight, and skills acquisition to treatment outcomes in group CBT for schizophrenia were examined. Increased cognitive insight was associated with reduced positive, negative and total symptoms, but not improved psychosocial functioning. Greater participation was associated with increased cognitive insight, reduction in total and negative symptoms, and a trend was found for positive symptoms. Greater homework adherence was associated with greater skill acquisition, but skill acquisition was not significantly associated with change in any outcome. The therapeutic factors contributing to change in CBT for schizophrenia appear different for symptom and psychosocial functioning outcomes.     

Psychometric Evaluation of a Controlled Social Affiliation Paradigm: Findings From Anxiety,Depressive Disorder,and Healthy Samples

Social impairments are common across many psychiatric conditions. Standardized dyadic assessments intended to elicit social affiliation between unacquainted partners are used to elucidate mechanisms that disrupt relationship formation and inform possible treatment targets; however, the psychometric properties of such paradigms remain poorly understood. This study evaluated the psychometric properties of a controlled social affiliation paradigm intended to induce connectedness between a target participant and trained confederate. Individuals with an anxiety or depressive disorder diagnosis (clinical group; n = 132) and those without (control group; n = 35) interacted face-to-face with a trained confederate; partners took turns answering a series of increasingly intimate questions about themselves. Social connectedness, affect, and affiliative behavior measures were collected during the interaction. Participant symptom and social functioning measures were collected to examine validity. The paradigm elicited escalating social connectedness throughout the task for both participants and confederates. Parallel forms (i.e., different question sets) elicited similar affiliation outcomes. Self-reported (but not behavioral) affiliation differed across some demographic variables (e.g., participant gender, Hispanic ethnicity). Within-task affiliation measures were associated with one another and with global social connectedness and social anxiety symptom measures, but not with somatic anxiety measures. Clinical participants reported lower social affiliation and positive affect reactivity and higher negative affect reactivity than healthy participants. These findings provide initial psychometric support for a standardized and controlled dyadic affiliation paradigm that could be used to reliably probe social disconnection mechanisms across psychopathology.     

Convergent validity of Rorschach and TAT scales of object relations.

The Rorschach Mutuality of Autonomy Scale (MOA) and the Social Cognition and Object Relations Scale (SCORS) have been shown to be reliable and valid measures of interpersonal functioning. Utilizing a sample of 57 outpatients with a Diagnostic and Statistical Manual of Mental Disorders Axis II diagnosis, this study extends the findings of previous research demonstrating the reliability and convergent validity of each measure. Analyses focused on the convergent validity between the Rorschach MOA Scale and 8 SCORS variables (complexity, affect, emotional investment in relationships, emotional investment in values and morals, understanding of social causality, management of impulses/aggression, self-esteem, identity/coherence of self) ratings of Thematic Apperception Test narratives. The conceptual nature and clinical utility of these findings are discussed in relation to psychological assessment.     

Unique sets of social and mood characteristics differentiate autistic and negative schizotypy traits in a young adult non-clinical sample

While well-established as distinct disorders, new evidence linking autism and schizophrenia has emerged. One line of evidence is the strong correlation identified between the social traits assessed by the Autism Spectrum Quotient (AQ:Social) and the negative traits of schizotypy. To further explore this association, the current study examined whether these sets of traits are convergent or divergent in the degree to which they relate to specific aspects of socio-emotional functioning. Regression analyses conducted on self-report data collected from 284 undergraduate students showed that the social items from the AQ uniquely relate to levels of social anxiety and social skills, while negative schizotypy traits uniquely relate to social anhedonia and depression. Additionally, AQ:Social and negative schizotypy traits were found to share a significant proportion of variance, independent of each of the socio-emotional variables examined. The results thus provide further evidence of shared atypical social function linked to both autistic-like traits and negative schizotypy traits, but importantly also highlight clear differences in the specific socio-emotional profiles associated with these sets of traits.     

Psychometric characteristics of role-play assessments of social skill in schizophrenia

There is an extensive literature documenting that people with schizophrenia have marked impairments in social role functioning and social skill. One of the most widely employed strategies for assessing social skill has been role-play tests: simulated social interactions that are videotaped for subsequent behavioral coding. There has been considerable discussion of the validity of the approach in the literature, but there has not been adequate consideration of other psychometric characteristics of role-play tests. This paper examines the psychometric characteristics of a representative role-play measure: the Maryland Assessment of Social Competence (MASC). Data from 5 large schizophrenia studies that included the MASC were examined: a study of victimization in women who abuse drugs, a study of health care among people with diabetes, a study of vocational outcomes, a study of social skill among drug abusers, and a clinical trial comparing two antipsychotic medications. Data were examined in terms of five questions: (1) Can role-play scenes be rated reliably? (2) How are role-play ratings distributed across populations? (3) How many and which behaviors should be rated? (4) How many role-play scenes are required? (5) Is role-play behavior temporally stable? Overall, the data suggest that the MASC, and by implication other similar role-play procedures, does have good psychometric properties. However, several things often taken for granted in the literature warrant careful consideration in the design of research using role-play. Implications of the results for design of research are discussed.     

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).     

Manualized Group Cognitive-Behavioral Therapy for Social Anxiety in At-Risk Mental State and First Episode Psychosis: A Pilot Study of Feasibility and Outcomes

Social anxiety has received scant attention in studies of schizophrenia and related psychoses. However, some data suggest it may be an obstacle to vocational and functional outcome. This pilot study investigated the feasibility of a group-based cognitive behavioral therapy (CBGT) to reduce social anxiety in those at risk for developing psychosis or in the early phase. Twenty-nine patients with first-episode psychosis (FEP) or at ultra high risk for developing psychosis or often referred to as at-risk mental state (ARMS) with comorbid social anxiety attended a CBGT intervention weekly for 14 weeks in 90-minute sessions. Baseline, post-treatment, and follow-up ratings of social anxiety were measured using the Social Interaction Anxiety Scale, the Social Phobia Inventory, and the Brief Social Phobia Scale. Psychotic symptoms and general psychopathology were also measured before and after the intervention. Results suggest that the proposed CBGT is feasible and beneficial for socially anxious patients at risk, or with experience of, psychosis. Participants significantly improved on three outcome measures of social anxiety after completing this intervention (all p’s < .002). Participants who completed treatment also showed a significant reduction on measures of depression and negative symptoms. Future research should examine the relative efficacy of this brief manualized CBGT intervention for the treatment of social anxiety and psychotic symptoms in a larger randomized controlled trial.     

Behavioral assessment of public-speaking anxiety using a modified version of the Social Performance Rating Scale

The current study aimed to extend the evaluation of the utility of the Social Performance Rating Scale (SPRS) [Behav. Res. Ther. 36 (1998) 995]. We examined the utility of a modified SPRS for the behavioral assessment of public-speaking anxiety among patients with social phobia (n = 49). The videotaped performance of public-speaking fearful patients in a public-speaking task was rated using four of the five SPRS ratings and was compared to global ratings by patients and observers, as well as to self-report and clinician-administered measures of social anxiety. The pattern of correlations with criterion measures of social anxiety provided evidence for the convergent and divergent validity of this modified SPRS for the behavioral assessment of public-speaking anxiety.     

The relative importance of political skill dimensions for predicting managerial effectiveness

The present study uses relative weight analysis to garner support for the incremental validity of political skill over more traditional managerial skills for predicting managerial effectiveness and to help identify the underlying theoretical mechanisms driving this relationship. In addition, we explore boundary conditions, in terms of gender and organizational level, where political skill may be more or less critical. Using 199 middle- and upper-level managers enrolled in leadership development programmes and multisource data, the findings supported political skill’s incremental validity over more traditional measures of managerial skills for predicting managerial effectiveness. In addition, two of five political skill dimensions—image management and interpersonal influence—were significantly important predictors of managerial effectiveness, providing support for social influence theory as perhaps the best theoretical model for understanding the political skill-effectiveness relationship. Also, an individual’s gender and level in the organizational hierarchy had significant moderating effects on the relationship between three political skill dimensions and managerial effectiveness.     

Is there more to complicated grief than depression and posttraumatic stress disorder? A test of incremental validity

There is growing interest in complicated grief reactions as a possible new diagnostic category for inclusion in the Diagnostic and Statistical Manual of Mental Disorders. However, no research has yet shown that complicated grief has incremental validity (i.e., predicts unique variance in functioning). The authors addressed this issue in 2 studies by comparing grief, depression, and posttraumatic stress disorder (PTSD) symptoms with different measures of functioning (interviewer ratings, friend ratings, self-report, and autonomic arousal). The 1st study (N = 73) used longitudinal data collected at 4 and 18 months postloss, and the 2nd study (N = 447) used cross-sectional data collected 2.5-3.5 years postloss. With depression and PTSD controlled, grief emerged as a unique predictor of functioning, both cross-sectionally and prospectively. The findings provide convergent support for the incremental validity of complicated grief as an independent marker of bereavement-related psychopathology.     

Social Anxiety in Children with Anxiety Disorders: Relation with Social and Emotional Functioning

Investigated the psychometric properties of the Social Anxiety Scale for children-Revised (SASC-R) as well as relations between social anxiety and children's social and emotional functioning. Participants were a clinic sample of children, ages 6–11 with anxiety disorders (N = 154) who completed the SASC-R. For a subset of these children, parent ratings of social skills, and self-ratings of perceived competence and peer interactions were also obtained. Factor analysis of the SASC-R supported the original three-factor solution and internal consistencies were in the acceptable range. Among children with simple phobia, scores on the SASC-R differentiated those with and without a comorbid social-based anxiety disorder. Social anxiety was also associated with impairments in social and emotional functioning. Specifically, highly socially anxious children reported low levels of social acceptance and global self-esteem and more negative peer interactions. Girls with high levels of social anxiety were also rated by parents as having poor social skills, particularly in the areas of assertive and responsible social behavior.     

An examination of the construct validity of the Social Anhedonia Scale

Two studies bearing on the construct validity of the Social Anhedonia Scale (SA) are reported. Study 1 reported convergent validity coefficients between the SA scale and numerous measures of traits reflecting a generalized attitude toward others (e.g., social interest and empathy) as well as several traits reflecting maladjustment without a social component as a test of discriminant validity (e.g., pessimism and rigidity). Study 1 found impressive convergent validity for the SA scale and mixed discriminant validity. Study 2 found that the SA scale was related to two dimensions of striving for security, one of which is strongly influenced by negative interpersonal tendencies, suggesting support for the validity of the SA scale. Implications for the measurement and concept of social anhedonia are presented.     

Psychometric Properties of a Social Skills Assessment using a Virtual Environment

Social Anxiety Disorder (SAD) is a marked and persistent fear of social and/or performance situations in which embarrassment or scrutiny from others may occur. One form of behavioral assessment is a Role Play Task (RPT). However, RPTs often are not feasible in clinical settings due to the common obstacles in implementation. Thus, the current study examines the feasibility, acceptability and psychometric properties of a virtual environment based social skills assessment compared to the traditional RPT. Forty-six children, ages 7 to 14, participated in two assessment conditions: RPT and a virtual environment behavioral assessment (VE BAT). Participants reported self-ratings of anxiety and acceptability, while blinded observers rated social skills and overall social anxiety. An ANCOVA, covarying for age, revealed (a) no significant task difference for voice volume, speech latency, number of words spoken, effectiveness, and SAM ratings; (b) that the VE BAT was more feasible to implement in terms of personnel time and costs and; (c) more overall anxiety during the RPT task than during the VE BAT task. In addition, the VE BAT demonstrated moderate concurrent validity when correlating the self-report ratings of anxiety with the Social Phobia and Anxiety Inventory for Children (SPAI-C). The current study addresses many of the impediments to conducting RPTs in a clinical setting and, overall, supports the utilization of VE BATS as a viable alternative for the behavioral assessment of social skills in children. Further implications address the potential for the armamentarium for social skills training with children with SAD.     

A preliminary investigation of reaction time variability in relation to social functioning in children evaluated for ADHD

Reaction time variability (RTV) is a ubiquitous phenomenon in Attention-Deficit/Hyperactivity Disorder (ADHD). Few studies have examined RTV in relation to functional outcomes such as social impairment in children with ADHD. In this exploratory study, we investigated whether RTV is associated with social functioning in children at risk for ADHD. Specifically, we explored the association between RTV (tau derived from correct go trials of a Stop-Signal task) and social functioning in 198 children ages 7–12 years referred for an ADHD evaluation. Social functioning measures included child and/or parent ratings of social competence, aggression, social problems, and impairment in relationships. In regression analyses that also included Oppositional Defiant Disorder symptoms and sex, higher RTV was significantly associated with lower ratings of social competence, and higher proactive/reactive aggression ratings on the child self-report measures. RTV was not significantly associated with parent report of social functioning or relationship impairment. This study provides preliminary evidence that RTV may be associated with social functioning in children at risk for ADHD. We propose that lapses of attention affecting cognitive control may also negatively impact social information processing thereby affecting social functioning. Replication is warranted and longitudinal studies are needed to investigate whether RTV predicts social dysfunction in ADHD.     

Relationships between Early Social Experience and Adult Aggressive Behavior in Inbred Mice

Important methodological problems exist in the measurement of children's ethnic attitudes. Specifically, little information has been generated regarding both the convergent and discriminant validity of the ethnic attitude measures used in this area of research. The present study explores these aspects of validity by examining: (a) the relationships among three measures of ethnic attitude (the Doll Choice, the Preschool Racial Attitude Measure II, and the Katz-Zalk Projective Prejudice Test), and (b) the relationships between these measures and two measures of a second construct, egocentrism (the Role-Taking Task and the Perspective-Taking Task). Results indicated that only one of the three ethnic attitude measures revealed a pattern of correlations suggestive of both convergent and discriminant validity. The findings are interpreted as indicating the possibility that various ethnic attitude measures may be tapping different aspects of the same construct. In addition, the possibility is raised that the Doll Choice, and perhaps other ethnic attitude measures, may reflect aspects of ethnic attitude which are related to a child's more general cognitive role-taking skills.     

The problem of confounding social support and depressive symptoms: A brief report on a college sample

The problem of confounding social support and depressive symptoms was addressed by examining the convergent and discriminant validity of interview and questionnaire measures of social support and depression using the multitrait-multimethod matrix approach. Participants were 40 late-adolescent college students with half the sample selected on the basis of mild to moderate scores on self-reported depressive symptoms. Measures of depression displayed excellent convergent and discriminant validity, and measures of objective features of social networks were found to have moderate convergent and discriminant validity. However, the subjective measures of satisfaction with social support used were found to have neither adequate convergent nor discriminant validity. Implications for the conceptualization and assessment of social support are highlighted.