Behavioral assessment of auditory processing deficits in schizophrenia: Literature review and suggestions for future research

During the last decades, a considerable number of studies about auditory processing deficits in schizophrenia have been published, some of them using the term of Auditory Processing Disorder (APD). Due to heterogeneous methodology and inconsistent results concrete conclusions may not be straightforward. We focused on studies that used at least one behavioral test for the assessment of auditory processing in schizophrenia, in order to identify new evidence on auditory processing deficits in schizophrenia, and to consider fields for future research. 28 studies met inclusion criteria and are presented in this review. The articles were divided into three groups, those that implemented a test battery approach, those that used only Dichotic Listening (DL), those that used DL along with imaging or electrophysiology techniques. Most of the studies that implemented a test battery showed significant performance differences between patients and controls. This indicates APD presence. Due to the limited number of studies implementing a test battery, this is not conclusive. The majority of all studies that used a DL task showed that patients' performance or laterality was significantly lower than that of controls. Age, duration of illness, total and specific positive symptoms seem to affect significantly DL performance and auditory laterality. The results support the existence of various schizophrenia subgroups that differ in their auditory processing performance, and also have structural and functional specificities. Further research in the field is needed, especially studies that implement a test battery, and studies that examine possible correlations between clinical variables and auditory processing deficits.     

Irritability and parenting practices as mediational variables between temperament and affective,anxiety, and oppositional defiant problems

Irritability and parenting are potential targets for transdiagnostic studies to identify the common and core dysfunctional characteristics underlying several diagnostic pictures with the goal of addressing these issues in treatment. Our objective was to investigate the different paths from temperament to child psychopathology (affective, anxiety, and oppositional problems) through irritability and parenting using a prospective design from ages 3 to 7. A sample of 614 3-year-old preschoolers was followed at ages 4, 6, and 7. Parents answered questionnaires about temperament (age 3), irritability (age 4), parenting practices (age 6), and psychopathology (age 7). Statistical analyses were carried out through structural equation modeling (SEM) to test the mediation effect of irritability and parenting practices from temperament (negative affectivity and effortful control) through to affective, anxious, and oppositional problems. The proposed model fit the data well. SEM showed (a) an indirect effect from temperament to affective problems, via irritability and positive parenting; (b) a direct effect from negative affectivity to anxiety, plus an indirect effect from both temperament dimensions, via irritability and autonomy parenting practices; and (c) an indirect effect from temperament to oppositional problems, via irritability and punitive parenting. Irritability and parenting are transdiagnostic mediational variables that should be focused on in intervention programs for affective, anxiety, and oppositional problems.     

Something torn or burst or unbearable: a psychoanalytically-informed exploration of the experience of somatic symptoms

Experiences of and responses to bodily symptoms have long held interest, from earlier roots in hysteria to the most recent category of somatic symptom disorder (SSD) in DSM 5. SSD’s focus on distress implies that symptoms hold meaning for individuals. This study used a psychoanalytically-informed, multiple interview method and analysis to explore such possible meanings. Six participants were interviewed on three occasions each, with four themes emerging as follows: (1) a foreign body in charge; (2) left alone with the foreign body; (3) the body works for the mind; and (4) the body mirrors the mind. Bion’s idea of an active container-contained function and the construct of psychic pain formed a useful framework for understanding themes. The distress that lies in somatic symptoms was formulated as potentially stemming from an initial difficulty with containment in the primary object relationship. It is argued that distress may indicate a struggle with suffering that is not only somatic but also psychological in nature; and that the symptomatic body may have reached its limits in containing psychic pain. Implications for working clinically include the importance of close and sustained attention, through the clinician’s reverie, to somatic and emotional feeling states to help guide treatment.     

The mediating role of joint attention in the relationship between motor skills and receptive and expressive language in siblings at risk for autism spectrum disorder

Language problems are highly prevalent in younger siblings of children with autism spectrum disorder (HR-sibs), yet little is known about early predictors. There is growing evidence that motor and language development are linked and this connection might be mediated by joint attention. Developmental changes in motor abilities change how children interact with objects and people (e.g., by showing), which may influence language development. This association has however not yet been studied in HR-sibs. The interrelationship between motor, joint attention and language skills was explored in younger siblings of typically developing children (LR-sibs, N = 31) and HR-sibs (N = 32). In both groups, motor skills (composite of fine and gross motor skills) at 10 months influenced receptive and expressive language at 36 months directly and indirectly through joint attention at 14 months. Group status moderated this direct and indirect effect with mainly significant effects in HR-sibs. This indicates that lower motor skills can have cascading effects on joint attention and language in HR-sibs. Consequently, assessment of early motor skills in HR-sibs might hold promise for early identification of motor difficulties but can also be indicative of language difficulties later in life, especially when difficulties with joint attention are also present.     

Generalisation of threat expectancy increases with time

Excessive fear generalisation is a feature characteristic of clinical anxiety and has been linked to its aetiology. Previous animal studies have shown that the mere passage of time increases fear generalisation and that brief exposure to training cues prior to long-term testing reverses this effect. The current study examined these phenomena in humans. Healthy participants learned the relationship between the presentation of a picture of a neutral male face and the delivery of a mild shock. One group was immediately tested with a novel picture of a somewhat different male face (generalisation test). Another group was tested one week later. A third group was also tested one week later and was additionally exposed to the training picture prior to testing. During picture presentations, shock-expectancy ratings were obtained as a measure of fear. Fear generalisation increased from the immediate test to the 1-week follow-up test. This result could not be attributed to level of neuroticism or a general increase in fear (incubation). Furthermore, the time-dependent increase in fear generalisation vanished following brief exposure to the training picture. Results indicate that human fear generalisation is a temporally dynamic process and that memory for stimulus details can be re-established following a reminder treatment.     

自闭症谱系障碍者的视运动知觉

视运动知觉是人脑对外界物体的运动特性的知觉。视运动知觉异常是自闭症谱系障碍者的一种常见表现, 其检测光流、二阶运动、协同性运动、生物运动及运动速度的能力异于健康控制组, 且过度迷恋重复性运动物体。该群体视运动知觉异常的原因探析集中于背侧/M细胞通路特定假设、复杂性假设、神经噪声假设、经验缺失假设、时空加工异常假设、极端男性脑理论和社会脑假设。但到目前为止, 尚缺乏一个统一准确的、可验证的解释。未来研究应注重考察自闭症者视运动知觉异常的个体差异和神经生理机制, 进一步整合和验证解释理论, 并着眼开发有效的视运动知觉测评工具和干预策略     

Obsessional Beliefs and Symptoms of Obsessive–Compulsive Disorder in a Clinical Sample

The aim of the present study was to investigate the relationships among a broad range of obsessive–compulsive disorder (OCD) symptoms and obsessional beliefs in a clinical sample of OCD patients. Ninety-nine treatment-seeking adult OCD patients completed the Obsessive Beliefs Questionnaire and the Obsessive–Compulsive Inventory-Revised. Hierarchical regression analyses, controlling for comorbid symptoms, suggested that washing was predicted by responsibility/threat estimation beliefs. Checking/doubting was not predicted by any obsessional beliefs. Hoarding was predicted by perfectionism/certainty beliefs. Neutralizing was predicted by responsibility/threat estimation beliefs. Obsessing was predicted by importance/control of thoughts and perfectionism/certainty beliefs. Ordering was predicted by perfectionism/certainty beliefs. A principal components analysis of OCD symptom dimensions and accompanying beliefs yielded two components, accounting for 53% of the variance: one, which was labeled “Fear/Threat,” consisted of importance/control of thoughts, obsessing, responsibility/threat estimation, and washing. The second, which was labeled “Incompleteness/Not Just Right,” consisted of neutralizing, perfectionism/certainty, checking/doubting, and hoarding.     

Comorbidity of Pediatric Obsessive–Compulsive Disorder and Anxiety Disorders: Impact on Symptom Severity and Impairment

This study explored the impact of comorbidity on symptom severity and treatment outcome in a sample of 75 pediatric Obsessive–Compulsive Disorder (OCD) patients. Forty received cognitive–behavioral therapy (CBT). Overall, 56% had a comorbid disorder. Results revealed that youth with comorbid disorders (anxiety or otherwise) endorsed significantly more anxiety symptoms than youth with OCD only. Youth with comorbidities instead of or in addition to anxiety exhibited more severe OCD symptoms than youth with OCD alone or an anxiety-only comorbidity. Youth in the comorbidities instead of or in addition to anxiety group had the poorest CBT response relative to the other groups. These results suggest that relative to those with OCD alone or with an anxiety disorder comorbidity, youth with comorbidities instead of or in addition to anxiety have a differing clinical presentation (e.g., more severe symptoms) and worse psychotherapy outcome.