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1.
Eur Arch Psychiatry Clin Neurosci ; 273(8): 1747-1760, 2023 Dec.
Article in English | MEDLINE | ID: mdl-36477406

ABSTRACT

Negative symptoms are prominent in individuals with schizophrenia (SZ) and youth at clinical high-risk for psychosis (CHR). In SZ, negative symptoms are linked to reinforcement learning (RL) dysfunction; however, previous research suggests implicit RL remains intact. It is unknown whether implicit RL is preserved in the CHR phase where negative symptom mechanisms are unclear, knowledge of which may assist in developing early identification and prevention methods. Participants from two studies completed an implicit RL task: Study 1 included 53 SZ individuals and 54 healthy controls (HC); Study 2 included 26 CHR youth and 23 HCs. Bias trajectories reflecting implicit RL were compared between groups and correlations with negative symptoms were examined. Cluster analysis investigated RL profiles across the combined samples. Implicit RL was comparable between HC and their corresponding SZ and CHR groups. However, cluster analysis was able to parse performance heterogeneity across diagnostic boundaries into two distinct RL profiles: a Positive/Early Learning cluster (65% of participants) with positive bias scores increasing from the first to second task block, and a Negative/Late Learning cluster (35% of participants) with negative bias scores increasing from the second to third block. Clusters did not differ in the proportion of CHR vs. SZ cases; however, the Negative/Late Learning cluster had more severe negative symptoms. Although implicit RL is intact in CHR similar to SZ, distinct implicit RL phenotypic profiles with elevated negative symptoms were identified trans-phasically, suggesting distinct reward-processing mechanisms can contribute to negative symptoms independent of phases of illness.


Subject(s)
Psychotic Disorders , Schizophrenia , Adolescent , Humans , Magnetic Resonance Imaging , Learning , Reward , Prodromal Symptoms
2.
J Ethn Subst Abuse ; 21(1): 174-196, 2022.
Article in English | MEDLINE | ID: mdl-32065558

ABSTRACT

The study explored associations among childhood abuse, post-traumatic stress symptoms (PTSS), and alcohol misuse in a sample of low-income African-American women (N = 172). Using bootstrapping techniques, a mediation effect was found of childhood physical and emotional abuse on alcohol misuse via PTSS symptom severity, avoidance, and hyperarousal, as well as for childhood sexual abuse on alcohol misuse via PTSS symptom severity and hyperarousal. Our results suggest that PTSS indicators, particularly symptom severity and hyperarousal, may be important mechanisms underlying the association of experiences of abuse during childhood and alcohol misuse in adulthood.


Subject(s)
Alcoholism/etiology , Child Abuse/ethnology , Child Abuse/psychology , Stress Disorders, Post-Traumatic , Adult , Black or African American , Alcoholism/epidemiology , Alcoholism/ethnology , Alcoholism/psychology , Child , Female , Humans , Stress Disorders, Post-Traumatic/epidemiology , United States/epidemiology
3.
Suicide Life Threat Behav ; 52(1): 99-109, 2022 02.
Article in English | MEDLINE | ID: mdl-34608660

ABSTRACT

OBJECTIVE: Suicide is a leading cause of death among adolescents, and suicidal thoughts represent key predictors to suicidal behavior. Yet, suicidal thoughts can be challenging to accurately assess. Symptoms that commonly co-occur with suicidal thoughts, such as depressive symptoms, may provide valuable information for predicting these thoughts. Although clinicians commonly collect multi-informant reports about adolescent depressive symptoms, these reports often yield discrepant findings as individual predictors of adolescents' suicidal thoughts. METHOD: We tested the ability of specific patterns of multi-informant reports to predict adolescents' suicidal thoughts. Ninety adolescent inpatients and their parents (i.e., "dyads") reported on adolescent depressive symptoms, and adolescents completed self-report assessments of suicidal thoughts at baseline and three-month follow-up. RESULTS: Dyads displayed variability in reporting patterns, and these patterns uniquely predicted suicidal thoughts. Adolescents reporting elevated depressive symptoms displayed increased concurrent suicidal thoughts relative to adolescents reporting subthreshold depressive symptoms, regardless of parent report. Yet, only adolescents who reported elevated depressive symptoms and whose parents reported subthreshold adolescent depressive symptoms displayed increased future suicidal thoughts. CONCLUSIONS: Identifying patterns of multiple informants' reports about adolescent depressive symptoms may improve the prediction of suicidal thoughts. These findings have important implications for assessing adolescents at risk for suicide.


Subject(s)
Adolescent Behavior , Suicide , Adolescent , Depression/diagnosis , Humans , Inpatients , Risk Factors , Suicidal Ideation
4.
Psychiatry Res ; 307: 114322, 2022 01.
Article in English | MEDLINE | ID: mdl-34922238

ABSTRACT

Evidence supports the use of brief psychosis-spectrum screening measures to identify individuals at elevated risk for psychosis, however, there is limited research on psychosis-spectrum screening among adolescents hospitalized for acute mental health concerns. Given the psychiatric vulnerability of this population, screening efforts within inpatient settings may help identify adolescents at greatest risk for ongoing mental health concerns including psychosis. This study investigates the use of two brief screening tools to identify psychosis-spectrum symptoms in psychiatrically hospitalized adolescents. Upon intake, adolescents completed two screening measures, the PRIME Screen-Revised and the Youth Self-Report Thought Problems scale, followed by a brief interview to evaluate psychosis-spectrum diagnoses. Associations between screening scores and diagnostic status were explored to evaluate the use of these tools to identify psychosis-spectrum conditions in this population. The sample included 57 adolescents, 28 of whom met psychosis-spectrum criteria. Psychosis-spectrum status was strongly correlated with PRIME scores (r = 0.59) and Thought Problems T scores (r = 0.55). Logistic regression analyses indicated that both screening measures demonstrate promising accuracy (74-81%) for identifying adolescents meeting psychosis-spectrum criteria. The PRIME and Thought Problems scale may be appropriate screening tools for use in adolescent inpatient settings to identify those experiencing clinically significant psychosis-spectrum symptoms.


Subject(s)
Inpatients , Psychotic Disorders , Adolescent , Humans , Mass Screening , Psychiatric Status Rating Scales , Psychotic Disorders/diagnosis , Psychotic Disorders/psychology , Self Report
5.
Int J Yoga Therap ; 31(1)2021 Jan 01.
Article in English | MEDLINE | ID: mdl-34469534

ABSTRACT

Low-income, racial-minority, high-risk populations have limited access to evidence-based treatments for posttraumatic stress disorder (PTSD), and their acceptance of complementary interventions is unknown. Trauma Center Trauma-Sensitive Yoga (TC-TSY), which has demonstrated efficacy in community samples, has not yet been widely used with ethnic minority low-income individuals. This article presents a culturally tailored version of a TC-TSY intervention delivered as a drop-in service in a public hospital-based clinic to patients with histories of interpersonal violence and suicide attempts. TC-TSY was iteratively tailored to meet the unique clinical needs of individuals within this setting. Group facilitator observations are summarized; they describe a successful initial implementation and culturally informed adaptation of the group intervention. The facilitators' observations illustrated that group members accepted the integration of this structured, gentle yoga practice into outpatient behavioral health programming and identified site-specific modifications to inform formal study. The process by which TC-TSY was adapted and implemented for Black individuals with a history of interpersonal trauma at risk for suicidal behavior can serve as a guide for tailoring other complementary, integrative interventions to meet the needs of unique clinical settings. This process is offered as a foundation for future systematic testing of this complementary, integrated, culturally adapted trauma therapy in high-risk clinical populations.


Subject(s)
Meditation , Stress Disorders, Post-Traumatic , Yoga , Ethnic and Racial Minorities , Ethnicity , Humans , Minority Groups , Stress Disorders, Post-Traumatic/therapy
6.
Schizophr Res ; 227: 63-71, 2021 01.
Article in English | MEDLINE | ID: mdl-33526203

ABSTRACT

Studies attempting to deconstruct the heterogeneity of schizophrenia and the attenuated psychosis syndrome consistently find that negative symptoms are a core dimension that is distinct from other aspects of the illness (e.g., positive and disorganized symptoms). Negative symptoms are also highly predictive of poor community-based functional outcomes, suggesting they are a critical treatment target. Unfortunately, pharmacological and psychosocial treatments for negative symptoms have demonstrated limited effectiveness. To address this critical unmet therapeutic need, the NIMH sponsored a consensus development conference to delineate research priorities for the field and stimulate treatment development. A primary conclusion of this meeting was that next-generation negative symptom rating scales should be developed to address methodological and conceptual limitations of existing instruments. Although second-generation rating scales were developed for adults with schizophrenia, progress in this area has lagged behind for youth at clinical-high risk (CHR) for developing psychosis (i.e. those meeting criteria for a prodromal syndrome). Given that negative symptoms are highly predictive of the transition to diagnosable psychotic illness, enhancing our ability to detect negative symptoms in CHR youth is paramount. The current paper discusses conceptual and methodological limitations inherent to existing scales that assess negative symptoms in CHR youth. The theoretical and clinical implications of these limitations are evaluated. It is concluded that new scales specifically designed to assess negative symptoms in CHR youth are needed to accurately chart mental illness trajectories and determine when, where, and how to intervene. Recent efforts to develop next-generation measures designed specifically for CHR youth to meet this urgent need in the field are discussed. These new approaches offer significant progress for addressing issues inherent to earlier scales.

7.
Schizophr Res ; 222: 104-112, 2020 08.
Article in English | MEDLINE | ID: mdl-32522469

ABSTRACT

Studies attempting to deconstruct the heterogeneity of schizophrenia and the attenuated psychosis syndrome consistently find that negative symptoms are a core dimension that is distinct from other aspects of the illness (e.g., positive and disorganized symptoms). Negative symptoms are also highly predictive of poor community-based functional outcomes, suggesting they are a critical treatment target. Unfortunately, pharmacological and psychosocial treatments for negative symptoms have demonstrated limited effectiveness. To address this critical unmet therapeutic need, the NIMH sponsored a consensus development conference to delineate research priorities for the field and stimulate treatment development. A primary conclusion of this meeting was that next-generation negative symptom rating scales should be developed to address methodological and conceptual limitations of existing instruments. Although second-generation rating scales were developed for adults with schizophrenia, progress in this area has lagged behind for youth at clinical-high risk (CHR) for developing psychosis (i.e. those meeting criteria for a prodromal syndrome). Given that negative symptoms are highly predictive of the transition to diagnosable psychotic illness, enhancing our ability to detect negative symptoms in CHR youth is paramount. The current paper discusses conceptual and methodological limitations inherent to existing scales that assess negative symptoms in CHR youth. The theoretical and clinical implications of these limitations are evaluated. It is concluded that new scales specifically designed to assess negative symptoms in CHR youth are needed to accurately chart mental illness trajectories and determine when, where, and how to intervene. Recent efforts to develop next-generation measures designed specifically for CHR youth to meet this urgent need in the field are discussed. These new approaches offer significant progress for addressing issues inherent to earlier scales.


Subject(s)
Psychotic Disorders , Schizophrenia , Symptom Assessment , Adolescent , Adult , Humans , Prodromal Symptoms , Psychiatric Status Rating Scales , Psychotic Disorders/diagnosis , Psychotic Disorders/therapy , Schizophrenia/diagnosis , Schizophrenia/therapy
8.
Schizophr Bull ; 46(5): 1191-1201, 2020 Sep 21.
Article in English | MEDLINE | ID: mdl-32103266

ABSTRACT

OBJECTIVE: Anhedonia, traditionally defined as a diminished capacity for pleasure, is a core symptom of schizophrenia (SZ). However, modern empirical evidence indicates that hedonic capacity may be intact in SZ and anhedonia may be better conceptualized as an abnormality in the temporal dynamics of emotion. METHOD: To test this theory, the current study used ecological momentary assessment (EMA) to examine whether abnormalities in one aspect of the temporal dynamics of emotion, sustained reward responsiveness, were associated with anhedonia. Two experiments were conducted in outpatients diagnosed with SZ (n = 28; n = 102) and healthy controls (n = 28; n = 71) who completed EMA reports of emotional experience at multiple time points in the day over the course of several days. Markov chain analyses were applied to the EMA data to evaluate stochastic dynamic changes in emotional states to determine processes underlying failures in sustained reward responsiveness. RESULTS: In both studies, Markov models indicated that SZ had deficits in the ability to sustain positive emotion over time, which resulted from failures in augmentation (ie, the ability to maintain or increase the intensity of positive emotion from time t to t+1) and diminution (ie, when emotions at time t+1 are opposite in valence from emotions at time t, resulting in a decrease in the intensity of positive emotion over time). Furthermore, in both studies, augmentation deficits were associated with anhedonia. CONCLUSIONS: These computational findings clarify how abnormalities in the temporal dynamics of emotion contribute to anhedonia.

9.
Dev Psychopathol ; 32(1): 219-227, 2020 02.
Article in English | MEDLINE | ID: mdl-30739633

ABSTRACT

Emotion regulation dysfunction is characteristic of psychotic disorders, but little is known about how the use of specific types of emotion regulation strategies differs across phases of psychotic illness. This information is vital for understanding factors contributing to psychosis vulnerability states and developing targeted treatments. Three studies were conducted to examine emotion regulation across phases of psychosis, which included (a) adolescent community members with psychotic-like experiences (PLEs; n = 262) and adolescents without PLEs (n = 1,226); (b) adolescents who met clinical high-risk criteria for a prodromal syndrome (n = 29) and healthy controls (n = 29); and (c) outpatients diagnosed with schizophrenia or schizoaffective disorder (SZ; n = 61) and healthy controls (n = 67). In each study, participants completed the Emotion Regulation Questionnaire and measures of psychiatric symptoms and functional outcome. The three psychosis groups did not differ from each other in reported use of suppression; however, there was evidence for a vulnerability-related, dose-dependent decrease in reappraisal. Across each sample, a lower use of reappraisal was associated with poorer clinical outcomes. Findings indicate that emotion regulation abnormalities occur across a continuum of psychosis vulnerability and represent important targets for intervention.


Subject(s)
Emotional Regulation , Psychotic Disorders/psychology , Schizophrenic Psychology , Adolescent , Adult , Child , Female , Humans , Male , Middle Aged , Surveys and Questionnaires , Young Adult
10.
J Psychiatr Res ; 121: 68-81, 2020 02.
Article in English | MEDLINE | ID: mdl-31783235

ABSTRACT

OBJECTIVE: Recent conceptual frameworks propose anhedonia reflects abnormalities in the temporal dynamics of positive emotion in schizophrenia, characterized by intact consummatory and impaired anticipatory pleasure. A comprehensive meta-analysis can directly test this theory using self-report data. METHOD: A meta-analysis was performed on studies reporting Temporal Experience of Pleasure Scale (TEPS) data from healthy controls and schizophrenia or schizotypy groups. The TEPS was examined as it contains subscales to measure both consummatory and anticipatory pleasure separately. Statistical heterogeneity and study bias were examined. Meta-regressions evaluated moderators. RESULTS: 53 studies were retrieved (7,797 participants). Results revealed small effect sizes for comparisons of combined schizophrenia/schizotypy and control groups for both consummatory and anticipatory pleasure. Within-group comparisons of pleasure conditions were nonsignificant. The percentage of male schizophrenia/schizotypy participants significantly moderated anticipatory and consummatory pleasure for the combined sample and schizotypy alone; male participants were found to report reduced pleasure. There was only minor evidence of bias; sensitivity analysis confirmed result robustness. Exploratory outlier removal for schizophrenia within-group pleasure comparisons revealed a statistically significant difference between reported anticipatory and consummatory pleasure, with consummatory pleasure reduced relative to anticipatory (i.e., in the opposite direction of the majority of experimental research findings). CONCLUSIONS: These findings provided only modest support for the temporal dynamics of positive emotion conceptualization because they revealed no evidence for: 1) specific anticipatory pleasure deficits in schizophrenia-spectrum participants compared to controls; 2) significant reductions in anticipatory pleasure relative to consummatory pleasure in schizophrenia-spectrum participants.


Subject(s)
Anhedonia/physiology , Anticipation, Psychological/physiology , Pleasure/physiology , Schizophrenia/physiopathology , Schizotypal Personality Disorder/physiopathology , Humans
11.
Drug Alcohol Depend ; 206: 107728, 2020 01 01.
Article in English | MEDLINE | ID: mdl-31740207

ABSTRACT

BACKGROUND: Striatal neuroadaptations are regarded to play an important role in the progression from voluntary to compulsive use of addictive substances and provide a promising target for the identification of neuroimaging biomarkers. Recent advances in surface-based computational analysis enable morphological assessment linking variations in global and local striatal shape to duration and magnitude of substance use with a degree of sensitivity that exceeds standard volumetric analysis. METHODS: This study used a new segmentation methodology coupled with local surface-based indices of surface area and displacement to provide a comprehensive structural characterization of the striatum in 34 patients entering treatment for substance use disorder (SUD) and 49 controls, and to examine the influence of recent substance use on abnormal age-related striatal deformation in SUD patients. RESULTS: Patients showed a small reduction in striatal volume and no difference in surface area or shape in comparison to controls. Between-group differences in shape were likely neutralized by the bidirectional influence of recent substance use on striatal shape in SUD patients. Specifically, there was an interaction between age and substance such that among older patients more drug use was associated with greater inward striatal contraction but more alcohol use was associated with greater outward expansion. CONCLUSIONS: This study builds on previous work and advances our understanding of the nature of striatal neuroadaptations as a potential biomarker of disease progression in addiction.


Subject(s)
Age Factors , Corpus Striatum/pathology , Substance-Related Disorders/pathology , Adult , Biomarkers/analysis , Computational Biology , Disease Progression , Female , Humans , Male , Organ Size , Substance-Related Disorders/therapy
12.
Schizophr Bull ; 45(6): 1319-1330, 2019 10 24.
Article in English | MEDLINE | ID: mdl-30649527

ABSTRACT

Network analysis was used to examine how densely interconnected individual negative symptom domains are, whether some domains are more central than others, and whether sex influenced network structure. Participants included outpatients with schizophrenia (SZ; n = 201), a bipolar disorder (BD; n = 46) clinical comparison group, and healthy controls (CN; n = 27) who were rated on the Brief Negative Symptom Scale. The mutual information measure was used to construct negative symptom networks. Groups were compared on macroscopic network properties to evaluate overall network connectedness, and microscopic properties to determine which domains were most central. Macroscopic analyses indicated that patients with SZ had a less densely connected negative symptom network than BD or CN groups, and that males with SZ had less densely connected networks than females. Microscopic analyses indicated that alogia and avolition were most central in the SZ group, whereas anhedonia was most central in BD and CN groups. In addition, blunted affect, alogia, and asociality were most central in females with SZ, and alogia and avolition were most central in males with SZ. These findings suggest that negative symptoms may be highly treatment resistant in SZ because they are not very densely connected. Less densely connected networks may make treatments less likely to achieve global reductions in negative symptoms because individual domains function in isolation with little interaction. Sex differences in centralities suggest that the search for pathophysiological mechanisms and targeted treatment development should be focused on different sets of symptoms in males and females.


Subject(s)
Affect , Anhedonia , Aphasia , Bipolar Disorder/psychology , Motivation , Schizophrenia/physiopathology , Schizophrenic Psychology , Social Behavior , Adult , Bipolar Disorder/physiopathology , Female , Humans , Male , Middle Aged , Sex Factors , Systems Analysis , Young Adult
13.
Arch Suicide Res ; 23(1): 47-63, 2019.
Article in English | MEDLINE | ID: mdl-29482489

ABSTRACT

Using self-harm Implicit Association Tests (IATs), we sought to test whether (1) suicidal adolescents show implicit identification with self-harm and whether (2) IATs are reliable and sensitive to psychiatric change and (3) predict future suicide attempts. We administered 6 self-harm IATs to 71 adolescents from a psychiatric inpatient unit and assessed suicidal behaviors at admission, discharge and 3 months after discharge. Results were in the expected direction for each IAT but not statistically significant. After aggregating trials across IATs, suicide attempters showed increased implicit identification with self-harm, compared with non-suicidal controls. IATs showed good reliability and sensitivity to psychiatric change but did not prospectively predict suicide attempts. Adolescent suicide attempters may have stronger implicit associations with self-harm than non-suicidal controls.


Subject(s)
Adolescent Behavior/psychology , Psychological Techniques/standards , Self-Injurious Behavior , Suicidal Ideation , Suicide, Attempted , Adolescent , Behavioral Symptoms/diagnosis , Female , Humans , Male , Predictive Value of Tests , Reproducibility of Results , Risk Assessment/methods , Self-Injurious Behavior/diagnosis , Self-Injurious Behavior/psychology , Suicide, Attempted/prevention & control , Suicide, Attempted/psychology
14.
Schizophr Res Cogn ; 12: 1-7, 2018 Jun.
Article in English | MEDLINE | ID: mdl-29928593

ABSTRACT

Hedonic response is preserved in schizophrenia. However, it is unclear whether this is also true in individuals meeting criteria for "prodromal" psychosis, who are considered to be at symptomatic high risk for developing the disorder. In this study, we examined neurophysiological and self-reported response to emotional stimuli in UHR (n = 23) and healthy control (CN: n = 30) participants who passively viewed pleasant, unpleasant, and neutral images for 500 ms while the electroencephalogram was recorded and then provided self-reports of valence and arousal to the stimuli. The Late Positive Potential (LPP) event related potential (ERP) component was used as a neurophysiological marker of emotional reactivity. Results indicated that CN participants had higher LPP amplitude for pleasant and unpleasant compared to neutral stimuli; however, UHR youth displayed no differences in LPP amplitude among pleasant, unpleasant, and neutral stimuli. Self-report data mirrored neurophysiological data, as UHR youth had lower reports of positive emotion to pleasant stimuli and negative emotion to unpleasant stimuli compared to CN participants. Furthermore, the presence of a mood disorder diagnosis predicted reduced neurophysiological emotional reactivity in UHR youth. Findings suggest that youth at UHR for psychosis display diminished subjective and neurophysiological reactivity to emotional stimuli, and that symptoms of depression may result in diminished emotional reactivity.

15.
Schizophr Res ; 197: 156-161, 2018 07.
Article in English | MEDLINE | ID: mdl-29499966

ABSTRACT

Anhedonia (i.e., diminished capacity to experience pleasure) has traditionally been viewed as a core symptom of schizophrenia (SZ). However, modern laboratory-based studies suggest that this definition may be incorrect, as hedonic capacity may be intact. Alternative conceptualizations have proposed that anhedonia may reflect an impairment in generating mental representations of affective value that are needed to guide decision-making and initiate motivated behavior. The current study evaluated this hypothesis in 42 outpatients with SZ and 19 healthy controls (CN) who completed two tasks: (a) an emotional experience task that required them to indicate how positive, negative, and calm/excited they felt in response to a single emotional or neutral photograph; (b) a relative value judgment task where they selected which of 2 photographs they preferred. Results indicated that SZ and CN reported similar levels of positive emotion and arousal in response to emotional and neutral stimuli; however, SZ reported higher negative affect for neutral and pleasant stimuli than CN. In the relative value judgment task, CN displayed clear preference for stimuli differing in valence; however, SZ showed less distinct preferences for positive over neutral stimuli. Findings suggest that although in-the-moment experiences of positive emotion to singular stimuli may be intact in SZ, the ability to make relative value judgments that are needed to guide decision-making is impaired. Original conceptualizations of anhedonia as a diminished capacity for pleasure in SZ may be inaccurate; anhedonia may more accurately reflect a deficit in relative value judgment that results from impaired value representation.


Subject(s)
Anhedonia/physiology , Choice Behavior/physiology , Cognitive Dysfunction/physiopathology , Emotions/physiology , Judgment/physiology , Psychotic Disorders/physiopathology , Schizophrenia/physiopathology , Adult , Cognitive Dysfunction/etiology , Female , Humans , Male , Middle Aged , Psychotic Disorders/complications , Schizophrenia/complications
16.
Psychol Med ; 48(14): 2337-2345, 2018 10.
Article in English | MEDLINE | ID: mdl-29361997

ABSTRACT

BACKGROUND: Prior studies using self-report questionnaires and laboratory-based methods suggest that schizophrenia is characterized by abnormalities in emotion regulation (i.e. using strategies to increase or decrease the frequency, duration, or intensity of negative emotion). However, it is unclear whether these abnormalities reflect poor emotion regulation effort or adequate effort, but limited effectiveness. It is also unclear whether dysfunction results primarily from one of the three stages of the emotion regulation process: identification, selection, or implementation. METHOD: The current study used ecological momentary assessment (EMA) to address these questions in the context of everyday activities. Participants included 28 outpatients diagnosed with schizophrenia (SZ) and 28 demographically matched healthy controls (CN) who completed 6 days of EMA reports of in-the-moment emotional experience, emotion regulation strategy use, and context. RESULTS: Results indicated that SZ demonstrated adequate emotion regulation effort, but poor effectiveness. Abnormalities were observed at each of the three stages of the emotion regulation process. At the identification stage, SZ initiated emotion regulation efforts at a lower threshold of negative emotion intensity. At the selection stage, SZ selected more strategies than CN and strategies attempted were less contextually appropriate. At the implementation stage, moderate to high levels of effort were ineffective at decreasing negative emotion. CONCLUSIONS: Findings suggest that although SZ attempt to control their emotions using various strategies, often applying more effort than CN, these efforts are unsuccessful; emotion regulation abnormalities may result from difficulties at the identification, selection, and implementation stages.


Subject(s)
Affective Symptoms/physiopathology , Ecological Momentary Assessment , Schizophrenia/physiopathology , Self-Control , Adult , Affective Symptoms/etiology , Female , Humans , Male , Middle Aged , Schizophrenia/complications
17.
Schizophr Res ; 189: 43-49, 2017 11.
Article in English | MEDLINE | ID: mdl-28189529

ABSTRACT

In the psychosis prodrome, sub-threshold positive symptoms are often preceded by negative symptoms. Individuals exhibiting these attenuated symptoms are primarily adolescents and young adults at clinical high-risk (CHR) for developing a psychotic disorder. In the CHR state, negative symptoms are highly predictive of the transition to diagnosable illness, making the assessment of these symptoms very important. Existing scales used to evaluate negative symptoms in this critical population are informative but have conceptual and psychometric limitations and/or were not designed according to modern conceptions delineated in the 2005 NIMH Negative Symptom Consensus Conference. The current study reports the development of the Prodromal Interview of Negative Symptoms (PINS) - a next-generation scale designed in accordance with the consensus conference recommendations. Preliminary data on the psychometric properties of the PINS is reported as part of ongoing scale development that will use a data-driven, iterative process to generate a final scale. Analysis of data from 53 CHR cases, 30 of whom were re-evaluated at 12months, indicated that the beta version of the PINS demonstrated good internal consistency, inter-rater reliability, convergent validity, and discriminant validity. These preliminary findings provide direction for a revision of this measure, which resulted in the PINS-2, a promising new measure for the assessment of negative symptoms in CHR populations. This manuscript presents both the initial scale and resulting untested instrument, as well as a series of plans and recommendations for future development.


Subject(s)
Prodromal Symptoms , Psychometrics , Psychotic Disorders/diagnosis , Psychotic Disorders/psychology , Adolescent , Child , Female , Humans , Male , Neuropsychological Tests , Psychiatric Status Rating Scales , Reproducibility of Results , Young Adult
18.
Innov Clin Neurosci ; 14(11-12): 59-67, 2017 Dec 01.
Article in English | MEDLINE | ID: mdl-29410938

ABSTRACT

Objective: The Positive and Negative Syndrome Scale is a primary outcome measure in clinical trials examining the efficacy of antipsychotic medications. Although the Positive and Negative Syndrome Scale has demonstrated sensitivity as a measure of treatment change in studies using traditional univariate statistical approaches, its sensitivity to detecting network-level changes in dynamic relationships among symptoms has yet to be demonstrated using more sophisticated multivariate analyses. In the current study, we examined the sensitivity of the Positive and Negative Syndrome Scale to detecting antipsychotic treatment effects as revealed through network analysis. Design: Participants included 1,049 individuals diagnosed with psychotic disorders from the Phase I portion of the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) study. Of these participants, 733 were clinically determined to be treatment-responsive and 316 were found to be treatment-resistant. Item level data from the Positive and Negative Syndrome Scale were submitted to network analysis, and macroscopic, mesoscopic, and microscopic network properties were evaluated for the treatment-responsive and treatment-resistant groups at baseline and post-phase I antipsychotic treatment. Results: Network analysis indicated that treatment-responsive patients had more densely connected symptom networks after antipsychotic treatment than did treatment-responsive patients at baseline, and that symptom centralities increased following treatment. In contrast, symptom networks of treatment-resistant patients behaved more randomly before and after treatment. Conclusions: These results suggest that the Positive and Negative Syndrome Scale is sensitive to detecting treatment effects as revealed through network analysis. Its findings also provide compelling new evidence that strongly interconnected symptom networks confer an overall greater probability of treatment responsiveness in patients with psychosis, suggesting that antipsychotics achieve their effect by enhancing a number of central symptoms, which then facilitate reduction of other highly coupled symptoms in a network-like fashion.

19.
Theriogenology ; 81(2): 220-4, 2014 Jan 15.
Article in English | MEDLINE | ID: mdl-24100162

ABSTRACT

Red pandas (Ailurus fulgens) are threatened with extinction owing to habitat loss, exacerbated by their unique ecology and low fecundity. Regional breeding programs manage captive red panda populations. Recommendations not to breed may be made for various reasons, including genetic overrepresentation of certain individuals. No recommendations have been published on the use of contraception for red pandas. This article discusses the use of the GnRH analog deslorelin as a reversible method of contraception in both male and female pandas. The mean time from last contraception to conception was 3 years with a 4.6-mg deslorelin implant. The average dose of GnRH implant received was 1.09 mg/kg (range, 0.88-1.32). Males returned to breeding sooner than females. No reproductive side effects were noted with up to three consecutive annual GnRH implants.


Subject(s)
Ailuridae/physiology , Contraception/veterinary , Triptorelin Pamoate/analogs & derivatives , Animals , Breeding , Contraception/methods , Endangered Species , Female , Male , Time Factors , Triptorelin Pamoate/therapeutic use
20.
Nature ; 421(6919): 152-5, 2003 Jan 09.
Article in English | MEDLINE | ID: mdl-12520298

ABSTRACT

Ocean-atmosphere interactions in the tropical Pacific region have a strong influence on global heat and water vapour transport and thus constitute an important component of the climate system. Changes in sea surface temperatures and convection in the tropical Indo-Pacific region are thought to be responsible for the interannual to decadal climate variability observed in extra-tropical regions, but the role of the tropics in climate changes on millennial and orbital timescales is less clear. Here we analyse oxygen isotopes and Mg/Ca ratios of foraminiferal shells from the Makassar strait in the heart of the Indo-Pacific warm pool, to obtain synchronous estimates of sea surface temperatures and ice volume. We find that sea surface temperatures increased by 3.5-4.0 degrees C during the last two glacial-interglacial transitions, synchronous with the global increase in atmospheric CO2 and Antarctic warming, but the temperature increase occurred 2,000-3,000 years before the Northern Hemisphere ice sheets melted. Our observations suggest that the tropical Pacific region plays an important role in driving glacial-interglacial cycles, possibly through a system similar to how El Niño/Southern Oscillation regulates the poleward flux of heat and water vapour.


Subject(s)
Climate , Ice , Seawater , Temperature , Animals , Antarctic Regions , Atmosphere , Calcium/metabolism , Calcium Carbonate/metabolism , Calibration , Carbon Dioxide/metabolism , Geologic Sediments/chemistry , Indonesia , Magnesium/metabolism , Oxygen Isotopes/metabolism , Pacific Ocean , Plankton/metabolism , Seawater/chemistry , Time Factors
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