Use of naloxone in schizophrenic psychoses and manic syndromes

Since 1975, different morphinomimetic peptides have been isolated from hypophyseal-hypothalamic extracts: the pentapeptides methionine-enkephalin and leucine-enkephalin, and the longer peptides alpha-, beta- and gamma-endorphin. The primary structure of most of these peptides is also present in that of beta-lipotropin. The morphinomimetic properties of endorphins can be blocked with opiate-antagonists. In rats, moreover, the endorphins influence behavior which cannot be blocked with opiate antagonists. On the basis of the hypothesis that hyperactivity of endorphin systems may be involved in the pathogenesis of schizophrenia and manic syndromes, the effect of opiate antagonists on psychotic and manic symptoms has been examined in a number of clinical studies in the past few years. A transient therapeutic effect has been demonstrated in about 30% of the patients so treated. Our own double-blind controlled study of 5 schizophrenic and 5 manic patients in the context of a World Health Organization project failed to reveal any therapeutic effect after subcutaneous injection of 20 mg naloxone. The possible reasons of the negative results are discussed.     

Selective attention in schizophrenic and manic psychoses: The effect of distraction on information processing.

Attempted to identify the general level of cognitive processing that is especially vulnerable to distraction in schizophrenia. The extent and nature of distraction were compared in 12 schizophrenic patients (mean age, 27.8 yrs), 12 manic patients (mean age, 28.2 yrs), and 12 controls (mean age, 26.7 yrs) using neutral and distractor word-span tests. Also, all patients were evaluated by the Nurse's Observation Scale for Inpatient Evaluation, and 10, 11, and 12 controls, schizophrenics, and manics, respectively, completed the MMPI. On one set of tests, serial position curves indicated that in the presence of distraction the overall deterioration in schizophrenics' performance reflected their tendency to forget early, and not late, items in the lists. On a 2nd set of tests, both schizophrenics and manics were abnormally distracted, regardless of the speed of presentation. Although the controls were also somewhat distracted by irrelevant words, their impairment was significantly diminished at slower rates of presentation. With distraction, schizophrenics and manics were less able to use the extra time in slow presentations for active mental operations such as rehearsal. Both groups made more intrusive errors than normal Ss. Results indicate that distraction interferes with schizophrenics' and manics' information processing at some level beyond the comparatively passive stages of recognition and sensory storage. Problems in selective attention seem to be more closely related to thought disorder than to diagnostic categories. (25 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Lexical cohesion and formal thought disorder during and after psychotic episodes.

Compared speech samples obtained from 10 schizophrenics (mean age 28 yrs), 11 manics (mean age 26.2 yrs), 11 schizoaffectives (mean age 25.8 yrs), and 10 normals (mean age 33.6 yrs) for the amount of lexical cohesion both within and between clauses. Two speech samples were obtained for each patient: one shortly after admission to a psychiatric hospital and another several weeks following discharge. All psychiatric patients showed evidence of formal thought disorder at admission, and all 3 groups showed a significant decline in the extent of thought disorder at follow-up. There were no differences between groups with regard to between-clause lexical cohesion at either point in time. Within-clause lexical cohesion did distinguish among the psychiatric groups at the 1st assessment interval; schizophrenics showed less within-clause lexical cohesion than the manics or schizoaffective patients. The manics and the schizoaffectives showed a significant decline in the amount of within-clause lexical cohesion from initial assessment to follow-up. The schizophrenics exhibited a modest decline in the amount of between-clause lexical cohesion. Results indicate that diagnostic differences in lexical cohesion depended on the specificity of the measure and suggest that there are subtle differences between the forms of verbal-communication impairment observed in schizophrenic and affective disorders. (9 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Conflicting predictions from Broen's and Chapman's theories of schizophrenic thought disorder.

Developed multiple-choice vocabulary items containing a correct alternative which was the dominant (most frequent) response for normal ss, an associative distractor alternative of nearly equal frequency, and an irrelevant alternative. W. Broen and L. Storms's theory predicts that a response which is nondominant for normals can never become dominant for schizophrenics, while L. Chapman's theory predicts that such a response can do so if it expresses a normal response bias. 26 chronic schizophrenics chose significantly more associative than correct responses on items for which 26 normals (matched on sex, age, education, and social position) chose significantly more correct than associative. Results are consistent with chapman's theory. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Impairment in abstract conceptualization and Bannister and Fransella's grid test of schizophrenic thought disorder.

Hypothesized that measures of thought disorder derived from D. Bannister and F. Fransella's (see record 1966-10277-001) theory and from an earlier theory would covary in a sample of 38 male psychiatric inpatients not initially diagnosed as schizophrenics. Ss were administered Part II of the Object Sorting Task and Bannister and Fransella's grid test of schizophrenic thought disorder. Results support the hypothesis that the recently developed grid measures are related to earlier theories which consider impairment in abstract conceptualization the hallmark of schizophrenic thought disorder. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Communication deviance in families of schizophrenic and manic patients.

Levels of communication deviance (CD) distinguish parents of schizophrenic patients from parents of nonpsychotic patients, but the prevalence of intrafamilial CD in other psychotic disorders has not been examined. Levels of CD were compared across biological parents of schizophrenic (n?=?39) and bipolar manic (n?=?16) patients and across patients themselves. CD ratings were based on Thematic Apperception Test (TAT) protocols (parents only) and family interactions (parents and patients). Total levels of CD did not distinguish between groups of parents or patients. However, instances of odd word usage were more frequent among parents of manic patients than among parents of schizophrenic patients on both CD measures. Also, during the interaction task, odd word usage was more frequent among manic patients, whereas schizophrenic patients made more ambiguous references. Results suggest that high levels of intrafamilial CD are not unique to schizophrenia. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relationship between formal thought disorder and retardation in schizophrenia.

17 schizophrenics admitted into the hospital less than 6 mo before were compared on Bannister's Grid Test of Schizophrenic Thought Disorder with 19 schizophrenics admitted over 6 mo before and with a group of 17 nonschizophrenic, psychiatric controls under 3 conditions: fast rate of responding, slow rate of responding, and in-between rate of responding. It was predicted that the schizophrenics would show more thought disorder under fast than slow conditions and that the recently admitted schizophrenics would be more thought disordered than the earlier admitted schizophrenics. Contrary to expectations, the patients tended to show less thought disorder on the test when their responses were speeded than when they were encouraged to take their time. Moreover, the earlier admitted schizophrenics showed more thought disorder than the recently admitted schizophrenics under all 3 conditions. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychological deficit versus impression management in schizophrenic word association performance.

Schizophrenic performance has been interpreted as being the result of ability loss and of impression management. An experiment is reported which allows a direct test of the ability loss assumption as opposed to one form of the impression management hypothesis. 20 healthy presenter and 20 sick presenter schizophrenics were given differential "normative" information concerning the meaning of word association performance. Healthy presenters shifted their performance in the direction predicted by the impression management hypothesis but sick presenters did not. Results suggest that the likelihood of occurrence of impression management depends heavily on the degree of pathology displayed by S. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The relationship between formal thought disorder and executive functioning component processes.

In 2 studies, associations between formal thought disorder (FTD) and 2 components of executive functioning, processing of context and interference resolution, were investigated. One study, involving people with schizophrenia, examined associations between performance on processing of context (N-back) and interference resolution (interference in Steinberg probe recognition) tasks and FTD. The second study, involving nonpsychiatric participants, was an analogue study that examined the effects of simulated processing of context (performance of 1-back with distraction) and interference resolution (telling new stories about previously seen pictures) deficits on FTD in a speech production task. In both studies, processing of context deficits predicted FTD. Moreover, in both studies, the effect of processing of context deficits on FTD was especially pronounced when combined with interference resolution deficits. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Hesitation patterns in the speech of thought-disordered schizophrenic and manic patients.

Conventional hesitations (those between clauses) and idiosyncratic hesitations (those occurring within clauses) were measured in speech samples obtained from thought-disordered schizophrenics, thought-disordered manics, undergraduate students, and nonstudent normal Ss (10 Ss/group). Ss' mean ages were 28.0, 26.5, 21.6, and 30.8 yrs, respectively. Findings are consistent with a report by S. R. Rochester et al (1977): The conventional hesitations of thought-disordered schizophrenics were longer than those of the undergraduate normals. They were not, however, significantly longer than the conventional hesitations of nonstudent normals who were demographically more similar to the schizophrenic Ss. The conventional hesitations of the schizophrenics were longer than those of the manic Ss, in spite of the fact that the manics were also considered thought-disordered. An examination of the relation between hesitation durations and various specific subtypes of thought-disorder within each S group indicated that longer conventional hesitations were not significantly related to phenomena such as derailment, circumstantiality, and loss of goal. Contrary to Rochester's hypothesis, results indicate that the cognitive mechanisms associated with extended conventional pause times are not clearly related to the verbal communication problems that are often experienced by schizophrenics. (17 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Sentence perception and distractibility in schizophrenic, manic, and depressed patients.

Previous research with schizophrenics suggested that distraction may have its primary effect on controlled information processing. To explore this hypothesis, 8 schizophrenics, 8 manics, 8 depressives, and 8 normal Ss (all Ss were aged 18–45 yrs) were asked to shadow short stories in both the presence and absence of a competing message and to answer questions afterward about the content of the shadowed message. The shadowing performance of all 3 patient groups was equivalent to that of normal Ss and was not affected by distraction. Shadowing errors of commission indicated that schizophrenics did use semantic and syntactic information to anticipate words in the relevant message, but the schizophrenics also inserted more semantically irrelevant words than any of the other 3 groups. Distraction did interfere with the schizophrenics' ability to recall the content of relevant passages, but not with the performance of the other 3 groups. Data indicate that distraction may have a specific rather than general influence on controlled information processing or that distraction may reduce schizophrenics' overall capacity to handle information in short-term memory. The analysis of shadowing errors suggested that performance on such laboratory tasks may be closely related to the verbal communication problems encountered by many schizophrenic patients, but also that these symptoms may not be a simple function of selective attention difficulties. (30 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The relationship between anxiety and oral word association performance.

To test the comparative validity of 2 theories of anxiety (Sarason's interfering response and Spence and Taylor's drive theory), associations to word stimuli were analyzed. According to drive theory, anxiety should interfere with the number of different associations to the same word. Words that stimulate few associations should result in short reaction times and few disturbance of responsiveness and rare responses. According to interference theory there should be an effect upon association without an interaction between the degree of association value of the word and anxiety level of S. The results were interpreted as supporting Sarason's theory. From Psyc Abstracts 36:04:4HK68G. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Early metalinguistic competence: Speech monitoring and repair behavior.

This article examines 2–3-year-olds' responses to specific (e.g., "Where did he go?") and neutral (e.g., "What?") requests for clarification. The focus is on children's ability to locate the linguistic errors that provoked neutral questions of clarification and their success in providing appropriate repair. It is argued that this behavior provides evidence for a speech monitor that detects errors and enables repair. Contrary to A. Karmiloff-Smith's (1992) claim, control over the production and comprehension of specific structures does not necessarily precede monitoring. Rather, metalinguistic abilities that are implicated in speech monitoring develop simultaneously with the acquisition of primary linguistic behavior and do not require awareness. It is claimed that such metaprocesses are fundamental to the use of language as a vehicle for the expression of intentional content. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Relation between latency and redundancy-associated deficit in schizophrenic reaction time performance.

Evaluated the independence of 2 well-established measures of information-processing difficulties in process schizophrenics, namely, reaction time measures of latency and redundancy-associated deficit. Training exercises were designed to improve the speed of reaction time performance in 16 male Ss (average age 32.5 yrs). These exercises were successful in reducing latency over the course of training and from pre- to posttraining assessments to levels falling around the range of performance expected of normals. Redundancy-associated deficit, however, did not change from pre- to postassessment, indicating that this index is not a simple reflection of latency and is not responsive to training procedures involving positive motivation. Intercorrelations of the 2 indexes also showed that these measures were independent, at least within the process end of the schizophrenic spectrum. Furthermore, the 2 measures correlated with different types of S factors. Latency measures correlated with measures of chronicity, and the redundancy-deficit measure was correlated with prognosis. Findings help to clarify the utility of reaction time indexes as markers of various aspects of schizophrenic pathology. (33 ref) (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)     

Social competence and outcome in psychiatric disorder.

Relationship of premorbid social competence of patients necessitating hospitalization to length of hospitalization, frequency of hospitalization, and time between hospitalizations was studied. Case histories of 251 patients were analyzed. As with previous studies, a positive relationship between the variables was found. Those at the lower end of the social competence continuum had longer periods of hospitalization and greater likelihood of rehospitalization. Social competence was therefore seen to be related to prognosis. Results were discussed in terms of developmental approach to personality and, in particular, psychopathology. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Language production and thought disorder in schizophrenia.

The authors examined the relationship between language production (LP) processes and thought disorder. Thirty-nine schizophrenic or schizoaffective participants completed tasks measuring discourse planning, monitoring, and grammatical–phonological encoding, as well as an interview used to rate thought disorder. The authors found that different LP processes were differentially related to different thought disorder subtypes. Incompetent references were strongly and selectively related to discourse planning performance. In addition, word approximations–neologisms were strongly and specifically associated with grammatical–phonological encoding performance. The article concludes with a discussion of the implications of these results for understanding the multifaceted nature and etiology of thought disorder. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Left-handedness and thought disorder in the schizophrenias.

The relation between language dysfunction and handedness was examined in a sample of 58 male schizophrenic patients. Severity and type of language dysfunction were assessed using ratings on categories of thought disorder derived from the Schedule of Affective Disorders and Schizophrenia (Spitzer & Endicott, 1977). Hand preferred for writing was the criterion for handedness. In this sample, the incidence of left-handedness was raised and left-handedness was associated with the presence and severity of thought disorder. These findings are congruent with the hypothesis that a sizable proportion of left-handed schizophrenic individuals are left-handed because of a disruption in the pattern of hemispheric dominance that also impairs language functioning. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Differences in test performance between brain-damaged, schizophrenic, and medical patients.

Gave 18 white male hospitalized patients from each of 3 diagnostic categories (brain-damaged, schizophrenic, and medical) a battery of 9 psychological tests, including 5 from the Halstead Impairment Index, the Bender Visual-Motor Gestalt Test, the Trail Making Test (R. Reitan), and 2 tests from the WAIS. 16 measures were obtained, and the 3 groups of Ss were compared on each. The performance of the brain-damaged was significantly inferior to the medical patients on 14 of the 16 measures, and to the schizophrenics on 9 of the 16. There were no significant differences between the schizophrenics and the medical group on any of the 16 measures. When the scores on the 4 different tests were combined into Z scores, 78% of the brain-damaged, 67% of the schizophrenics, and 78% of the medical Ss were correctly diagnosed for presence or absence of brain damage. (PsycINFO Database Record (c) 2010 APA, all rights reserved)