Are psychotic psychopathology and neurocognition orthogonal? A systematic review of their associations.

A systematic review (58 studies, 5,009 individuals) is presented of associations between psychopathological dimensions of psychosis and measures of neurocognitive impairment in subjects with a lifetime history of nonaffective psychosis. Results showed that negative and disorganized dimensions were significantly but modestly associated with cognitive deficits (correlations from -.29 to -.12). In contrast, positive and depressive dimensions of psychopathology were not associated with neurocognitive measures. The patterns of association for the 4 psychosis dimensions were stable across neurocognitive domains and were independent of age, gender, and chronicity of illness. In addition, significantly higher correlations were found for the negative dimension in relation to verbal fluency (p = .005) and for the disorganized dimension in relation to reasoning and problem solving (p = .004) and to attention/vigilance (p = .03). Psychotic psychopathology and neurocognition are not entirely orthogonal, as heterogeneity in nonaffective psychosis is weakly but meaningfully associated with measures of neurocognition. This association suggests that differential latent cerebral mechanisms underlie the cluster of disorganized and negative symptoms versus that of positive and affective symptoms. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Attitudes toward posthumous organ donation and commitment to donate.

Constructed and administered verbal attitude scales to 110 adults (aged 17–66 yrs), which resulted in reliable measurement of 2 independent dimensions, prodonation and antidonation. Cluster analysis revealed that the positive dimension involves belief in the humanitarian benefits of organ donation and feelings of pride experienced by the donor. The negative dimension reflects fears of body mutilation and of receiving inadequate medical treatment when one's life is at risk. Positive and negative scores in combination predicted willingness to sign a donor card. An analysis of variance (ANOVA) revealed significant main effects for both positive and negative attitude. Ss with strong positive attitudes and weak negative attitudes were especially willing to sign donor cards. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Intensity and frequency: Dimensions underlying positive and negative affect.

Research on emotions and several happiness scales suggests that positive and negative affect are strongly inversely correlated. However, work on subjective well-being indicates that over time, positive and negative affect are independent across persons. To reconcile this inconsistency, 2 dimensions are proposed for personal affective structure: the frequency of positive vs negative affect and the intensity of affect. In 3 studies, 68 undergraduates and 34 33–85 yr old community residents completed daily and momentary reports on their moods. In support of the intensity dimension, the correlations between positive and negative intensity were strong and positive in all 3 studies. The intensities of specific emotions across Ss were also highly correlated. Across the 3 studies the frequency and intensity of affect varied independently. Although average levels of positive and negative affect showed low correlations, this relation became strongly inverse when intensity was partialed out. Thus, the intensity dimension helps explain the relative independence of positive and negative affect. (29 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Self-reflection and the psychosis-prone brain: An fMRI study.

Objective: The Cortical Midline Structures (CMS) play a critical role in self-reflection, together with the insula. Abnormalities in self-referential processing and its neural underpinnings have been reported in schizophrenia and at-risk populations, suggesting they might be markers of psychotic vulnerability. Psychometric measures of schizotypal traits may be used to index psychosis proneness (PP) in nonclinical samples. It remains an unresolved question whether differences in self-reflective processing are associated with PP. Method: Six hundred students completed the Community Assessment of Psychic Experiences Questionnaire, positive subscale. Two groups were formed from the extremes of the distribution (total N = 36). fMRI was used to examine CMS/insula function during a self-reflection task. Participants judged personality trait sentences about self and about an acquaintance. Results: High PP subjects attributed less positive traits to others (i.e., acquaintances) than subjects with low PP. Across groups, the contrasts self > semantic and self > other induced activation in CMS and insula, whereas other > semantic did not produce insula activation. Other > self induced posterior cingulate cortex activation in low PP but not in high PP. In addition, high PP subjects showed stronger activation than low PP in left insula during self > semantic. Examining valence effects revealed that high PP individuals showed increased activation in left insula, right dMPFC, and left vMPFC for positive self-related traits, and in bilateral insula, ACC, and right dMPFC for negative self-related traits. Conclusions: The findings suggest that aspects of self-referential processing and underlying brain mechanisms are similar in clinical and subclinical (high PP) forms of psychosis, suggesting that these may be associated with vulnerability to psychosis. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Independence and bipolarity in the structure of current affect.

The independence of positive and negative affect has been heralded as a major and counterintuitive finding in the psychology of mood and emotion. Still, other findings support the older view that positive and negative fall at opposite ends of a single bipolar continuum. Independence versus bipolarity can be reconciled by considering (a) the activation dimension of affect, (b) random and systematic measurement error, and (c) how items are selected to achieve an appropriate test of bipolarity. In 3 studies of self-reported current affect, random and systematic error were controlled through multiformat measurement and confirmatory factor analysis. Valence was found to be independent of activation, positive affect the bipolar opposite of negative affect, and deactivation the bipolar opposite of activation. The dimensions underlying D. Watson, L. A. Clark, and A. Tellegen's (1988) Positive and Negative Affect schedule were accounted for by the valence and activation dimensions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Proteolysis of the phage lambda CII regulatory protein by FtsH (HflB) of Escherichia coli

BACKGROUND: It has been suggested that the expression of psychosis may reflect an active morbid process that is associated with increasingly poor outcome unless ameliorated by antipsychotic drugs. METHODS: The subjects of this study were 48 in-patients with schizophrenia, many of whom had been admitted before the introduction of antipsychotic drugs to rural Irish psychiatric hospitals in the late 1950s. Each patient was assessed for positive and negative symptoms, and for general and executive (frontal) cognitive function. RESULTS: After controlling for age and for duration and continuity of subsequent antipsychotic treatment, current severity both of negative symptoms and of general cognitive impairment was predicted strongly by increasing duration of initially untreated psychosis; duration of illness following initiation of antipsychotic medication failed to predict the severity thereof. Neither of these indices of illness duration predicted the severity of positive symptoms or of executive dyscontrol. CONCLUSIONS: Increasing duration of initially untreated psychosis was associated specifically with heightened accrual of prominent negative symptoms and general cognitive impairment. Executive dyscontrol, though also prominent in these patients, may be 'locked-in' at an earlier phase of the illness.     

Social consequences of mental illness.

The person who is publicly known to have had a hospitalization for "mental illness" was inferred to be vulnerable to a sharp depreciation of social esteem in a wide range of social roles. Cross-validation across samples of Ss and across time indicated that the frame of reference of the normal adult population, as to the role status of ex-mental-hospital patients, is both general (widely consensual) and specific (differentiated from other negative social roles that evoke anxiety and fear and carry a social stigma). 2 broad dimensions were postulated to underlie the evaluative complex for ex-mental-hospital patients—an "anxiety-fear" dimension and a "sympathy-contempt" dimension. (32 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The etiology of associations between negative emotionality and childhood externalizing disorders.

Despite consistent documentation of associations between childhood negative emotionality and externalizing psychopathology, few genetically informative studies have investigated the etiology of that association. The goal of the current study was to delineate the etiology of the covariation of negative emotionality and childhood externalizing problems (e.g., oppositional defiant disorder, conduct disorder, inattention, and hyperactivity/impulsivity). Twin families were recruited from Georgia state birth records and completed parental report questionnaires of negative emotionality and common Diagnostic and Statistical Manual of Mental Disorders (4th ed., text rev.; American Psychiatric Association, 2000) child psychiatric disorders. Results suggest both genetic and environmental influences underlying negative emotionality and each externalizing symptom dimension, with additional evidence for sibling competition/rater contrast effects for inattention and hyperactivity/impulsivity. Bivariate model-fitting analyses indicated that a portion of the additive (43%–75%) and nonadditive (26%–100%) genetic influences underlying each symptom dimension was accounted for by the genetic influences underlying negative emotionality. Finally, an independent pathways model examining the etiology of the association between negative emotionality and the externalizing dimensions indicated that a substantial portion of the additive genetic, nonadditive genetic, and nonshared environmental influences underlying externalizing behavior is shared with negative emotionality. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Elevated blood lead levels in children are associated with lower erythropoietin concentrations

PURPOSE: We investigated the incidence of well-directed violent behavior and suicide attempts in patients with temporal lobe epilepsy, with special attention to postictal psychosis. METHODS: We compared 57 episodes of postictal psychosis with 62 episodes of acute interictal (or alternative) psychosis and with 134 complex partial seizures. All patients were matched for age and for age at onset of seizures. RESULTS: The incidence of well-directed violent behavior against human beings was significantly higher (23%) during postictal psychotic episodes than during acute interictal episodes (5%) and postictal confusion (1%). Suicide attempts were also more frequent during postictal psychosis (7%) than during either acute interictal psychosis (2%) or postictal confusion (0%). CONCLUSIONS: Our study showed that well-directed violent and self-destructive behavior was not a feature of epileptic psychosis in general but a specific hallmark of postictal psychosis.     

Personality and the genetic risk for alcohol dependence.

The extent to which the genetic risk for alcohol dependence (AD) and conduct disorder (CD) and their common genetic risk overlap with genetic factors contributing to variation in dimensions of personality was examined in a study of 6,453 individuals from 3,383 adult male and female same-sex and unlike-sex twin pairs from the Australian Twin Registry. The associations between the personality dimensions of positive emotionality, negative emotionality, and AD and CD risk were modest, whereas the associations between behavioral undercontrol and AD and CD risk were substantially higher. Genetic influences contributing to variation in behavioral undercontrol accounted for about 40% of the genetic variation in AD and CD risk and about 90% of the common genetic risk for AD and CD. These results suggest that genetic factors contributing to variation in dimensions of personality, particularly behavioral undercontrol, account for a substantial proportion of the genetic diathesis for AD and most of the common genetic diathesis for AD and CD among both men and women. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Symptom dimensions and brain morphology in schizophrenia and related psychotic disorders

The heterogeneity of symptoms in schizophrenia may reflect heterogeneity of underlying pathophysiological mechanisms. Factor analytic studies have consistently identified three symptom factors, psychotic, negative and disorganized, as independent dimensions of schizophrenic psychopathology. This study examined the relationship of these symptom dimensions with volumes of specific brain regions. One-hundred and sixty-six schizophrenia spectrum patients were clinically evaluated with the Comprehensive Assessment of Symptoms and History (CASH) and scanned with a 1.5 Tesla magnetic resonance imaging scanner. Regions of interest (ROIs) were manually traced on 5 mm and 3 mm coronal slices by a single technician, blind to all aspects of subject identity. Correlations between ROI volumes and indices of symptom severity were determined. Analyses of covariance were then used to test for specific relationships between each of the three symptom dimensions and ROI volumes. Tests were made of each dimension, controlling for all others. Overall symptom severity was significantly correlated with larger ventricle volumes (lateral, third and temporal horns) and smaller temporal lobe, hippocampal and superior temporal gyral volumes. Both psychotic and negative symptom severity predicted increased third ventricular volume. Psychotic symptom severity uniquely predicted decreased superior temporal gyral volume as well as increased temporal horn volume. Within the psychotic symptom dimension, hallucinations alone predicted left superior temporal gyral volume. No significant associations between disorganized symptoms and any ROIs were demonstrated. These results provide clues to the localization of specific brain regions underlying symptom clusters in schizophrenia, and provide further validating evidence for the construct of independent dimensions of psychopathology within schizophrenia and related psychotic disorders.     

Relationships between dimensions of anxiety and sensation seeking.

To determine more precisely the relationship between the general dimensions of sensation seeking and anxiety, 130 male and 112 female undergraduates were administered the Sensation-Seeking Scales (SSS) and the S–R Inventory of General Trait Anxiousness (S–R GTA). The intercorrelations among the 5 scales from the SSS and the 4 scales from the S–R GTA were computed and compared to theoretical predictions. Results show that the majority of the correlations were negative, with the strongest relationship existing between anxiety in physically dangerous situations and sensation-seeking needs. The variation in the intercorrelations, ranging from moderately negative to low positive, is interpreted as supporting the necessity of multidimensional measures of anxiety and sensation-seeking constructs. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Tumor-associated antigen TA-90 immune complex assay predicts subclinical metastasis and survival for patients with early stage melanoma

BACKGROUND: TA-90 is a tumor-associated antigen first identified in the urine and sera of patients with metastatic melanoma. In the early stages of disease, TA-90 is present in circulating immune complexes (ICs) that may be detected with an antigen specific enzyme-linked immunosorbent assay (ELISA). In this study, the authors evaluated the efficacy of the TA-90 IC assay in detecting subclinical metastasis of early stage melanoma and predicting the survival of patients with this disease. METHODS: Archival sera were collected preoperatively from 114 patients who underwent wide excision with or without regional lymphadenectomy in the treatment of clinical Stage I melanoma. Sera were analyzed for TA-90 IC in a blinded fashion, and results were correlated with the patient's clinical course as determined by database and chart review. Subclinical metastases were considered present at the time of surgery if the lymphadenectomy specimen was pathologically positive and/or the patient subsequently developed recurrence. RESULTS: The TA-90 IC assay predicted subclinical metastasis in 43 of 56 patients (P < 0.0001), with 14 false-positive and 13 false-negative results. Sensitivity and specificity for the detection of occult metastasis were 77% and 76%, respectively. Positive and negative predictive values were 75% and 77%, respectively. Fifteen of 18 tumor positive regional lymph node basins (83%) and 34 of 46 recurrences (74%) were accurately predicted when considered independently (P < 0.004). Preoperative TA-90 IC status was also highly correlated with survival: 5-year overall and disease free survival rates were 63% and 46%, respectively, for the TA-90 IC positive group, compared with 88% and 82%, respectively, for the TA-90 IC negative group (P=0.0001). A multivariate analysis with standard prognostic variables identified preoperative TA-90 IC status as a strong, independent prognostic factor for both overall and disease free survival. CONCLUSIONS: To the authors' knowledge, TA-90 is the first tumor marker that accurately predicts subclinical metastatic disease and survival for patients with early stage melanoma. For this reason, the TA-90 IC assay has the potential to improve dramatically the prognostic evaluation of patients with this disease. Its role in postoperative risk stratification and early detection of recurrence is being evaluated in a prospective study.     

A question of compensation: The social life of the fundamental dimensions of social perception.

This research examines the impact of the compensation effect between the fundamental dimensions of warmth and competence on behavioral confirmation. In Experiment 1, participants were presented with 2 groups that varied on 1 of the 2 dimensions and asked to select the questions that they wanted to pose to learn more about the groups. Participants preferred to ask negative (positive) questions about the unmanipulated dimension to the high (low) group. In Experiment 2, participants rated the 2 groups on the basis of na?ve people answers to those questions. As predicted, compensation emerged. Experiment 3 involved interactions among 3 participants, 1 interviewing the other 2 using the questions selected in Experiment 1. Ratings of targets' reactions again showed compensation. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Medical thoracoscopy in the management of pneumothorax

In a general practice population of 11,300 patients, 223 were known to have diabetes mellitus. Thirteen diabetic patients (5.8%) had a previous diagnosis of thyroid disease. The study excluded 17 patients who received sole diabetes care at a secondary referral centre (of whom 5 had a previous diagnosis of thyroid disease), 8 with a previous diagnosis of thyroid disease receiving community care, and 1 patient who declined screening. New thyroid disease was diagnosed in 11 patients (8 female, 3 male): 5 with primary hypothyroidism, 4 with subclinical hypothyroidism, 1 with hyperthyroidism and 1 with subclinical hyperthyroidism. Thus the prevalence of undiagnosed thyroid disease in diabetic patients receiving community diabetes care was 5.5% (9.5% of female patients), and the prevalence of thyroid disease (previously known and diagnosed as a result of screening) in the entire population of diabetic patients registered in the general practice was 10.8%. These findings suggest that screening for thyroid disease should be considered in patients receiving diabetes care in the community.     

Components of social support and quality of life in severely mentally ill, low income individuals and a general population group

Satisfaction with social support and quality of life (QOL) were assessed for 60 psychiatric patients, 79 welfare recipients and 266 people of the general population using the Social Provisions Scale (SPS) and the Satisfaction with Life Domains Scale (SLDS). Psychiatric patients reported less satisfaction than the general population on all components of social support. They have a comparable level of satisfaction with welfare recipients on most of the components, with the exception of emotional integration and opportunity for nurturance. However, patients satisfaction with QOL was quite similar to the general population, although higher than welfare recipients on some dimensions. Their lower satisfaction with the personal-intimate dimension suggest deficiencies in social support. All components of social support were consistently related to QOL in the general population. Attachment and reassurance of worth was significant for psychiatric patients but only attachment was related to QOL for the welfare recipients group. The pairing of SPS and SLDS scales seem to be good instruments for discriminating the majority of psychiatric patients.     

Dimensions of the proximal thoracic aorta from childhood to adult age: reference values for two-dimensional echocardiography. Ligurian Group of SIEC (Italian Society of Echocardiography)

BACKGROUND: Two-dimensional echocardiography (2-DE) represents the main tool for detecting and monitoring abnormalities of proximal thoracic aorta. However, previous studies performed to assess the reference values of aortic diameters using this technique are few and, often, involve a small number of subjects. Furthermore, such a study has not been performed on an Italian population. METHODS: To assess the reference values and the growth curves of the dimensions of the proximal thoracic aorta in an Italian population, we measured aortic diameters at the level of the anulus, of the sinuses of Valsalva and of the supraaortic ridge, by using 2-DE, in 134 healthy volunteers (78 males, 56 females), aged 35 +/- 16 years (range 5-76). Sex, age, weight, height, body surface area (BSA), heart rate, systolic and diastolic blood pressure were analyzed as determinants of proximal thoracic aorta diameters. In addition, to compare the specificity of the reference values, we have obtained with those provided by literature, we studied another independent group of 23 healthy volunteers, aged 32 +/- 15 years (range 11-65). RESULTS: In our study population, mean values and range of aortic 2-DE diameters were 2.1 +/- 0.3 cm (range 1.3-2.9) at the level of the anulus, 2.6 +/- 0.4 cm (range 1.7-3.7) at the level of the sinuses of Valsalva and 2.4 +/- 0.4 cm (range 1.5-3.4) at the level of the supraaortic ridge. At multivariate regression analysis, sex and age emerged as the only independent determinants of the aortic root diameters (r2 = 0.35, 0.43, and 0.52 for aortic diameter at the level of anulus, sinuses of Valsalva, and supraaortic ridge, respectively). On average, aortic root dimensions at the level of the anulus, of the sinuses of Valsalva and of the supraaortic ridge in females were 1.5 mm, 2.8 mm, and 1 mm, respectively, smaller than those of males of comparable age, height and weight. The growth curves showed that proximal thoracic aorta increases in size in the first 30 years of life; thereafter, it remains relatively constant in size up to 55 years, after which the proximal thoracic aorta tends to enlarge gradually. The ratios of sinuses of Valsalva to annular diameter and of supraaortic ridge to annular diameter (1.27 +/- 0.17 and 1.17 +/- 0.16, respectively) were found to be indexes of aortic root dimension independent of sex and age. No correlation was found between aortic root dimensions and systolic blood pressure. M-mode echocardiography systematically overestimated 2-DE aortic diameters at the level of the anulus, as well as at the level of the sinuses of Valsalva and of the supraaortic ridge (+0.8 +/- 0.04 cm, +0.2 +/- 0.04 cm, and +0.4 +/- 0.04 cm, respectively, p < 0.0001 for all). In the control population, our reference values demonstrated a specificity significantly higher than that of the main reference values reported in literature (97 +/- 2% versus 62 +/- 4%, p < 0.0001). CONCLUSIONS: Our study provides a prospectic, systematic and detailed analysis of 2-DE proximal thoracic aorta diameters in a wide group of healthy Italian subjects. Our data show that: 1) 2-DE aortic root dimensions are influenced by sex and age but not by body size or blood pressure; 2) the ratios of sinuses of Valsalva to annular diameter and of supraaortic ridge to annular diameter are indexes of aortic root dimension which are independent of age and sex; 3) M-mode diameter systematically overestimates 2-DE diameters of the aortic root; and 4) Italian population based reference values showed higher specificity than values provided by literature.     

Self-esteem in schizophrenia: Relationships between self-evaluation, family attitudes, and symptomatology.

Participants with schizophrenia (N=59) were assessed on self-evaluation, symptomatology, and positive and negative affect (expressed emotion) from significant others. An interview-based measure of self-evaluation was used and two independent dimensions of self-esteem were derived: negative and positive evaluation of self. As predicted, negative self-evaluation was strongly associated with positive symptoms, a more critical attitude from family members was associated with greater negative self-evaluation, and analyses supported a model whereby the impact of criticism on patients' positive symptoms was mediated by its association with negative self-evaluation. The interview-based method of self-esteem assessment was found to be superior to the questionnaire because its predictive effects remained after depressed mood was accounted for. (PsycINFO Database Record (c) 2010 APA, all rights reserved)