Acceptance and expressed emotion in Mexican American caregivers of relatives with schizophrenia

The relation between Expressed Emotion (EE) and caregiver acceptance was tested with the use of video-recorded interactions between 31 Mexican American family caregivers and their relatives with schizophrenia. Borrowing the concept from Integrative Behavioral Couple Therapy, acceptance was defined as caregiver's engagement with the ill relative along with low levels of expectations for behavioral change. Three aspects of caregiver acceptance were measured: global acceptance of the patient, unified detachment (i.e., nonblaming but engaged problem discussion), and low aversive responses to patient behavior (e.g., criticisms and demanding change). Relative to high EE caregivers, low EE caregivers were consistently more accepting of their ill relatives across the three measures of acceptance. Unified detachment was negatively associated with emotional overinvolvement and aversive responses were positively related to criticism. Warmth was not related to acceptance. The findings suggest that the study of acceptance in family caregivers is a heuristic avenue for future research due to its potential to shed light on specifically what family members do in caring for their ill relatives with schizophrenia.     

Can learning potential in schizophrenia be assessed with the standard CVLT‐II? An exploratory study

This study examined the potential of using the regular administration of a common neuropsychological test, the CVLT-II, to assess learning potential in schizophrenia. Based on List A trial 1 performance and the learning slope, a schizophrenia sample was divided into three learning potential groups (non-learners, learners and high-achievers) that differed in the use of learning strategies. High-achievers utilized more semantic clustering than learners and non-learners, and non-learners were less consistent in words recalled than the other two groups. This standard administration approach is a promising, time-saving alternative to the modified tests of learning potential used so far.     

Synchrnoic consciousness from a neurological point of view: the philosophical foundations for neuroethics

Daniel Kolak’s theory of synchronic consciousness according to which the entire range of dissociative phenomena, from pathologies such as MPD and schizophrenia to normal dream states, are best explained in terms of consciousness becoming simultaneously identified as many selves, has revolutionary therapeutic implications for neurology and psychiatry. All these selves, according to Kolak—even the purely imaginary ones that exist as such only in our dreams—are not just conscious but also self-conscious, with beliefs, intentions, living lives informed by memories (confabulatory, in the case of the fictional ones) and personal histories. Kolak’s derivation of psychiatrically relevant aspects of his theory—a neurological rendition of a Kantian transcendental argument—can be given a straightforward neurological, and therefore open to scientific scrutiny, interpretation that would then more easily lend itself to the clinical setting in which these perplexing phenomena, along with their purveyors, must live and cope. This will be the main focus of this paper.     

Eye movement dysfunction in first-degree relatives of patients with schizophrenia: a meta-analytic evaluation of candidate endophenotypes

Several forms of eye movement dysfunction (EMD) are regarded as promising candidate endophenotypes of schizophrenia. Discrepancies in individual study results have led to inconsistent conclusions regarding particular aspects of EMD in relatives of schizophrenia patients. To quantitatively evaluate and compare the candidacy of smooth pursuit, saccade and fixation deficits in first-degree biological relatives, we conducted a set of meta-analytic investigations. Among 18 measures of EMD, memory-guided saccade accuracy and error rate, global smooth pursuit dysfunction, intrusive saccades during fixation, antisaccade error rate and smooth pursuit closed-loop gain emerged as best differentiating relatives from controls (standardized mean differences ranged from .46 to .66), with no significant differences among these measures. Anticipatory saccades, but no other smooth pursuit component measures were also increased in relatives. Visually-guided reflexive saccades were largely normal. Moderator analyses examining design characteristics revealed few variables affecting the magnitude of the meta-analytically observed effects. Moderate effect sizes of relatives v. controls in selective aspects of EMD supports their endophenotype potential. Future work should focus on facilitating endophenotype utility through attention to heterogeneity of EMD performance, relationships among forms of EMD, and application in molecular genetics studies.     

Narrative, identity and mental health: How men with serious mental illness re-story their lives through sport and exercise

ObjectivesIt has been suggested that mental illness threatens identity and sense of self when one's personal story is displaced by dominant illness narratives focussing on deficit and dysfunction. One role of therapy, therefore, is to allow individuals to re-story their life in a more positive way which facilitates the reconstruction of a meaningful identity and sense of self. This research explores the ways in which involvement in sport and exercise may play a part in this process.DesignQualitative analysis of narrative.MethodWe used an interpretive approach which included semi-structured interviews and participant observation with 11 men with serious mental illness to gather stories of participants’ sport and exercise experiences. We conducted an analysis of narrative to explore the more general narrative types which were evident in participants’ accounts.FindingsWe identified three narrative types underlying participants’ talk about sport and exercise: (a) an action narrative about “going places and doing stuff”; (b) an achievement narrative about accomplishment through effort, skill or courage; (c) a relationship narrative of shared experiences to talk about combined with opportunities to talk about those experiences. We note that these narrative types differ significantly from—and may be considered alternatives to—dominant illness narratives.ConclusionThis study provides an alternative perspective on how sport and exercise can help men with serious mental illness by providing the narrative resources which enabled participants to re-story aspects of their lives through creating and sharing personal stories through which they rebuilt or maintained a positive sense of self and identity.     

Effortful versus automatic emotional processing in schizophrenia: Insights from a face-vignette task

Adaptive emotional responding relies on dual automatic and effortful processing streams. Dual-stream models of schizophrenia (SCZ) posit a selective deficit in neural circuits that govern goal-directed, effortful processes versus reactive, automatic processes. This imbalance suggests that when patients are confronted with competing automatic and effortful emotional response cues, they will exhibit diminished effortful responding and intact, possibly elevated, automatic responding compared to controls. This prediction was evaluated using a modified version of the face-vignette task (FVT). Participants viewed emotional faces (automatic response cue) paired with vignettes (effortful response cue) that signalled a different emotion category and were instructed to discriminate the manifest emotion. Patients made less vignette and more face responses than controls. However, the relationship between group and FVT responding was moderated by IQ and reading comprehension ability. These results replicate and extend previous research and provide tentative support for abnormal conflict resolution between automatic and effortful emotional processing predicted by dual-stream models of SCZ.     

Accounting for the phenomenology and varieties of auditory verbal hallucination within a predictive processing framework

Two challenges that face popular self-monitoring theories (SMTs) of auditory verbal hallucination (AVH) are that they cannot account for the auditory phenomenology of AVHs and that they cannot account for their variety. In this paper I show that both challenges can be met by adopting a predictive processing framework (PPF), and by viewing AVHs as arising from abnormalities in predictive processing. I show how, within the PPF, both the auditory phenomenology of AVHs, and three subtypes of AVH, can be accounted for.     

Deficits of subliminal self-face processing in schizophrenia

Most studies show that self-processing in schizophrenia is impaired at the supraliminal level. Schizophrenic patients generally lack the ability to prioritize the processing of self-related information, such as their own face. However, some evidence suggests that schizophrenic patients may retain intact subliminal processing abilities even though their conscious experiences are compromised. We conducted the first study exploring schizophrenic patients’ subliminal self-face processing. Using a breaking continuous flash suppression (bCFS) paradigm, we interocularly suppressed face images (self, famous, and unknown faces). Participants’ reaction times to detect the faces when they broke the suppression were recorded as an index for the subliminal processing of faces. Unlike the healthy controls, schizophrenic patients did not demonstrate a processing advantage for their own face when it broke interocular suppression; only a face familiarity effect was found. These findings contribute to the understanding of self-processing deficits in schizophrenia.     

Schizotypal traits are not related to multisensory integration or audiovisual speech perception

Multisensory integration, the binding of sensory information from different sensory modalities, may contribute to perceptual symptomatology in schizophrenia, including hallucinations and aberrant speech perception. Differences in multisensory integration and temporal processing, an important component of multisensory integration, are consistently found in schizophrenia. Evidence is emerging that these differences extend across the schizophrenia spectrum, including individuals in the general population with higher schizotypal traits. In the current study, we investigated the relationship between schizotypal traits and perceptual functioning, using audiovisual speech-in-noise, McGurk, and ternary synchrony judgment tasks. We measured schizotypal traits using the Schizotypal Personality Questionnaire (SPQ), hypothesizing that higher scores on Unusual Perceptual Experiences and Odd Speech subscales would be associated with decreased multisensory integration, increased susceptibility to distracting auditory speech, and less precise temporal processing. Surprisingly, these measures were not associated with the predicted subscales, suggesting that these perceptual differences may not be present across the schizophrenia spectrum.