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Query: UMLS:C0036341 (schizophrenia)
 60,220 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The effectiveness of group treatments for people with schizophrenia has not been examined on symptom-specific (positive and negative symptoms) outcomes, and the differential effects of the most popular group treatments remain unknown. We conducted a meta-analysis of randomized controlled trials that tested (a) the effectiveness of 7 frequently used group treatments on positive and negative symptoms and (b) if treatment-specific outcome improvement was associated with improvement on schizophrenia symptoms. Major databases were searched from 1990 to 2018 for randomized controlled trials of group treatment for people with schizophrenia, including first-episode psychosis. A random effects meta-analysis and meta-regression was conducted on 52 studies representing 4,156 individuals that produced a significant, small effect on symptom-specific outcomes (g = 0.30), with 4 group treatments (cognitive remediation, multifamily, psychoeducational, and social skills training) posting significant improvement. In addition, change on treatment-specific outcomes explained 16% of schizophrenia symptom and 44% of general functioning improvement. Results are discussed with respect to how they replicate past meta-analytic findings and possible revision of practice guidelines to incorporate evidence-based group treatments for schizophrenia. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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PMID:Group therapy for schizophrenia: A meta-analysis. 3247 61

Prior research indicates that individuals with schizophrenia (SZ) display emotion regulation abnormalities that are critically linked to increased symptom severity and poor functional outcome. However, processes contributing to the aberrant implementation of various strategies are unclear. The current study took a multimodal approach to identifying mechanisms underlying the impaired implementation of 2 strategies: reappraisal and distraction. Participants included 25 individuals with SZ and 25 healthy controls (CN) who completed separate event-related potential and eye-tracking/pupil dilation tasks. On each task, participants were required to either passively view unpleasant or neutral stimuli or reduce negative affect using reappraisal or distraction emotion regulation strategies. The late positive potential (LPP) event related potential component was used as an objective neurophysiological indicator of emotion regulation effectiveness. Eye tracking and pupil dilation were used to determine whether the implementation of reappraisal and distraction were associated with abnormal patterns of visual attention and reduced cognitive effort, respectively. Results indicated that CN could effectively decrease the amplitude of the LPP for both reappraisal and distraction compared with unpleasant passive viewing; however, individuals with SZ showed comparable LPP amplitude among conditions, indicating a failure to effectively implement these strategies. In CN, successful down-regulation of negative affect was associated with different patterns of visual attention across regulation strategies. During reappraisal, there was an increase in fixations to arousing scene regions, whereas distraction was associated with reduced attention to arousing interest areas. In contrast, individuals with SZ made fewer fixations to arousing interest areas during reappraisal and more fixations to arousing interest areas during distraction. Furthermore, pupil dilation results suggested that individuals with SZ failed to exert adequate effort while implementing reappraisal. Collectively, these findings suggest that individuals with SZ are ineffective at implementing reappraisal and distraction; dysfunctional patterns of visual attention and low cognitive effort may contribute to these difficulties. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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PMID:Neurophysiological evidence for emotion regulation impairment in schizophrenia: The role of visual attention and cognitive effort. 3252 26

Developmental epidemiological work shows that rates of depression as assessed by diagnostic interviews increase from childhood through early adulthood. It could be assumed that the trajectory of depression as assessed by self-report questionnaire measures would be characterized by a similar pattern. We aimed to evaluate this assumption and more clearly establish the longitudinal trajectory of depression in youth, when repeatedly assessed over time with a self-report questionnaire and with a diagnostic interview. Participants were 679 youth ages 7-16 years at baseline (Mage = 11.8, SD = 2.4, 56% girls). They completed the Children's Depression Inventory (CDI) every 3 months for 3 years (13 time points) and were interviewed every 6 months using the Kiddie Schedule for Affective Disorders and Schizophrenia (K-SADS) to ascertain onset of depression diagnosis. A series of growth curve models was fit to the CDI and K-SADS data. A piecewise model characterized growth in depression as assessed by the CDI, with an initial negative linear slope (b = -0.64) spanning the first 3 assessments, and a positive quadratic second slope (b = 0.015; linear component: b = -0.22) spanning the remaining 10 assessments. Depression, as assessed by the K-SADS, grew continuously over time (a positive linear slope, b = 0.23). Findings illustrate differences between longitudinal trajectories of depression when assessed repeatedly by self-report questionnaire and diagnostic interview. Implications for research designed to study longitudinal depression trajectories are discussed. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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PMID:Longitudinal patterning of depression repeatedly assessed across time among youth: Different trajectories in self-report questionnaires and diagnostic interviews. 3253 43

Episodic future thinking (EFT) refers to mental simulation of possible future events, a process that mostly depends on episodic memory (EM). EFT impairment in schizophrenia was proposed to disturb continuity in self-functioning. Schizophrenia patients are also impaired in EM as well as executive functions (EFs). In the present study, we aimed to clarify the relationship between EFT and memory functions in schizophrenia by assessing (a) whether a group of individuals with schizophrenia (schizophrenia group [SG]) who have relatively intact long-term memory functions differ from healthy controls (control group [CG]) in terms of EFT performance, and (b) whether such difference is biologically represented in terms of cortical activity. We also aimed to clarify the role of EFs in EFT in 3 task conditions: past remembering with a single cue (PR), future imagination with a single cue (FI-1C), and future imagination with 3 given cues (FI-3C). Cortical activity was monitored by functional near-infrared spectroscopy. Although the two groups showed a comparable performance in the PR, the SG performed worse than the CG in the two future-imagination conditions. In the CG, mental flexibility predicted EFT, and EM predicted PR. No such relationship was observed in the SG. In the CG only, activity was higher in the FI-1C than the PR in the middle and superior temporal cortices. In the SG, activity in the rostral prefrontal cortex (rPFC) was negatively correlated with performance in FI-3C. These results suggest that EFT is still observed but not associated with EFs in individuals with schizophrenia having relatively intact memory functions. Altered activity in the rPFC may be associated with EFT impairment in schizophrenia. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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PMID:Investigation of the cortical activity during episodic future thinking in schizophrenia: A functional near-infrared spectroscopy study. 3255 41

Episodic future thinking for positive future events is known to evoke positive affect. We aimed to assess whether it specifically evokes anticipated and anticipatory pleasure for future events, and behavioral intention. As a secondary aim, we examined if this differed compared to a condition of thinking of positive past events. In two studies, participants nominated 5 upcoming positive events and 5 positive past events. They then completed guided episodic thinking of past events and guided episodic thinking of future events. After guided episodic thinking, they rated the nominated future events on detail/vividness, mental imagery, anticipated and anticipatory pleasure, and behavioral intention. In Study 1 (N = 32, M age = 37.0, SD = 19.7), increases on all variables were found relative to baseline, although expected pleasure was at trend level. There were no significant differences between future and past conditions. In Study 2 (N = 29, M age = 38.4, SD = 16.3), participants were asked to nominate future events that were not already planned, and perceived control was also assessed. Again, increases in detail/vividness, mental imagery, and anticipated and anticipatory pleasure were found, this time with stronger effects for the future condition. No change was found for perceived control or intention. In both studies, increases in detail/vividness, mental imagery, and anticipated and anticipatory pleasure were generally positively correlated with increases in behavioral intention. This study provides evidence that guided episodic thinking increases anticipated and anticipatory pleasure for positive future events. Clinical implications, particularly in depression and schizophrenia-spectrum disorders, are discussed. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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PMID:Increasing anticipated and anticipatory pleasure through episodic thinking. 3255 46

The current study examined whether subgroups of individuals with schizophrenia could be identified based on their profiles of trait positive and negative emotional experience, and whether those subgroups differed in their symptom presentation and functional outcome. Participants included 192 outpatients diagnosed with schizophrenia or schizoaffective disorder (SZ) and 149 demographically matched healthy controls who completed the trait version of the Positive and Negative Affect Scale, as well as symptom and functional outcome assessments. Cluster analysis determined whether patients could be separated into meaningful subgroups based on their trait emotional experience profiles, and discriminant function analysis determined whether these groups were valid and adequately separated. Forty-two percent of the patients fell into an affectively normal cluster, whereas 28% and 30% fell into low positive affect (PA) and high negative affect (NA) clusters, respectively. These subgroups differed significantly on positive symptoms, negative symptoms, Diagnostic and Statistical Manual of Mental Disorders diagnoses, and functional outcomes. Trait emotional experience is heterogeneous in outpatients with psychotic disorders, and meaningful subgroups of patients with different profiles of PA and NA can be identified. These subgroups show meaningful differences in clinical presentation, which may necessitate different treatment approaches. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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PMID:Heterogeneity of emotional experience in schizophrenia: Trait affect profiles predict clinical presentation and functional outcome. 3258 84

Positive schizotypy includes magical beliefs and unusual perceptual experiences and is highly correlated with the cognitive-perceptual symptoms of schizotypal personality disorder. Increased openness to experience is associated with increased genetic risk for schizophrenia, and it has been commonly thought that positive schizotypy might also be related to increased openness. However, much previous research has failed to identify a sizable association between positive schizotypy and openness. The current research examined whether associations between positive schizotypy and openness might be higher (a) when using measures that more effectively assess the maladaptively high end of openness and (b) for distinct aspects of openness. Participants (n = 672) completed two measures of openness, the Big Five Aspects Scale (BFAS) and Experiential Permeability Index (EPI). We found that associations between positive schizotypy and BFAS-Open were small. However, in item response theory analyses, there was evidence that one facet of the EPI Oddity subscale highly associated with BFAS-Open was more sensitive to the maladaptively high end of openness than BFAS-Open. Further, positive schizotypy was more strongly associated with this EPI facet than with BFAS-Open. In addition, positive schizotypy was especially associated with a second facet of the EPI Oddity subscale. Hence, our study provides further evidence that associations between positive schizotypy and openness increase when assessing the maladaptively high end of openness and that positive schizotypy is most highly associated with particular facets of openness. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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PMID:Positive schizotypy, maladaptive openness, and openness facets. 3258 93

In clinical trials, standardized assessment conducted by research staff facilitates identification of treatment benefit. Narrative notes completed by clinicians offer a novel source to characterize and contextualize outcomes. In this study, we examine qualitative analysis of clinical notes as a method to augment quantitative outcome measures and supply meaningful context in clinical trials. Two hundred eighty-four clinical progress notes from 19 participants with schizophrenia or schizoaffective disorder assigned to receive either auditory-targeted cognitive training or treatment as usual were included. Qualitative analysis of weekly progress notes written by clinicians involved in ongoing care of the participants was used to identify overall outcome trajectories and specific changes in program participation, social functioning, and symptom severity. Trajectories were compared with the parent study's 2 primary outcome measures. Qualitative analysis identified personalized and complex trajectories for individual participants. Approximately half the participants improved overall. Most participants displayed improved program participation and social functioning, whereas most participants experienced symptom deterioration. Engagement in targeted cognitive training did not impact change in trajectories. Qualitative trajectories were congruent (e.g., both indicated improvement) with the 2 primary outcome measures for 26-36% of the participants depending on the comparison. Including qualitative analysis of clinician progress notes provides useful context and identifies underlying processes not captured in quantitative data. However, they cannot replace quantitative outcome measurement. Better alignment with clinician- and patient-targeted outcomes may strengthen clinical trials. Qualitative analysis of routinely collected data can benefit research and programmatic decision making in usual care settings. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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PMID:Contextualizing the road to recovery: A novel method of assessing outcome trajectories in clinical trials. 3265 11

Cognitive deficits in schizophrenia, which include impairments in working memory and attention, represent some of the most disabling symptoms of this complex psychiatric condition, and lack effective treatments. NMDA receptor (NMDAr) hypofunction is a strong candidate mechanism underlying schizophrenia pathophysiology, and has been modeled preclinically using acute administration of NMDAr antagonists to rodents to investigate biological mechanisms underpinning cognitive dysfunction. However, whether and how NMDAr hypofunction specifically influences all affected cognitive domains is unclear. Here we studied the effects of the NMDAr antagonist MK-801 (dizocilpine) on tasks of attention and working memory in rats using automated touchscreen chambers. Adult male Wistar rats were trained to perform the trial-unique nonmatching to location (TUNL) task of spatial working memory, or the 5-choice serial reaction time task (5CSRTT) of attention. Once trained, rats received injection of vehicle (saline) or low-dose MK-801 (0.06 mg/kg sc) 10 min prior to commencing test sessions. MK-801 significantly impaired working memory, as evidenced by reduced performance accuracy on the TUNL task (p < .0001), compared with vehicle. However, we found no significant effects on attentional processing or perseveration on the 5CSRTT. Additional measures indicated that MK-801 impaired behavioral flexibility in the TUNL task, and decreased response inhibition in both tasks. Using the automated touchscreen system to measure different cognitive functions under the same testing environment, we demonstrate that spatial working memory, response inhibition, and behavioral flexibility are more vulnerable to NMDAr hypofunction than attentional processing. This may have implications for the NMDAr hypofunction hypothesis of schizophrenia. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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PMID:Acute NMDA receptor antagonism impairs working memory performance but not attention in rats-Implications for the NMDAr hypofunction theory of schizophrenia. 3265 24

Social interaction promotes survival by helping animals to form stable and supportive groups. Additionally, maladaptive social behavior is a hallmark of disorders such as autism and schizophrenia. In many different animal species, including humans, social interaction can be inherently rewarding. Lately there has been growing interest in studying the neurobiological underpinnings of social interaction and learned social behavior in rodent behavioral models. One common procedure is conditioned place preference (CPP) to measure the rewarding effects of social interaction and social reward learning. Social CPP was originally used in rats but has been adapted recently for use in mice, enabling use of the vast array of genetic tools available in mice. Here we studied the role of age, sex, bedding, and prior social isolation on the expression of social CPP in male and female mice. We found that without social deprivation male mice display moderate and temporary social CPP during early adolescence but not adulthood. Early life social isolation increased social CPP in female but not male mice. In contrast, cocaine CPP was robust and long-lasting in male and female mice. Our results demonstrate that social CPP in mice is variable, occurring under only specific conditions, and that social isolation promotes social reward in female but not male mice. We discuss potential methodological and interpretive issues of the mouse social CPP model. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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PMID:Parametric investigation of social place preference in adolescent mice. 3267 90


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