Length of hospitalization and rate of readmission of paranoid and nonparanoid schizophrenics.

The underrepresentation of paranoids-a group that manifests less psychological deficit-in hospitalized chronic schizophrenic cohorts has been cited as a source of sampling bias in behavioral studies comparing acute and chronic schizophrenics. The sampling bias hypothesis assumes this underrepresentation to be due to the better social prognosis of paranoid patients. The present study examined hospitalization and follow-up records for 1,249 consecutive inpatient admissions. Consistent with the sampling bias assumption, paranoids were found to be hospitalized more briefly than nonparanoids and to experience fewer rehospitalizations 1, 3, and 5 yrs after discharge. As expected, the social prognosis of 1st admissions was found to be more favorable than that of readmissions, independently of paranoid symptomatology. (21 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

"A very narrow bridge": Diagnosis and management of mental illness among Bratslav hasidim.

Describes psychotherapeutic techniques employed by therapists working with 19 male members of a small Hasidic sect (aged 17–40 yrs). Ss were diagnosed as having paranoid schizophrenia, schizoaffective disorder, or personality disorder during 1 yr. Schizophrenia was diagnosed in 79% of these Ss, compared with a 15% rate for all new referrals. Most Ss were not born into the sect, but joined as young adults. In order to distinguish between culturally normal and abnormal symptomatology, therapists became acquainted with the behavior and values of the sect. Two case examples (aged 30 and 31 yrs) are included. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Neuropsychological functioning after mercury exposure.

Observed visuographic and paranoid symptomatology in 26 dentists (mean age, 49.9 yrs) with elevated mercury levels. Neuropsychological functions were assessed with measures such as the Wechsler Adult Intelligence Scale (WAIS), the Bender-Gestalt Test, and the SCL-90 (Revised). Although the observed changes were mild, their presence suggests subtoxic hazards associated with dental practice and underscore a continual need for maintaining mercury hygiene. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Age on first hospitalization of schizophrenics: A developmental approach.

Compared ages at 1st hospitalization of 3 groups of schizophrenics: 64 males in a VA hospital and 60 male and 60 female patients in a state hospital. Paranoid Ss were approximately 8 yrs older when first admitted than the nonparanoids. In both diagnostic categories males were hospitalized about 5 yrs earlier than females. Working females with a diagnosis of paranoia were hospitalized approximately 10 yrs later than the paranoid females who remained at home and the nonparanoid females of either employment status. State hospital males were younger on 1st admission than VA hospital males. The ages of the 2 diagnostic groups in the VA were comparable, whereas in the state hospital the nonparanoid group was younger than the paranoid group by about 8 yrs. The need to pay greater attention to the differences between schizophrenic males and females and to scrutinize more closely differences between state and VA hospital patients is emphasized. (48 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relation between current diagnostic criteria for schizophrenia and the dimensions of premorbid adjustment, paranoid symptomatology, and chronicity.

46 broadly defined schizophrenics were diagnosed according to 7 current diagnostic criteria for schizophrenia, and the subtyping dimensions of premorbid adjustment, paranoid symptomatology, and chronicity were assessed. Despite the minimal overlap between many of these criteria, samples selected by each of these systems were comparable in terms of the 3 subtyping dimensions. Results indicate that patients diagnosed as schizophrenic by each of these criteria were similar to schizophrenics who failed to meet those particular criteria with respect to premorbid adjustment, paranoid symptomatology, and chronicity. (39 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Representational boundaries in role portrayals among paranoid and nonparanoid schizophrenic patients.

Studied the boundary properties of self and other representations in 31 normal Ss (mean age 18.8 yrs) and in 18 paranoid (mean age 21.2 yrs), 14 intermediate (mean age 21.9 yrs), and 16 nonparanoid (mean age 22.1 yrs) inpatient schizophrenics, using a dramatic role-playing technique. Role test and Rorschach responses were scored for presence of fluid and rigid boundaries between representations of human characters. Paranoid schizophrenics evidenced higher levels of rigid boundaries, nonparanoid schizophrenics had higher levels of fluid boundaries, and normal Ss showed fewer fluid or rigid boundaries. Rorschach and role test measures of boundary disruption were significantly correlated with each other and with other measures of psychopathology. Findings suggest that the relative balance between fluid and rigid representational boundaries is an effective discriminator of paranoid and nonparanoid subtypes and that the presence of either type of boundary imagery discriminates schizophrenics from normal Ss. (31 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A multidimensional scaling analysis of schizophrenics' and normals' perceptions of verbal similarity.

Compared the judgments of similarity of words by 14 paranoid and 14 nonparanoid schizophrenics (mean ages, 29.43 and 30.64 yrs, respectively) with those by 14 normals (mean age, 32.79 yrs). The judgments were analyzed using an individual-differences multidimensional scaling procedure. A greater judgmental consistency was obtained among the normals than among the paranoid schizophrenics and larger differences among stimulus dimensions, in their contributions to predictable judgmental variance, were obtained for the normals as compared with the schizophrenics, especially the paranoid schizophrenics. Stimulus dimensions resembling the potency, activity, and evaluative dimensions of the semantic differential were less influential in the judgments of the schizophrenics, especially those classified as paranoid, than in the judgments of the normals. Results are discussed in terms of overinclusiveness among schizophrenics in multidimensional similarity judgments, as well as in terms of the potential importance to schizophrenics' deficiencies in semantic interpretations of the reduced influence of relevant dimensions of meaning. (37 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Association of social competence with episodic vs remitted status in paranoid and nonparanoid schizophrenia.

Assessed 4 groups of schizophrenics—episodic paranoid, episodic nonparanoid, remitted paranoid, and remitted nonparanoid (mean ages 26.57, 25.57, 31.79, and 30.93 yrs, respectively)—on E. Zigler and J. Levine's (1973) scale of social competence. Additional measures included a symptom sign inventory and the Maine Scale of Paranoid and Nonparanoid Schizophrenia. The paranoids and nonparanoids were not significantly different from one another. However, the remitted patients were significantly more socially competent than the episodic patients. Implications are discussed for the relationship between symptom severity, hospitalization, and social competence. (French abstract) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Premorbid adjustment and paranoid-nonparanoid status in schizophrenia.

Using 98 schizophrenics, good premorbids were found to be evenly distributed regarding paranoid vs. nonparanoid symptomatology. Poor premorbids were predominantly nonparanoid and rarely paranoid. However, paranoids were predominantly good premorbids, whereas nonparanoids were distributed between good and poor premorbids. (15 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Multivariate cognitive performance levels and response styles among paranoid and nonparanoid schizophrenics.

Examined paranoid and nonparanoid schizophrenic performance on a battery of information processing measures spanning precategorical processing, short-term memory, and long-term memory. 20 paranoid (mean age 30.9 yrs) and 20 nonparanoid (mean age 29.3 yrs) schizophrenics and 40 normals (mean age 26.69 yrs) were administered the Symptom-Sign Inventory and the Psychotic-Neurotic Discriminator Scale. Multivariate analyses of the multiple processing indexes revealed 2 performance dimensions. The 1st represented "processing efficiency" maximally separating the paranoids and nonpatients with the nonparanoids falling in between. The 2nd dimension reflected a response style of propensity toward stating the presence of stimuli or stimulus properties, with the most extreme separation occurring between the paranoids (higher propensity) and nonparanoids. Though closer to the paranoids, the nonpatients fell between the 2 schizophrenic groups. Discussion draws on the bidimensional characterization of the paranoids and nonparanoids as well as on their differential performance on individual measures. (50 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Premorbid adjustment and paranoid-nonparanoid status in schizophrenia: A further investigation.

Investigated the interrelations between premorbid social competence, role orientation as expressed in symptomatology, and paranoid-nonparanoid status in 295 Veterans Administration (VA) hospital and 300 state hospital male schizophrenic patients. Among state hospital paranoid schizophrenics, paranoids had higher premorbid social competence scores (Phillips-Zigler Social Competence Index) than nonparanoids. For VA hospital schizophrenics, paranoid-nonparanoid status was unrelated to premorbid social competence. State hospital patients had lower premorbid competence scores and a higher incidence of nonparanoid diagnosis than VA hospital patients. The prevalence of a number of symptoms also differed between the 2 hospitals. The role orientation symptom pictures differed both for hospitals and for paranoid and nonparanoid status. The relationships between role orientation, paranoid-nonparanoid status, and premorbid social competence are discussed within a developmental framework. (23 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Schizophrenic memory-search performance involving nonverbal stimulus properties.

Investigated schizophrenic memory-search performance by conducting a memory-search choice-reaction-time (CRT) task involving nonverbal stimulus properties (real-life sizes of items). Procedures were designed to diminish ambiguities concerning previous evidence of possible schizophrenic impairment in scanning and comparison operations involving memory-held items. Ss (aged 18–60 yrs) were 20 paranoid and 20 nonparanoid schizophrenics, 20 psychiatric controls, and 20 normal Ss. Results indicate that scanning and comparison operations proceeded at comparable rates among the schizophrenics and controls. On the other hand, rates of encoding the presented stimulation for a given trial (the trial's probe item) into a task-facilitative format proceeded at a slower rate among the paranoid Ss in particular. Discussion focuses on specific memory-search CRT paradigmatic conditions in which intact speed of memorial item comparisons tended to be most evident among these patients. Results resemble earlier observations of the present 2nd author (see record 1978-31872-001) on memory-search CRT performance among paranoid and nonparanoid schizophrenics when probe stimulation has remained in view throughout each trial. (38 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychiatric symptomatology among alcoholics: Comparisons between African Americans and Caucasians.

Using data collected on 190 patients in a hospital-based substance abuse treatment center in a large midwestern city, this study compared psychiatric symptomatology between 39 African-American and 151 Caucasian adults. Although the groups were equivalent in consumption and frequency of usage, African-American alcoholics used significantly more substances (beyond alcohol) than did Caucasians. With regard to psychiatric symptomatology, African Americans reported higher levels of somatization, obsessive–compulsive behavior, depression, hostility, paranoid ideation, and psychoticism, and an overall higher degree of stress. Although the overall level of alcoholic self-reported severity did not distinguish the 2 groups, African Americans exhibited lower levels of global functioning as assessed by trained clinical staff. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Increases in depressive symptomatology in the rural elderly: Results from a cross-sectional and longitudinal study.

Depressive symptomatology was examined in a large sample of noninstitutionalized older adults using the Center for Epidemiological Studies-Depression scale (CES-D). Both cross-sectional and longitudinal data showed age-related increases in mean CES-D scores and increases in the percentage of respondents scoring at or above the cutoff score of 16. Variables collected at baseline in the longitudinal study from 2,032 participants 65 yrs of age and older were significant predictors of depressive symptomatology 3 and 6 yrs later. Baseline CES-D scores accounted for the largest proportion of the variance. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Use of the SADS—C as a diagnostic and symptom severity measure.

Examined the reliability of an abbreviated form of the full Schedule for Affective Disorders and Schizophrenia (SADS), the SADS—C, in 2 studies. A total of 120 nonparanoid and paranoid schizophrenic, bipolar manic, and unipolar depressed patients and 26 normal Ss (mean age for all groups 31.8 yrs) were interviewed using the SADS—C and a number of other diagnostic instruments. Results of both studies suggest that the SADS—C is a reliable brief rating instrument capable of differentiating among psychopathological groups. (20 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Left hemisphere dysfunction and left hemisphere overactivation in schizophrenia.

Reports 2 experiments relating schizophrenia to functional brain asymmetry. In Exp I, 24 schizophrenics (mean age, 30.8 yrs) were compared to 24 matched controls (mean age, 37.3 yrs) on 2 tachistoscopic tasks (Syllable Test and Dot Location Test) designed to measure verbal and spatial information processing in the 2 hemispheres. Unlike the controls, the schizophrenics showed a right hemisphere superiority both on the verbal and on the spatial tests, indicating left hemisphere dysfunction in the initial processing of verbal information. In Exp II, lateral eye movements, as an index of contralateral hemispheric activation, were measured in a group of 24 paranoid schizophrenics (mean age, 28.9 yrs), 24 nonparanoid schizophrenics (mean age, 32.7 yrs), and 24 matched controls (mean age, 31.2 yrs). The eye movements were elicited by presenting the Ss with verbal neutral, verbal emotional, spatial neutral, and spatial emotional questions. The schizophrenics had significantly more rightward eye movement, compared to controls, regardless of question type, indicating left hemisphere overactivation. Results suggest that schizophrenia is associated with a pattern consisting of both left hemisphere dysfunction and overactivation. (63 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Fluid and rigid boundaries of paranoid and nonparanoid schizophrenics on a role-playing task

The concepts of fluid and rigid boundaries were assessed in an improvisational role-playing task in an attempt to differentiate paranoid from nonparanoid schizophrenics. Thirty-one schizophrenic patients divided into paranoid, intermediate, and nonparanoid groups were given an improvisational role-playing task. The resulting scenes were analyzed by Fluid Boundary and Rigid Boundary scales, which were developed on the basis of specific aspects of the physical and verbal representations of characters, objects, and settings. The hypothesis that variations in the disruption or emphasis of representational boundaries differentiate paranoid and nonparanoid symptomatology received support. Paranoid schizophrenics scored higher on the Rigid Boundary scale, i.e erecting and/or exaggerating physical and interpersonal boundaries; and nonparanoid schizophrenics scored higher on Fluid Boundary scale, i.e. showing fused and fluid representations of characters, objects, and settings. Improvisational role-playing seems to hold promise as a medium with diagnostic value.     

Personal efficacy, external locus of control, and perceived contingency of parental reinforcement among depressed, paranoid, and normal subjects.

Hypothesized that different combinations of personal efficacy and outcome expectancies (i.e., locus of control) would characterize the thought structures of normal Ss and of psychiatric patients suffering from distinctly different disorders. 26 normal (mean age 30.1 yrs), 15 depressed, and 22 paranoid Ss (mean age of patients 34.5 yrs) completed scales that measured beliefs in personal efficacy, beliefs that outcomes are controlled either by chance or by powerful others, and perceived contingency of parental reinforcement. Findings show that normals judged themselves to be more efficacious than did psychiatric Ss, depressives expected outcomes to be controlled by chance, and paranoids expected outcomes to be under the control of powerful others. Among the normals, outcome expectancies were strongly associated with personal efficacy, but among the patients, these beliefs were unrelated. Depressives and paranoids equally reported more noncontingent parental reinforcement than did normals. Perceived contingency of parental reinforcement was predictive of outcome expectancies but not of personal efficacy. Data suggest that low personal efficacy may be a distinguishing characteristic of all psychiatric patients, whereas outcome expectancies may determine the specific nature of the psychiatric disorder. (28 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Attachment style and emotion regulation in dementia patients and their relation to caregiver burden

One hundred and sixty-eight patients with mid- to late-stage dementia and their caregivers participated in a study of the relation between patient emotional characteristics, dementia symptomatology, and caregiver burden. Measures included premorbid attachment style, premorbid emotion regulation style, and behavioral symptoms of dementia. The attachment patterns (secure, avoidant, ambivalent) of these elderly patients resembled those obtained in samples of younger individuals in terms of emotion regulation characteristics; however, the distribution of attachment styles was significantly different, with a lower proportion of ambivalently attached individuals in the present sample. In terms of the behavioral symptoms of dementia, ambivalent patients had more depression and anxiety than secure and avoidant patients; the latter patients experienced more activity disturbance than ambivalently attached individuals and were higher on paranoid symptomatology than securely attached persons. Caregivers of securely attached individuals experienced less total burden than did caregivers of both insecure groups. In regression analysis, attachment style accounted for the largest proportion of unique variance in the prediction of caregiver burden (8%); only 1 of 7 patient symptoms contributed a significant independent effect, namely depressed affect, which accounted for 4% of the variance.