Factors Influencing Occupational Competence in Schizophrenia

Abstract

Objective: To explore and compare the perception of productive activities (studies, work) held by young adults with schizophrenia and their therapists.

Method: An exploratory qualitative study was carried out using the Model of Competence (Rousseau, 2003). Nine client-therapist dyads were recruited. Data collected were transcribed, coded, and processed with QSR.N'VIVO (2002).

Results: Therapists and clients agree about the personal characteristics (e.g., motivation, coping) and activities (e.g., prior work or study experiences) that have positive (e.g., social skills) or negative influence (e.g., symptoms of schizophrenia) on competence in productive activities. Their perceptions differ about the environmental characteristics that influence competence: some elements are mentioned only by clients (e.g., work environment) or therapists (e.g., using community resources).

Conclusion: The framework offered by a specialized clinic can promote exchanges and the congruence of perceptions between therapists and clients. Interventions focusing on the environment should be further developed in relation to productive activities.     

Temporal processing dysfunction in schizophrenia

Schizophrenia may be associated with a fundamental disturbance in the temporal coordination of information processing in the brain, leading to classic symptoms of schizophrenia such as thought disorder and disorganized and contextually inappropriate behavior. Despite the growing interest and centrality of time-dependent conceptualizations of the pathophysiology of schizophrenia, there remains a paucity of research directly examining overt timing performance in the disorder. Accordingly, the present study investigated timing in schizophrenia using a well-established task of time perception. Twenty-three individuals with schizophrenia and 22 non-psychiatric control participants completed a temporal bisection task, which required participants to make temporal judgments about auditory and visually presented durations ranging from 300 to 600 ms. Both schizophrenia and control groups displayed greater visual compared to auditory timing variability, with no difference between groups in the visual modality. However, individuals with schizophrenia exhibited less temporal precision than controls in the perception of auditory durations. These findings correlated with parameter estimates obtained from a quantitative model of time estimation, and provide evidence of a fundamental deficit in temporal auditory precision in schizophrenia.     

Evaluation of a Peer-Led Mutual Support Group for Chinese Families of People with Schizophrenia

Family interventions in schizophrenia have shown positive effects on patients but little attention has been paid to their effects on family members, particularly those in non-Western countries. This randomized controlled trial evaluated the effectiveness of a bi-weekly, 12-session, family-led mutual support group for Chinese caregivers of schizophrenia sufferers over 6 months compared with standard psychiatric care. It was conducted with 76 families of outpatients with schizophrenia in Hong Kong of whom 38 were assigned randomly to either a mutual support group or standard care. Families' psychosocial health status and patients' symptom severity and length of re-hospitalizations at recruitment, one-week and 12-month post-intervention were compared between groups. Results of repeated-measures mixed model indicated that the mutual support group experienced significantly greater improvements in families' burden, functioning and number of support persons and length of patients' re-hospitalizations at two post-tests. The findings provide evidence that mutual support groups can be an effective family-initiated, community-based intervention for Chinese schizophrenia sufferers.     

Emotional Reactions to Simulations of Auditory Hallucinations

There is variability on how auditory hallucinations (AH) impact individuals, ranging from distress to comfort. A systematic study of how simulations of AH impact a non-clinical sample can address not only how AH simulations influence the general public, but also inform how actual AH influence individuals. Utilizing 504 undergraduates, different simulations of AH were presented to examine their impact on emotions and identify moderating variables. The simulations increased negative affect and decreased positive affect. Sex of the participant and differing levels of duration, volume, and context of the simulation did not influence the magnitude of the emotional responses. However, simulations with derogatory content led to greater increased negative affect and decreased positive affect than simulations with benevolent/neutral content. These results suggest that the content of simulations have a substantial effect, which is pertinent to administering simulations for training purposes and implementing psychosocial rehabilitation programs for those who hallucinate.

Body language reading of emotion in schizophrenia: Associations with symptoms and functional outcome

Our aim was to explore how body language reading of emotion relates to neurocognition, symptoms and functional outcome in schizophrenia. Fifty‐four individuals with schizophrenia and eighty‐four healthy controls participated in the study. Emotion perception was assessed with a point‐light display (PLD) task, the Emotion in Biological Motion (EmoBio) test, neurocognition was measured with the MATRICS Consensus Cognitive Battery (MCCB), and functioning was indexed by one measure of functional capacity and by one self‐report questionnaire. Clinical symptoms were assessed with a five factor Positive and Negative Syndrome Scale (PANSS) symptoms model. Participants with schizophrenia had impaired body language reading of emotions compared to healthy controls (Cohen's d = 0.69). In participants with schizophrenia, emotion perception was associated with neurocognition (r = 0.42), functional capacity (r = 0.27) and disorganization symptoms (r = –0.27). Mediation analyses showed that disorganization symptoms mediated the effects of emotion perception and neurocognition, respectively, on social functional capacity. These results suggest that in individuals with schizophrenia, reduced emotion perception from body movements has negative consequences for functional outcome, but that the effect is mediated through disorganization symptoms.     

The ability to tickle oneself is associated with level of psychometric schizotypy in non-clinical individuals

A recent study (Lemaitre et al., 2016, Consciousness and Cognition, 41, 64–71) found that non-clinical individuals who scored highly on a psychometric scale of schizotypy were able to tickle themselves. The present study aimed to extend this finding by investigating whether the ability to tickle oneself was associated with level of psychometric schizotypy considered as a continuous variable. One hundred and eleven students completed the Schizotypal Personality Questionnaire (SPQ). A mechanical device delivered tactile stimulation to participants’ palms. The device was operated by the experimenter (External) or the participant (Self). Participants were asked to rate the intensity, ticklishness and pleasantness of the stimulation. A significant association was observed between participants’ tactile self-suppression (External minus Self) and their score on the SPQ. These results suggest that the ability to suppress the tactile consequences of self-generated movements varies across the general population, and maps directly onto the personality dimension of schizotypy.     

Dream research in schizophrenia: Methodological issues and a dimensional approach

Dreaming in patients with schizophrenia was and is of particular interest to researchers and clinicians due to the phenomenological similarities between the dreaming state and schizophrenic daytime symptomatology such as bizarre thoughts or hallucinations. Extensive literature reviews have shown that dream studies in the field of psychopathology often do not fulfill common scientific criteria. The present paper focuses on the methodological issues like sampling methods, the dream collection method, and dream content analysis that are crucial with regard to the validity of the findings. It is also suggested that the so-called dimensional approach (linking severity of daytime symptoms directly to specific dream characteristics) will be very helpful for identifying which psychopathological symptoms of schizophrenia are most closely linked to dream content.     

Self in time and language

Time has been considered a crucial factor in distinguishing between two levels of self-awareness: the “core,” or “minimal self,” and the “extended,” or “narrative self.” Herein, I focus on this last concept of the self and, in particular, on the relationship between the narrative self and language. In opposition to the claim that the narrative self is a linguistic construction, my idea is that it is created by the functioning of mental time travel, that is, the faculty of human beings to project themselves mentally backwards in time to relive, or forward to anticipate, events. Moreover, I propose that narrative language itself should be considered a product of a core brain network that includes mechanisms, such as mental time travel, mindreading, and visuo-spatial systems.     

Metamemory knowledge and beliefs in patients with schizophrenia and how these relate to objective cognitive abilities

Subjective reports and theories about memory may have an influence on other beliefs and behaviours. Patients with schizophrenia suffer a wide range of deficits affecting their awareness of daily life, including memory. With the Metamemory Inventory in Adulthood (MIA) we ascertained patients’ memory knowledge and thoughts about their own cognitive capacities and about several aspects of cognitive functioning: personal capacities, knowledge of processes, use of strategies, perceived change with ageing, anxiety, motivation and mastery. The participants’ ratings were correlated with their intellectual, cognitive and psychiatric data. Patients felt they had a lower capacity and marginally lower mastery over their memory than comparison subjects. They reported less recourse to strategies, and higher levels of memory-related anxiety. However, their knowledge of basic memory processes, motivation to succeed, and perception of ageing effects were similar. So patients with schizophrenia do not suffer a general and non specific impairment of their metacognitive knowledge.