Exploring electrophysiological correlates of social cognition in subclinical schizotypy.

Impairments in social cognition and associated abnormalities in brain function are well documented in psychotic disorders. They may represent neurodevelopmental vulnerabilities and may therefore be present in less severe or even subclinical conditions of the schizophrenia spectrum, such as schizotypy. Schizotypy has features highly suggestive of social cognitive impairments, but little is known about possible related abnormalities of brain function. This exploratory pilot study examines electrophysiological event-related potentials (ERPs) implicated in schizophrenia, in 23 undergraduates with a range of subclinical schizotypal characteristics. ERPs were recorded in response to emotional face stimuli in an experimental paradigm designed to assess very early stages of social stimulus processing. Three ERPs were assessed, P100, N170 and P300. P100 and P300 were found to be related to multiple schizotypal features, but N170 was not. The results support occurrence of social cognitive impairments linked to abnormal brain function across the schizophrenia spectrum. Copyright © 2018 John Wiley & Sons, Ltd.

Effects of eliminating psychiatric rehabilitation from the secure levels of a mental-health service system.

Psychiatric rehabilitation (PR) is widely recognized as a treatment approach and an array of evidence-based practices effective for promoting the recovery of people with serious mental illness (SMI). However, its use in institutional settings is not widespread for unclear reasons. Policymakers may sometimes believe the superiority of PR in controlled research does not apply in the real world, for various reasons. This study exploits an unusual set of real-world circumstances surrounding the closure of a well-developed PR program in a state hospital. The program was closed after a period of mental-health services reform that significantly augmented the surrounding community-service system. The PR program was converted to conventional medical-institutional model-treatment units with no reduction in beds or funding within the state hospital. A database composed of public documents was used to analyze the consequences of the closing. Within the institution, the consequences included a persistent presence of long-term difficult-to-discharge patients, a slowed discharge rate, a net increase in the hospital's per capita treatment costs, and higher use of restraint/seclusion. Effects were also detectable in the surrounding mental-health service system, including degraded outcome of community-based step-down services and increased pressure on emergency/crisis services. The consequences of closing the program are consistent with expectations based on research, and demonstrate danger in assuming that real world exigencies obviate research findings.

Estimating premorbid intelligence: comparison of traditional and contemporary methods across the intelligence continuum.

The present investigation compared the North American Adult Reading Test (NAART), Wide Range Achievement Test-3 (WRAT-3) Reading subtest, Barona, and Oklahoma Premorbid Intelligence Estimate Best (OPIE) premorbid intelligence estimates in 64 chronic pain patients across three intelligence ranges. Results for the entire sample revealed that the NAART, Barona, and OPIE Best equations overestimated Wechsler Adult Intelligence Scale-Revised Full Scale IQ (WAIS-R FSIQ), while the WRAT-3 underestimated FSIQ. When the sample was divided into three intelligence ranges, the OPIE more accurately classified individuals with above average intelligence, while the WRAT-3 more accurately classified individuals with below average intelligence. Three methods (NAART, OPIE, and WRAT-3) provided relatively equivalent classifications of individuals in the average intelligence range. The Barona method tended to systematically under- and overestimate FSIQ across the intelligence continuum. These results suggest the potential utility of using different estimation methods for individuals in different IQ ranges, and speak to the need for development of estimation methods that incorporate current reading ability with best performance and demographic variables.