Attachment patterns and early-life adversities are relevant to understand the role of psychosocial factors in the vulnerability and the development of psychosis. The first aim of the study was to ...test whether a dimensional attachment instrument, the CAMIR (from French; Cartes: Modèles Individuels de Relation), may differentiate attachment styles by comparing a group of psychotic patients with a non-clinical sample. Also, we hypothesised that attachment dimensions would predict Social Functioning (SF) within the clinical group.
We tried to verify whether the reformulated Learned Helplessness Model and its more fully articulated form, the Hopelessness Theory of Depression, were adequate to predict symptoms and social ...functioning (SF) in persons with schizophrenia-spectrum disorders by comparing a clinical group (n = 25) with a non-clinical one (n = 30). Bivariate correlations and multiple linear regressions were conducted to assess relationships between the Attribution Styles Questionnaire (ASQ), clinical variables, and SF within the clinical group. Differences between groups were found for most of attributional dimensions. A “pessimistic style” predicted depression within the clinical group. An unstable attribution bias predicted positive symptoms. General psychopathology and a global attribution style predicted 50% of the variance in general SF. The Learned Helplessness Model was suitable to predict depression regardless of psychotic symptoms and may be useful to predict clinical symptoms and SF in persons with schizophrenia spectrum disorders. Clinical and theoretical implications were discussed.
Research in the field of psychosis broadly suggests that symptoms, neurocognitive deficits, social cognition, cognitive biases, and attachment experiences influence each other. However, little is ...known if any of these constructions play a more central role than others as they interact.
To clarify this issue, we conducted a “network” analysis to explore the interplay among a set of variables related to attachment, cognition domains, and psychotic symptoms in a small sample of outpatients with stabilised schizophrenia-spectrum disorders (n = 25). Eighteen participants (72%) were first-episode patients. We assessed psychotic symptoms, attachment dimensions, neurocognitive performance, “theory of mind”, emotion recognition, and “jumping to conclusions” bias using standardised instruments.
The study provides preliminary evidence about a network structure in which the secure attachment (SA) is the most central “node” within the interacting network considering all centrality measures, followed by general psychopathology. SA was closely connected to self-sufficiency (avoidant attachment) and child traumatism, as well as with neurocognition. Emotion recognition impairment was the most robust connection to positive symptoms and mediated the influence of SA on psychotic symptoms.
Beyond the importance of symptoms, our results, although preliminary, suggest the need to assess attachment experiences and cognition domains to improve specific interventions that can promote recovery in outpatients with psychosis.
•Patients with psychosis have a significant Facial Emotion Recognition (FER) deficit.•FER deficit is present early and increases along the psychosis continuum.•Fear recognition is similarly impaired ...in high-risk, first-episode and schizophrenia.•Psychotic-like experiences and symptoms are related to FER.•FER should be included in evaluation and treatment from early stages of the illness.
Our study aimed to explore the recognition of specific emotions across the course of psychosis.
A visual task representing the six basic emotions was used to assess facial emotion recognition (FER) in 204 healthy controls classified into 152 low-risk (LR) and 52 high-risk for psychosis (HR), following a psychometric risk approach; and 100 patients: 44 with first-episode psychosis (FEP) and 56 with multi-episode schizophrenia-spectrum disorders (MES). First, we performed a MANCOVA to compare the four conditions. Next, we conducted a logistic regression to explore whether specific FER deficits predicted the presence of psychosis. Finally, we investigated the relationships of FER with psychosis-like experiences (PLEs) and psychotic symptoms.
Global FER, anger and fear recognition were impaired in HR, FEP and MES. No differences between HR and FEP appeared. Moreover, fear and anger correctly classified 83% of individuals into LR or psychosis. FER was associated with PLEs and psychotic symptoms.
Concluding, FER is early impaired in HR individuals and increases along the psychosis continuum. However, fear recognition is similarly impaired throughout the illness, suggesting a possible vulnerability marker. Furthermore, deficits in anger and fear recognition predicted the presence of psychosis. Therefore, we suggest that FER may be essential in detecting psychosis risk.
Resumen: La investigación sugiere que los síntomas, la neurocognición y la cognición social (CS) se influyen mutuamente y se relacionan a su vez con el funcionamiento psicosocial en la esquizofrenia. ...Tanto los déficits neurocognitivos como en CS podrían tener mayor responsabilidad que los síntomas clínicos sobre el funcionamiento social. Distintos sesgos de razonamiento cognitivo, como el “salto a conclusiones”, contribuyen a la formación y mantenimiento de los síntomas, y al funcionamiento en la vida real. La rehabilitación cognitiva ha mostrado cierta utilidad en la mejora de la cognición y del funcionamiento en las habilidades de la vida diaria de las personas con psicosis a través de sus posibles efectos sobre la neuroplasticidad cerebral. Diferentes programas, como el Entrenamiento Metacognitivo, aparecen como intervenciones prometedoras para mejorar los sesgos de razonamiento. La neurocognición, la CS y ciertos sesgos de razonamiento se interrelacionan para predecir el funcionamiento social en la esquizofrenia. Distintas intervenciones podrían mejorar estos procesos a través de sus efectos sobre la neuroplasticidad cerebral. No obstante, a pesar del creciente cuerpo de investigación, los resultados distan de ser concluyentes.
Resumen: La investigación sugiere que los síntomas, la neurocognición y la cognición social se influyen mutuamente y se relacionan, a su vez, con el funcionamiento psicosocial en la esquizofrenia. La ...medida de los déficits neurocognitivos se ha desarrollado notablemente con el protocolo “MATRICS”. Estos déficits se han relacionado con un funcionamiento anormal de la corteza prefrontal dorsolateral y con defectos en su conectividad con otras áreas cerebrales. Por otro lado, el deterioro de la cognición social se ha vinculado al llamado “cerebro social” y se ha relacionado con los síntomas y el funcionamiento psicosocial. La atención, memoria y función ejecutiva parecen alteradas en la esquizofrenia, relacionándose con un funcionamiento anormal de estructuras cerebrales y su conectividad entre ellas. Déficits en diferentes dominios de la cognición social, vinculados al llamado “cerebro social”, se apuntan como un posible marcador endofenotípico de la esquizofrenia. No obstante, problemas tanto metodológicos como conceptuales impiden asumir estas conclusiones como definitivas.
Objective. The purpose of this paper is to provide evidence for the relationship between personality disorders (PDs), obsessive compulsive disorder (OCD), and other anxiety disorders different from ...OCD (non-OCD) symptomatology. Method. The sample consisted of a group of 122 individuals divided into three groups (41 OCD; 40 non-OCD, and 41 controls) matched by sex, age, and educational level. All the individuals answered the IPDE questionnaire and were evaluated by means of the SCID-I and SCID-II interviews. Results. Patients with OCD and non-OCD present a higher presence of PD. There was an increase in cluster C diagnoses in both groups, with no statistically significant differences between them. Conclusions. Presenting anxiety disorder seems to cause a specific vulnerability for PD. Most of the PDs that were presented belonged to cluster C. Obsessive Compulsive Personality Disorder (OCPD) is the most common among OCD. However, it does not occur more frequently among OCD patients than among other anxious patients, which does not confirm the continuum between obsessive personality and OCD. Implications for categorical and dimensional diagnoses are discussed.
Cognitive biases have been demonstrated to be important in developing and maintaining psychosis. However, self-report measures for everyday clinical practice have been developed only recently. We ...aimed to study one of these instruments for assessing cognitive biases: the Davos Assessment of Cognitive Biases Scale (DACOBS).
In a Spanish sample of 84 patients diagnosed with schizophrenia-spectrum disorders and 152 healthy controls, we examined a) the factor structure using Confirmatory Factor Analysis (CFA) to test the original one-, three- and seven-factor solutions, b) the reliability (Cronbach's alpha), c) the discriminative power (Multivariate Analysis of Covariance - MANCOVA) and d) the relationships of cognitive biases with positive psychotic-like experiences (PPLEs) in healthy individuals and with psychotic symptoms in schizophrenia-spectrum patients.
The CFA revealed that the seven-factor solution achieved the best fit. The DACOBS overall scale (Cronbach's alpha = .92) and subscales obtained good internal consistencies. MANCOVA, controlling for age and education, demonstrated that all subscales differentiated between healthy controls and psychotic patients (Wilks' Lambda = 0.87; F7, 226 = 4.70; p < .000; partial eta squared = 0.13). In addition, the DACOBS showed high correlations with PPLEs (controls) and moderate correlations with positive and general symptoms (patients), demonstrating its predictive validity.
Concluding, the DACOBS proved to be a psychometrically suitable instrument for assessing cognitive biases in psychosis and adequately differentiated between patients and healthy individuals within the Spanish population. Norm scores are provided.
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