Referential Communication Disturbances in the Speech of Nonschizophrenic Siblings of Schizophrenia Patients.

Several different types of communication disturbances have been identified in the speech of schizophrenia patients. This study assessed 6 types of referential communication disturbances in the speech of 32 stable outpatients, 23 of their nonschizophrenic siblings, and 27 control subjects. The siblings made more frequent reference failures of all types than control subjects and did not differ from the patients on most types of disturbance. Only on the arguably most "schizophrenic" type of disturbance, the missing information reference, did patients show more deviance than siblings. On the vague reference, siblings showed more deviance than patients. These results, which are very similar to those previously reported on parents of patients, support the idea that referential disturbances reflect vulnerability to schizophrenia. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Thought disorder in adolescent-onset schizophrenia

The nature of the thinking disturbances found in adolescent-onset psychotic conditions is not as well-characterized as the thought disorders found in adult psychotic patients. We used the Thought Disorder Index to examine whether schizophrenic patients in whom psychotic symptoms appear in adolescence show the same characteristic features of thought disorder as do adult schizophrenics. Quantitative and qualitative features of thought disorder were assessed in psychiatric inpatients with adolescent-onset schizophrenia, psychotic depression, and nonpsychotic conditions compared with normal control adolescents. Elevated thought disorder occurred in all groups of adolescents hospitalized for an acute episode of psychiatric illness. The magnitude of the elevation and the frequency of occurrence of disordered thinking were greatest in the psychotic adolescents. The qualitative features of the thought disturbances found in the schizophrenic adolescents were distinct from those observed in adolescents with psychotic depression. The thinking of the schizophrenic adolescents resembled that of adult schizophrenics. In both conditions thought disorder is characterized by idiosyncratic word usage, illogical reasoning, perceptual confusion, loss of realistic attunement to the task, and loosely related ideas.     

Interleukin-1 inhibits Leydig cell steroidogenesis without affecting steroidogenic acute regulatory protein messenger ribonucleic acid or protein levels

This study compared levels of referential communication disturbance in speech samples from 41 stable schizophrenia outpatients, 46 parents of patients, and 23 nonpsychiatric control participants in affectively positive versus affectively negative conditions. The speech of the patients and parents showed elevated frequencies of reference failures in the affectively positive condition compared with control participants: the speech of the patients became more disordered in the affectively negative condition, whereas the speech of the parents did not. These results support the idea that referential communication disturbances reflect vulnerability, as well as overt illness, but that affective reactivity of these disturbances is associated mainly with the manifest illness. These findings are consistent with biological, cognitive, and psychological theories about the processes underlying stress responsiveness of schizophrenic symptoms more generally.     

Velogenic Newcastle disease virus in captive wild birds

This study investigated the correlates of change in behavioral disturbance in geropsychiatric inpatients with dementia. It was hypothesized that improvement in specific psychiatric symptoms, such as psychosis and depression, contribute to the improvement of specific behavioral disturbances. All admissions between October 1993 and May 1995 were reviewed to identify those patients admitted to the Houston VA geropsychiatry unit with a diagnosis of dementia; 233 patients were included in the study. Improvement in behavioral disturbance symptoms was associated with decreases in depression, thought disorder, and hostility. However, the relative importance of depressive and psychotic symptoms varied depending upon the type of behavioral disturbance examined. These results may support a focused approach employing therapies specific to the type of behavioral disturbance.     

Affective reactivity of speech in schizophrenia patients and their nonschizophrenic relatives.

This study compared levels of referential communication disturbance in speech samples from 41 stable schizophrenia outpatients, 46 parents of patients, and 23 nonpsychiatric control participants in affectively positive versus affectively negative conditions. The speech of the patients and parents showed elevated frequencies of reference failures in the affectively positive condition compared with control participants; the speech of the patients became more disordered in the affectively negative condition, whereas the speech of the parents did not. These results support the idea that referential communication disturbances reflect vulnerability, as well as overt illness, but that affective reactivity of these disturbances is associated mainly with the manifest illness. These findings are consistent with biological, cognitive, and psychological theories about the processes underlying stress responsiveness of schizophrenic symptoms more generally. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Reference performance and positive and negative thought disorder: A follow-up study of manics and schizophrenics.

Manic (n?=?22) and schizophrenic (n?=?28) patients were examined with clinical and linguistic measures of language performance at an acute admission and at a follow-up. It was found that the frequency of incompetent references and the severity of negative thought disorder were stable independent traits of schizophrenics. Furthermore, low levels of verbal productivity, indexed both clinically and linguistically, predicted the likelihood that schizophrenic subjects would be psychotic at follow-up. The language performance of manic patients was not temporally stable, although high levels of reference failures at index predicted psychosis at follow-up. These results are evaluated in terms of their implications for differentiating state-specific aspects of speech competence from potential vulnerability markers in these two types of patients. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Thinking disorders in parents of young psychotic children.

Tested 17 parents of young psychotic children on the Object Sorting Test. 2 control groups were used. The sample differed from the replicated studies in that parents of adult schizophrenics were tested. Since childhood psychosis has substantial differences from adult schizophrenia, it was anticipated that parents of psychotic children would not show the same extent of thought impairment found in parents of adult schizophrenics. The Ss, however, showed more thought impairment than parents of normal children. Mothers showed more impairment than fathers. Findings were interpreted to suggest circumscribed test anxiety in association with a psychotic child rather than representing a formal thought disorder. (20 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Life events and psychopathology severity among first psychiatric admissions.

To test an expected relationship between life-events (LE) stress (Social Readjustment-Rating Scale) and severity of psychopathology among 1st-admission functional-disorder psychiatric inpatients, the present study considered LE in multivariate combination with other factors relevant to the severity of mental disorder. Intensive, reliable, structured interviews with 217 15–54 yr old patients yielded LE variables reflecting stress levels and changes in stress levels for various time periods during the preadmission year, 9 indices of pathology severity, and measures of demographic, prognostic, and social supports control factors. Bivariate correlations and a replicated multiple regression data analysis procedure were employed. Small, positive significant relationships were found between LE variables and types of symptomatology. Stress levels were related to severity of neurotic and suicidal symptoms, and increases in stress just prior to admission were related to severity of schizophrenia and psychotic symptoms. Stress variables were not related to overall impairment or severity of diagnostic classification. (48 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Superior temporal gyrus and planum temporale in schizophrenia: a selective review

1. The normal structure of the superior temporal gyrus (STG) has been elucidated from human and non-human primate research. This brain region is structurally complex, contains several distinct cellular regions and the area known as the planum temporale. 2. The STG connects with heteromodal neocortical regions and temporolimbic areas. 3. Functional studies of the normal STG in animals and in humans, using electrophysiology and PET/fMRI, emphasize the STG's role as part of a cortical network important in the interpretation, production and self-monitoring of language. 4. There is evidence for structural abnormalities of the STG in schizophrenia including both volume reductions and disturbances of normal asymmetries. 5. Functional studies of this region in schizophrenic patients, including measurements of evoked potentials and of bloodflow, are abnormal, especially when patients perform language tasks or experience hallucinations. 6. This structural and functional pathology in the STG probably represents one example of a more general disruption in schizophrenia of the neocortical network of which this region is an essential part. This disturbance may be closely associated with the symptoms of formal thought disorder and of auditory hallucinations commonly seen in the disorder.     

Conversational repair in schizophrenic and normal children

OBJECTIVE: Children acquire the skills to monitor the adequacy of their spoken message and to self-initiate repair strategies that modify the message during early, middle, and late childhood. To characterize further the communication deficits of childhood-onset schizophrenia, this study compared self-initiated repair strategies in schizophrenic and normal children and their relationship with formal thought disorder, discourse deficits, and distractibility. METHOD: Measures of self-initiated repair, formal thought disorder, and cohesion were coded in 32 schizophrenic and 47 normal children, aged 5.6 to 12.4 years, from speech samples elicited with the Story Game. RESULTS: The schizophrenic children used some repair strategies (false starts, fillers, referential revision) more infrequently than the normal children. Within the schizophrenic group, the children who were receiving neuroleptic medication underutilized repair and had more discourse deficits than the unmedicated patients. Loose associations and distractibility were associated with increased use of false starts but not fillers. CONCLUSIONS: In addition to formal thought disorder and discourse deficits, schizophrenic children underutilize self-initiated repair when presenting their thoughts to the listener, particularly if they are being treated with neuroleptics, a potential sign of increased clinical morbidity. Impoverished communication skills might reflect negative signs in childhood-onset schizophrenia.     

Self-experienced vulnerability, prodromic symptoms and coping strategies before schizophrenic and affective episodes

For the first time, the present study explores self-experienced vulnerability, prodromal symptoms and coping strategies preceding schizophrenic and affective episodes. 33 schizophrenic and 29 depressive patients were assessed retrospectively for preepisodic alterations by means of the "Bonn Scale for the Assessment of Basic Symptoms- BSABS" after complete recovery from the acute episode. 97% of the schizophrenic and 93% of the depressive patients showed preepisodic alterations. In the schizophrenic group the first alteration occurred with a median of 10 weeks and in the depressive group with a median of 18 weeks before the onset of the acute episode. With regard to self-experienced vulnerability depressive cases were significantly less tolerant to stress, i.e work under time pressure or unusual, unexpected requirements. With regard to prodromal symptoms schizophrenics showed significantly more often interpersonal irritation and certain perception and thought disturbances, whereas depressive patients reported more often adynamia and certain disturbances of proprioception. 73% of the schizophrenic patients and 90% of the depressive patients reacted to early symptoms with coping strategies. The preepisodic alterations in schizophrenic patients could be described in terms of mild psychotic productivity, early symptoms of depressive patients could be described as a mild depressive syndrome. Prospective studies are necessary to show if assessment of mild psychotic productivity could be used for early diagnosis and early intervention in schizophrenia.     

Subclinical thought disorder in first-degree relatives of schizophrenic patients. Results from a matched-pairs study with the Thought Disorder Index

To assess the frequency and quality of formal thought disorder in schizophrenic patients and their first-degree relatives, a consecutive series of 36 unmedicated patients, 20 siblings of these patients and 37 normal control subjects were examined with Holzman's Thought Disorder Index (TDI). As a proof of the internal validity of this tool, the patients demonstrated significantly more thought disorder than the controls as measured by the TDI total score and various subscores, which proved the internal validity of this tool in a German-speaking sample. In addition, in a pairwise comparison with controls who were individually matched by age and sex the patients' siblings had a significantly higher total TDI score and nonsignificant elevations on several subscores (combinatory and flippant). As to the level of severity of the thought disorder, the siblings mostly took an intermediate position between patients and controls. In conjunction with previous reports from other authors, our findings lend further support to the notion of subclinical thought disorder as an indicator of familial vulnerability to schizophrenia.     

Shortened REM latency as a psychobiological marker for psychotic depression? An age-, gender-, and polarity-controlled study

BACKGROUND: Previous reports suggest that the clinical dichotomy separating psychotic and nonpsychotic depression corresponds to different neurobiological profiles. The aim of the present study is to further investigate the psychobiological correlates of these two particular depressive subtypes. METHODS: Thyroid-stimulating hormone response to thyrotropin-releasing hormone postdexamethasone cortisol levels, and electroencephalgraphic sleep characteristics of 44 psychotic major depressive patients were compared to those of 44 nonpsychotic depressives matched for age, gender, and polarity. RESULTS: Some biological disturbances usually associated with depression (increased wakefulness, diminished rapid eye movement latency, hypercortisolism, blunted thyroid-stimulating hormone response to thyrotropin-releasing hormone stimulation) seemed to be significantly more pronounced in the psychotic depressed group as a reflection of greater illness severity; however, shortened REM latency was not influenced by severity and seemed to be more specifically related to the co-occurrence of psychotic and depressive symptoms. CONCLUSIONS: Our data provide further support for the validity of the clinical dichotomy separating psychotic and nonpsychotic major depression independently of severity.     

The spring-mass model and the energy cost of treadmill running

Cataphasia, one form of Leonard's unsystematic schizophrenias, shows a polymorphous, but nevertheless specific symptomatology. The key features of the psychopathology of this condition are formal thought and speech disorders. Hallucinations and delusional ideas can be present, but they are incidental and do not determine the syndrome. The characteristic elements of this thought disorder are logical derailment, paralogic thinking and, especially in the excited form, incoherence with contaminations up to "word salad". The speech shows strange verbalizations, paragrammatisms, agrammatisms, and occasionally neologisms. The course mostly fluctuates with acute attacks and incomplete remissions leading to residual states of varying degrees of severity determined by a flattened and somewhat euphoric affect. Usually the disorder appears in an excited or inhibited form. In the latter case, thought disorder is difficult to recognize. Sometimes it can only be stated by the facial expression, which reveals an internal emptiness and dullness, and a tendency to state fixedly at the examiner. Psychopharmacotherapy can diminish accompanying delusional ideas or hallucinations, but does not have much influences on the core syndrome of formal thought and speech disorder.     

Symptom correlates of attentional improvement following hospitalization for a first episode of affective psychosis

BACKGROUND: This study examined patients with a first-episode of affective psychosis during acute and compensated states in order to determine whether changes in attentional functioning over time were accompanied by changes in the severity of psychotic or affective symptoms. METHODS: Attentional performance was measured in patients (n = 27) using the degraded-stimulus continuous Performance Test (CPT) and symptoms were assessed at the time of index hospitalization, and 2 months after discharge. A comparison group of normal volunteers (n = 31) also performed the CPT two months apart. RESULTS: Patients performed significantly worse than controls at the initial testing but not at follow-up. The improvement in attentional performance significantly correlated with decreased severity of manic symptoms. CONCLUSIONS: Results suggest attentional dysfunction is a state-dependent characteristic of mania, and may provide an additional measure of clinical improvement following treatment.     

Formal thought disorder in schizophrenics and their twins.

Measured thought disorder in the co-twins of schizophrenic twins in 17 pairs of identical twins, 14 pairs of fraternal same-sex twins, and 12 unpaired twins. Ss were administered a modified version of the Scale for the Assessment of Thought, Language, and Communication Disorders. No evidence of genetic influence on thought disorder was found. A factor analysis of the thought disorder scales revealed 2 interpretable factors reflecting verbosity and discontinuities in the form of speech. Scales with high loadings on the verbosity factor showed signs of familial influence and were significantly correlated with severity of psychiatric history. Scales with high loadings on the discontinuity factor were associated with the florid psychotic phase of illness. (36 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Cognitive patterns and major depressive disorder: A longitudinal study in a hospital setting.

Assessed the cognitive patterns of individuals suffering from unipolar major depressive disorder, episodic and nonpsychotic type, shortly after admittance to an inpatient psychiatric facility and again shortly before discharge. In addition to the depressive group, a nondepressed psychiatric and a nondepressed normal group were administered the same measures (Hopelessness Scale, the Dysfunctional Attitude Scale, and the Attributional Style Questionnaire) at comparable points in time. In contrast to the concept of a traitlike depressive cognitive style that persists beyond remission of the current depressive episode, the depressives showed dramatic changes on all of the cognitive measures as their symptoms abated. Results suggest that unipolar major depressive disorder, episodic and nonpsychotic type, may be heterogeneous with respect to cognitive patterns. Whereas a sizeable group of Ss suffering from this disorder exhibited the hypothesized depressive cognitive profile during the depressive episode, others did not. (41 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Information Processing Deficits in Remitted Schizophrenics.

This study investigated early stages of information processing in schizophrenia as assessed by a backward-masking paradigm. Ten remitted process schizophrenics and 10 matched normal controls were tested. Subjects were matched for both age and intelligence. All schizophrenics met the criteria of an early onset, poor premorbid adjustment, evidence of formal thought disorder (e.g., language disturbance) and had previously exhibited hallucinations or delusions. Stimuli were tachistoscopically exposed under two masking conditions, two stimulus durations, and five masking latencies (stimulus onset asynchronies) over four 200-trial sessions, for a total of 800 trials. A two-alternative forced-choice recognition of a T or A served as the dependent measure. Results indicated that whereas schizophrenics were more impaired than normals under both masking conditions, they were particularly impaired under the pattern mask condition. These results add support to the growing evidence of an early information processing disturbance in schizophrenia that is trait dependent and is not an artifact of nonspecific pathological disturbance. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Body image disturbance in body dysmorphic disorder and eating disorders. Obsessions or delusions?

At this time, the question posed by this article's title--body image disturbance in body dysmorphic disorder and eating disorders: obsessions or delusions?--is probably best answered "both." Both disorders appear to be characterized by obsessional and delusional thinking. In addition, it is likely that their nondelusional and delusional variants constitute a single disorder encompassing a spectrum of insight, with the entire spectrum characterized by obsessional thinking. This view represents a considerable departure from DSM-III-R, in which the psychotic disorders were encapsulated in a separate section of the manual and considered different disorders from their nonpsychotic variants. The one exception was the mood disorders, which were acknowledged to have psychotic variants that were classified in the manual's "nonpsychotic" section. In DSM-IV, on the basis of emerging empirical evidence about the dimensional nature of the psychotic/nonpsychotic boundary, the dichotomy between delusional and nondelusional disorders is less clear. The double coding allowed for BDD acknowledges that BDD and its delusional disorder variant may constitute a single disorder; that allowed for OCD acknowledges that OCD may be delusional. With regard to eating disorders, however, DSM-IV is surprisingly silent, perhaps because delusional preoccupations are less common than in BDD. These issues also may apply to other disorders. Like BDD, hypochondriasis is classified as a somatoform disorder, with its delusional variant a type of delusional disorder, somatic type. Do the delusional and nondelusional variants of hypochondriasis constitute the same disorder? Do other types of somatic delusional disorder, such as parasitosis and olfactory reference syndrome (the belief that one emits a foul body odor) have nondelusional variants? It is likely that a number of disorders span a spectrum from delusional to nondelusional thinking, with unlimited shades of gray in between. Future research may indicate that obsessional disorders such as BDD, anorexia, OCD, and hypochondriasis, as well as other disorders such as major depression, should have qualifiers or subtypes--for example, "with good insight," "with poor insight," and "with delusional (or psychotic) thinking"--with an implied continuum of insight embraced by a single disorder. Such an approach, which scatters psychosis throughout the nomenclature, ultimately may be shown to be a more valid and clinically useful classification approach. Answers to these questions will not only improve our classification system but also may have important treatment implications. For example, the preliminary finding that delusional BDD responds preferentially to SRIs but not to neuroleptic agents contradicts conventional wisdom about the treatment of psychosis.(ABSTRACT TRUNCATED AT 400 WORDS)     

Psychological trauma and schizotypal personality disorder.

Two studies examined the relation between psychological trauma and schizotypal symptoms. In Study 1, in which 1,510 adults completed telephone interviews, both childhood maltreatment and the experience of an injury or life-threatening event were significantly associated with schizotypal symptoms. In Study 2, in which 303 adults (oversampled for having elevated levels of schizotypal symptoms) completed extensive in-person assessments, both childhood maltreatment and meeting posttraumatic stress disorder (PTSD) Criterion A were significantly associated with schizotypal symptoms. The links between schizotypal symptoms and at least some forms of psychological trauma could not be fully accounted for by shared variance with antisocial and borderline personality disorders, absorption/dissociation, PTSD symptom severity, family history of psychotic disorder, or signs of neurodevelopmental disturbance (as indexed by minor physical anomalies and inconsistent hand use). Schizotypal symptoms were more strongly associated with childhood maltreatment among men than among women, whereas schizotypal symptoms were more strongly associated with PTSD Criterion A among women than among men. Finally, among men, the association between childhood maltreatment and schizotypal symptoms was moderated by signs of neurodevelopmental disturbance. (PsycINFO Database Record (c) 2010 APA, all rights reserved)