Visual event-related potentials in schizotypal personality disorder and schizophrenia.

Schizophrenia (SZ) occurs among a spectrum of disorders with similar characteristics, including schizotypal personality disorder (SPD). Visual processing disturbances have been reported in both disorders, but it is not yet clear which processes are disturbed in both SZ and SPD, suggestive of a common endophenotype, and which appear only in SZ. In order to address this question, the authors evaluated visual event-related potentials (ERPs) elicited during a line-orientation discrimination task in control, SPD, and SZ participants. Visual ERPs allow specification of both the time course and physiological correlates of visual perception and cognition. SZ patients had smaller P100 and P300a amplitudes and prolonged P300b latency compared to the control group. SZ patients also had smaller N160, N200, P300a, and P300b amplitudes compared to the SPD group. SPD participants did not differ from control participants on any ERP measure. These data documented pervasive abnormalities in visual perception and attention in SZ but not in SPD, suggesting that these visual ERP disturbances may not represent a common endophenotype. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

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)     

Dual-task information processing in schizotypal personality disorder: Evidence of impaired processing capacity.

Working memory theories heavily rely on the concept of processing resources and the their efficient deployment. Some recent work with schizophrenia-spectrum patients has suggested that many associated cognitive impairments may be reduced to deficits in working memory, possibly related to reductions in information-processing capacity resources. In this study, 38 patients with schizotypal personality disorder (SPD), 22 patients with other personality disorders, and 14 healthy comparison participants performed a dual-task processing assessment that was designed specifically for use in this type of study. Participants recalled lists of digits at their predetermined maximum digit span and performed box-checking tests, first alone and then in a dual-task format. Instructions included equal prioritization of both tasks. SPD patients had significantly shorter digit spans, and they also showed more deterioration on both tasks. Performance operating characteristics curves indicated that SPD patients' reduced performance was not due to abnormal resource allocation strategies leading to strategic failures. The authors discuss the implications of these processing capacity limitations for understanding both the signature of cognitive impairment within the schizophrenia spectrum and general abnormalities in working memory. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Context processing in schizotypal personality disorder: Evidence of specificity of impairment to the schizophrenia spectrum.

Working memory abnormalities, which are particularly pronounced on context processing tasks, appear relatively specific to schizophrenia spectrum illnesses compared with other psychotic disorders. However, the specificity of context processing deficits to schizotypal personality disorder (SPD), a prototype of schizophrenia, has not been studied. The authors administered 3 versions of the modified AX Continuous Performance Test and an N-back working memory test to 63 individuals with SPD and 25 with other personality disorders, as well as 42 healthy controls. For the AX Continuous Performance Test standard and degraded versions, there was a significant Trial Type × Delay × Group interaction, as SPDs made significantly more errors reflecting poor maintenance of context and fewer errors reflecting good maintenance of context. SPDs also demonstrated poor performance on the N-back, especially at the 2-back condition. Context processing errors and N-back accuracy scores were related to disorganization symptoms. These findings, which are quite similar to those previously reported in patients with schizophrenia, suggest that context processing deficits are specific to the schizophrenia spectrum and are not a reflection of overall psychopathology. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The heterogeneous structure of schizotypal personality disorder: Item-level factors of the schizotypal personality questionnaire and their associations with obsessive-compulsive disorder symptoms, dissociative tendencies, and normal personality.

A. Raine et al.'s (1994) 3-factor scheme is currently the most widely accepted model of schizotypal personality disorder (SPD). Factor analytic studies of the Schizotypal Personality Questionnaire (SPQ; A. Raine, 1991) subscales, which represent the 9 Diagnostic and Statistical Manual of Mental Disorders (DSM) criteria for SPD, have provided the model's primary support. The use of only 9 modeled variables, however, limits the number of factors that can be extracted. To explicate this structure more fully, the authors conducted item-level factor analyses of the SPQ in a large student sample that completed the instrument twice within a 2-week interval. The authors' analyses failed to support either the 3-factor model of SPD or the 9 existing DSM-based subscales of the SPQ. Instead, 5 replicable dimensions emerged that capture recurrent symptom pairings found in the broader SPD literature: Social Anhedonia, Unusual Beliefs and Experiences, Social Anxiety, Mistrust, and Eccentricity/Oddity. These factors are only weakly correlated with each other and show differential correlational patterns with the Big Five personality traits, dissociative tendencies, and symptoms of obsessive-compulsive disorder. Moreover, they are congruent with dimensional models of personality psychopathology. Implications for SPD in DSM-V are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Correction to Saccuzzo and Schubert.

Reports an error in "Backward Masking as a Measure of Slow Processing in Schizophrenia Spectrum Disorders" by Dennis P. Saccuzzo and Donald L. Schubert (Journal of Abnormal Psychology, 1981, Vol. 90, No. 4, 305-312). There are several errors on page 307. The schizotypal personalities met the criteria identified by Spitzer, Endicott, and Gibbon (1979), not those of Spitzer, Endicott, and Robins (1977). The borderline personalities met the criteria identified by Spitzer et al. (1979) for unstable personalities, not those of Spitzer et al. (1977) for borderline personalities. (The following abstract of this article originally appeared in record 1981-28173-001.) Three groups of hospitalized adolescents (mean age 15.1 yrs; schizophrenics, schizotypal personalities, and borderline personality adolescent adjustment reactions) with 10 Ss in each group were compared for their ability to identify masked and unmasked stimuli. Results reveal that the schizophrenics required longer minimum exposure durations for criterion identification of unmasked stimuli. Under conditions of visual backward masking, however, schizotypal personalities as well as schizophrenics showed a relative deficit. Results support L. L. Heston's notion that schizophrenia spectrum disorders may be different degrees of expression of the same underlying defect. Previous results with visual backward masking in adults are also extended to adolescents. Findings are consistent with a slow information processing hypothesis for schizophrenia spectrum disorders. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Lateralized perceptual organization deficits on the global-local task in schizotypal personality disorder.

Right and left hemisphere contributions to perceptual organization functions were examined using a divided-attention version of the global-local task in a sample of 21 unmedicated participants diagnosed with schizotypal personality disorder (SPD) and 20 controls. The SPD participants showed an abnormal global processing advantage. When the visual angle of the hierarchical stimuli was increased from 3° to 9°, the controls showed an increasing local processing advantage, but the SPD participants continued to show an abnormal global processing advantage. These findings suggest a local processing deficit on divided-attention versions of the global-local task in schizophrenia spectrum disorders. Female SPD participants, who had less severe interpersonal deficit symptoms, showed a more abnormal global processing advantage. Hemispheric and processing resource mechanisms that might explain these findings are discussed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Emotional correlates of the different dimensions of schizotypal personality disorder.

Two studies explored which different dimensions of schizotypal personality disorder (SPD) were associated with negative affect, attention to emotions, clarity of emotions, and emotional intensity/instability. Study 1 included 247 college students, and questionnaires were used to measure SPD. Study 2 included 225 community residents, oversampling for individuals with elevated levels of SPD, and semistructured diagnostic interviews were used to measure SPD. In both studies (a) higher levels of negative affect were associated with higher levels of both cognitive-perceptual and interpersonal symptoms, (b) cognitive-perceptual disturbances were associated with greater attention to emotion, whereas interpersonal disturbances were associated with less attention to emotion, and (c) lower levels of emotional clarity were associated with higher levels of suspiciousness. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Conceptual behavior in psychotic and normal adolescents.

This study has investigated conceptual behavior in 16 psychotic adolescents matched with 16 adjusted adolescents on age, IQ, and socioeconomic status. A picture sorting test was administered to both groups. Psychotic adolescents categorize and verbalize less adequately than matched controls. Psychotic adolescents use narrower categories than control Ss, perhaps reflecting an inability to reduce effectively the complexity of a stimulus array. In the qualitative analyses of verbalizations, it was found that psychotics use more idiosyncratic verbalizations, possibly indicating the greater privacy and autism of their thinking processes. The conceptual level of the verbalizations offered by the psychotics was less "abstract." Social and emotional content seems to have no effect on categorization and verbalization variables in psychotics. (16 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Patterns of sedentary behavior among adolescents.

Objective: Reducing certain sedentary behaviors (e.g., watching television, using a computer) can be an effective weight loss strategy for youth. Knowledge about whether behaviors cluster together could inform interventions. Study Design: Estimates of time spent in 6 sedentary behaviors (watching television, talking on the telephone, using a computer, listening to music, doing homework, reading) were cluster analyzed for a sample of 878 adolescents (52% girls, mean age = 12.7 years, 58% Caucasian). Main Outcome Measures: The clusters were based on the sedentary behaviors listed above and compared on environmental variables (e.g., household rules), psychosocial variables (e.g., self-efficacy, enjoyment), and health behaviors (e.g., physical activity, diet). Results: Four clusters emerged: low sedentary, medium sedentary, selective high sedentary, and high sedentary. Analyses revealed significant cluster differences for gender (p     

Two-Year Stability and Change of Schizotypal, Borderline, Avoidant, and Obsessive-Compulsive Personality Disorders.

The authors examined the stability of schizotypal (STPD), borderline (BPD), avoidant (AVPD) and obsessive-compulsive (OCPD) personality disorders (PDs) over 2 years of prospective multiwave follow-up. Six hundred thirty-three participants recruited at 4 collaborating sites who met criteria for 1 or more of the 4 PDs or for major depressive disorder (MOD) without PD were assessed with semistructured interviews at baseline, 6, 12, and 24 months. Lifetable survival analyses revealed that the PD groups had slower time to remission than the MDD group. Categorically, PD remission rates range from 50% (AVPD) to 61% (STPD) for dropping below diagnostic threshold on a blind 24-month reassessment but range from 23% (STPD) to 38% (OCPD) for a more stringent definition of improvement. Dimensionally, these findings suggest that PDs may be characterized by maladaptive trait constellations that are stable in their structure (individual differences) but can change in severity or expression over time. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Context-Processing Deficits in Schizotypal Personality Disorder.

Research suggests that schizotypal personality disorder (SPD) is a part of the spectrum of schizophrenia-related illnesses. This article hypothesizes that a deficit in the representation and maintenance of context is a core cognitive disturbance in schizophrenia and that SPD individuals should demonstrate context-processing deficits. To test this hypothesis, the authors administered 3 versions of their AX-CPT task, designed to assess context processing, to 35 healthy controls and 26 individuals with DSM-IV SPD. They also administered working memory and selective attention tasks. SPD individuals displayed context representation deficits similar to those found in schizophrenia but did not show the same additional deficits in context maintenance. Context processing was strongly associated with working memory and selective attention performance in the SPD individuals. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A dimensional model of personality disorder: Incorporating DSM Cluster A characteristics.

The authors articulate an expanded dimensional model of personality pathology to better account for symptoms of DSM-defined Cluster A personality disorders. Two hundred forty participants (98 firstdegree relatives of probands with schizophrenia or schizoaffective disorder, 92 community control participants, and 50 first-degree relatives of probands with bipolar disorder) completed a dimensional personality pathology questionnaire, a measure of schizotypal characteristics, and Chapman measures of psychosis proneness. Scales from all questionnaires were subjected to an exploratory factor analysis with varimax rotation. A 5-factor structure of personality pathology emerged from the analyses, with Peculiarity forming an additional factor to the common 4-factor structure of personality pathology (consisting of Introversion, Emotional Dysregulation, Antagonism, and Compulsivity). These results support a 5-factor dimensional model of personality pathology that better accounts for phenomena encompassed by the Cluster A personality disorders in DSM-IV-TR (4th ed., text revised; American Psychiatric Association, 2000). This study has implications for the consideration of a dimensional model of personality disorder in DSM-V by offering a more comprehensive structural model that builds on previous work in this area. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Understanding the relations among gender, disinhibition, and disruptive behavior in adolescents.

This study examined whether disinhibition shows similar relations with attention-deficit/hyperactivity disorder (ADHD) and conduct disorder (CD) symptomatology among male and female adolescents. The mixed-incentive or punishment condition of Newman's go/no-go task was administered to 172 adolescents. As expected, ADHD symptoms in boys and girls were predictive of disinhibition (i.e., commission errors) in the mixed-incentive but not punishment condition. Also consistent with expectations, CD symptoms in boys were predictive of disinhibition in the mixed-incentive but not punishment condition. In contrast, CD symptoms in girls were not predictive of disinhibition in either condition. These findings are discussed in terms of implications for understanding sex differences in the etiology of ADHD and CD. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Power moves: Complementarity in dominant and submissive nonverbal behavior.

Two studies examine complementarity (vs. mimicry) of dominant and submissive nonverbal behaviors. In the first study, participants interacted with a confederate who displayed either dominance (through postural expansion) or submission (through postural constriction). On average, participants exposed to a dominant confederate decreased their postural stance, whereas participants exposed to a submissive confederate increased their stance. Further, participants with complementing responses (dominance in response to submission and submission in response to dominance) liked their partner more and were more comfortable than those who mimicked. In the second study, complementarity and mimicry were manipulated, and complementarity resulted in more liking and comfort than mimicry. The findings speak to the likelihood of hierarchical differentiation (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

HIV/AIDS communication among adolescents in psychiatric care and their parents.

The authors examined HIV/AIDS communication among 207 parent-adolescent dyads in psychiatric care to better understand the relationship between family communication and sexual risk behavior in an at-risk population. Dyads reported content and rated quality of family HIV/AIDS discussions, and adolescent sexual risk was assessed. Families discussed transmission, prevention, consequences, myths, and compassion. Parent-reported discussion of consequences was associated with greater sexual risk behavior, but only for girls. Higher quality communication reported by adolescents was associated with less sexual risk. Parents may send different messages about HIV/AIDS to sons versus daughters, and messages related to consequences may not effectively reduce risk among daughters. However, for boys and girls in psychiatric care, teaching parents how to discuss HIV/AIDS may promote safer sexual behavior. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Treating co-occurring Axis I disorders in recurrently suicidal women with borderline personality disorder: A 2-year randomized trial of dialectical behavior therapy versus community treatment by experts.

This study evaluated whether dialectical behavior therapy (DBT) was more efficacious than treatment by nonbehavioral psychotherapy experts in reducing co-occurring Axis I disorders among suicidal individuals with borderline personality disorder (BPD). Women with BPD and recent and repeated suicidal and/or self-injurious behavior (n = 101) were randomly assigned to 1 year of DBT or community treatment by experts (CTBE), plus 1 year of follow-up assessment. For substance dependence disorders (SDD), DBT patients were more likely to achieve full remission, spent more time in partial remission, spent less time meeting full criteria, and reported more drug- and alcohol-abstinent days than did CTBE patients. These findings suggest that improvements in co-occurring SDD among suicidal BPD patients are specific to DBT and cannot be attributed to general factors associated with nonbehavioral expert psychotherapy. Further, group differences in SDD remission were not explained by either psychotropic medication usage or changes in BPD criterion behaviors. DBT and CTBE did not significantly differ in the reduction of anxiety disorders, eating disorders, or major depressive disorder. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Dialectical behavior therapy for borderline personality disorder: A meta-analysis using mixed-effects modeling.

Objective: At present, the most frequently investigated psychosocial intervention for borderline personality disorder (BPD) is dialectical behavior therapy (DBT). We conducted a meta-analysis to examine the efficacy and long-term effectiveness of DBT. Method: Systematic bibliographic research was undertaken to find relevant literature from online databases (PubMed, PsycINFO, PsychSpider, Medline). We excluded studies in which patients with diagnoses other than BPD were treated, the treatment did not comprise all components specified in the DBT manual or in the suggestions for inpatient DBT programs, patients failed to be diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders, and the intervention group comprised fewer than 10 patients. Using a mixed-effect hierarchical modeling approach, we calculated global effect sizes and effect sizes for suicidal and self-injurious behaviors. Results: Calculations of postintervention global effect sizes were based on 16 studies. Of these, 8 were randomized controlled trials (RCTs), and 8 were neither randomized nor controlled (nRCT). The dropout rate was 27.3% pre- to posttreatment. A moderate global effect and a moderate effect size for suicidal and self-injurious behaviors were found, when including a moderator for RCTs with borderline-specific treatments. There was no evidence for the influence of other moderators (e.g., quality of studies, setting, duration of intervention). A small impairment was shown from posttreatment to follow-up, including 5 RCTs only. Conclusions: Future research should compare DBT with other active borderline-specific treatments that have also demonstrated their efficacy using several long-term follow-up assessment points. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relations between self-generated positive and negative expected smoking outcomes and smoking behavior: An exploratory study among adolescents.

The expected outcomes of drug use figure prominently in models of drug motivation. This report presents the relations between self-generated expected outcomes of smoking and smoking behavior in 674 adolescents. Expected outcomes of smoking were related to current smoking, experimentation, and susceptibility among never-smokers, even after controlling for key correlates of smoking behavior, including gender, grade, ethnicity, and peer smoking. Although more negative than positive smoking outcomes were accessible from memory, more positive than negative expected outcomes were correlated with smoking behavior. Both the content and number of self-generated expected outcomes provided unique associative information. In sum, greater elaboration of smoking-related memory networks, as well as the specific content of those networks, appear to be associated with smoking behavior. (PsycINFO Database Record (c) 2010 APA, all rights reserved)