Optimizing treatment of schizophrenia. Enhancing affective/cognitive and depressive functioning

Recognition and treatment of schizophrenia has largely focused on positive symptoms of the disorder, such as delusions, hallucinations, and disorganization. However, other important symptoms, such as depression, cognition, and social functioning, have not received comparable attention. Fifty percent of schizophrenic patients suffer from comorbid depression, which is a major risk factor for suicide in this population, while 10% to 25% suffer from comorbid obsessive-compulsive disorder. Cognitive deficits commonly observed in patients with schizophrenia include problems with concentration, attention, and memory, as well as problem-solving and verbal skills. These deficits are observed at early stages of the illness and can predict deficits in functional capabilities, such as occupational and social skills, educational attainment, and the ability to live independently. The severity of such impairments affects all patient in this population, including up to 10% of patients working full time and up to one third of those working part time. In light of the debilitating effects of depression, cognitive impairment, and other aspects of affective functioning on the quality of life of patients with schizophrenia, physicians need to partner with their patients to address these concerns and determine an appropriate treatment regimen. This can be done with simple functional-based cognitive questioning, the use of evidence-based psychosocial practices, and psychoeducation on the many pharmacotherapeutic options. It is recommended that depressive or suicidal symptoms of schizophrenia be treated with an antidepressant or mood stabilizer only if the symptoms have not subsided after treatment of the psychosis with an atypical antipsychotic. Additionally, relative to older medications, atypicals have demonstrated benefit in improving some of the cognitive impairments.     

Association of serotonin transporter promoter gene polymorphism with violence: relation with personality disorders, impulsivity, and childhood ADHD psychopathology

There is evidence that disturbances in central serotonin (5-HT) function have a role in impulsive aggression, violence, and criminality. A deletion/insertion polymorphism within the 5-HT transporter (5-HTT) promoter gene (5-HTT gene-linked polymorphic region, 5-HTTLPR) is thought to be associated with several psychopathological phenotypes related to disturbed impulse control, anxiety and depression. This study examined the association of the 5-HTTLPR with violent behavior in a sample of 153 male Caucasians referred for a forensic psychiatric examination. We found a significant excess of the short (s) allele and the s/s genotype in patients characterized by recurrent and overt physical violent behavior. This genetic variance explained 5% of the variance of violent behavior. When controlled for the impact of several psychopathologies related to violent behavior, this association was observed in individuals with a history of childhood attention deficit/hyperactivity disorder (ADHD)-related symptoms, but not presenting with personality disorder or increased impulsiveness. In conclusion, the results (i). suggest an association between serotonergic dysfunction and violent behavior, (ii). provide evidence for an-at least partial-genetic regulation of violent behavior in a subgroup of male offenders, and (iii). suggest a significant role for 5-HT transporter functionality for violent behavior.     

Task requirements influence sensory integration during grasping in humans

The sensorimotor transformations necessary for generating appropriate motor commands depend on both current and previously acquired sensory information. To investigate the relative impact (or weighting) of visual and haptic information about object size during grasping movements, we let normal subjects perform a task in which, unbeknownst to the subjects, the object seen (visual object) and the object grasped (haptic object) were never the same physically. When the haptic object abruptly became larger or smaller than the visual object, subjects in the following trials automatically adapted their maximum grip aperture when reaching for the object. This adaptation was not dependent on conscious processes. We analyzed how visual and haptic information were weighted during the course of sensorimotor adaptation. The adaptation process was quicker and relied more on haptic information when the haptic objects increased in size than when they decreased in size. As such, sensory weighting seemed to be molded to avoid prehension error. We conclude from these results that the impact of a specific source of sensory information on the sensorimotor transformation is regulated to satisfy task requirements.     

Monetary reward increases attentional effort in the flanker task

An important question is whether monetary reward can increase attentional effort in order to improve performance. Up to now, evidence for a positive answer is weak. Therefore, in the present study, the flanker task was used to examine this question further. Participants had to respond sooner than a certain deadline in a flanker task. One group of participants received a performance-contingent monetary reward, whereas the other group earned a fixed amount of money. As a result, monetary reward significantly improved performance in comparison with the control group. The analysis of speed-accuracy trade-off functions revealed that monetary reward increased attentional effort, leading to an enhanced quality of stimulus coding. Little evidence was found that reward also improved selective spatial attention.     

Sibling relationship quality in early adolescence: child and maternal perceptions and daily interactions

Correspondence between child and maternal perceptions of sibling relationship quality (standards, actual ratings, problems) and children's reports of daily interactions were assessed in 40 early adolescent children (M age=11.5 yrs) and their mothers (n=32). Children completed the Sibling Relationship Questionnaire (Furman & Buhrmester, 1985. Child Development, 56, 448–461) and Daily Checklist ratings of sibling interactions for 14 days. Mothers completed the Parental Expectations and Perceptions of Children's Sibling Relationship Questionnaire (Kramer & Baron, 1995. Family Relations, 44, 95–103). Overall, findings revealed correspondence between child perceptions of sibling warmth and maternal ratings of standards, actual ratings, and problems in sibling warmth but not conflict and rivalry. Maternal and child perceptions of sibling relationship qualities were positively associated with children's reports of ongoing interactions. Finally, regression analyses identified unique maternal and child correlates for both happy and prosocial daily interactions. Findings are discussed in light of recent research and theory on family dynamics. Copyright © 2010 John Wiley & Sons, Ltd.     

In‐court versus out‐of‐court testimonies: Children's experiences and adults' assessments

The study examined the effects of different presentation modes on child witnesses' experiences and adults' perception and assessments of the same witnesses. Child witnesses (N = 108) were interviewed about an event that they had either experienced or imagined. Adult mock jurors (N = 240) watched the children's testimonies live, via two‐way closed‐circuit television (CCTV), or via a pre‐recorded video. The results showed that the live observers perceived the children in more positive terms than did the two‐way CCTV observers, who in turn perceived the children in more positive terms than did the video observers. Briefly, it seems as the more proximal the presentation mode, the more positive the observers' perception. Somewhat in contrast to these results, a significantly smaller proportion of the children who testified on video stated that they were nervous, compared to the children who testified live or via two‐way CCTV. Copyright © 2009 John Wiley & Sons, Ltd.     

Blood pressure responses to hypnotic and nonhypnotic suggestions in normotensive subjects

Forty normotensive subjects participated on a voluntary basis in a study designed to compare the effect of suggestions on blood pressure (BP). Two experimental groups received suggestions presumed to be specific in lowering or raising BP after simple relaxation (relaxation group) or hypnotic induction (hypnotic group). A control group was used to record the BP changes over time. The time variable was significant for both systolic (SBP) and diastolic blood pressure (DBP). Induction procedures (hypnosis or relaxation) resulted in significant decreases in DBP in both experimental groups. In the control group there was a significant decrease in SBP. A specific suggestion to increase the BP resulted only in DBP increase in the hypnotic group. This group also gave an increase of both SBP and DBP over the entire experiment, whereas the relaxation group resulted in a significant decrease in SBP. There was no significant group variable, indicating no differences between the groups. Further research is needed to enable firm conclusions of the effect of suggestions on BP.     

Beyond principal component analysis: A trilinear decomposition model and least squares estimation

The paper derives sufficient conditions for the consistency and asymptotic normality of the least squares estimator of a trilinear decomposition model for multiway data analysis.     

Knowledge of Rules,Causal Systematicity,and the Language of Thought

Martin Davies' criterion for the knowledge of implicit rules, viz. the causal systematicity of cognitive processes, is first exposed. Then the inference from causal systematicity of a process to syntactic properties of the input states is examined. It is argued that Davies' notion of a syntactic property is too weak to bear the conclusion that causal systematicity implies a language of thought as far as the input states are concerned. Next, it is shown that Davies' criterion leads to a counterintuitive consequence: it groups together distributed connectionist systems with look-up tables. To avoid this consequence, a modified construal of causal systematicity is proposed and Davies' argument for the causal systematicity of thought is shown to be question-begging. It is briefly sketched how the modified construal links up with multiple dispositions of the same categorical base. Finally, the question of the causal efficacy of single rules is distinguished from the question of their psychological reality: implicit rules might be psychologically real without being causally efficacious. This revised version was published online in June 2006 with corrections to the Cover Date.