The impact of emotion dysregulation on positive and negative symptoms in schizophrenia spectrum disorders: A systematic review.

OBJECTIVES: Accumulating research evidence supports the role of emotion dysregulation in the etiology of schizophrenia spectrum disorders. The present systematic review synthesized the extant literature and aimed to determine the effects of cognitive emotion regulation strategies and global emotion dysregulation on positive and negative symptoms in schizophrenia spectrum disorders. METHOD: A comprehensive systematic review was conducted to identify quantitative studies published between 2000 and 2019. A total of 22 studies were included in this review. RESULTS: Overall, maladaptive cognitive emotion regulation strategies of rumination, worry, and suppression were generally related to more positive symptoms, while global emotion dysregulation was related to more positive and negative symptoms. CONCLUSIONS: Our results provide preliminary and conceptual evidence on the role of emotion dysregulation in understanding schizophrenia spectrum disorders. Psychological treatment should further determine the therapeutic value of addressing emotion dysregulation to improve positive and negative symptoms in schizophrenia spectrum disorders.

Comparing the CASI-4R and the PGBI-10 M for Differentiating Bipolar Spectrum Disorders from Other Outpatient Diagnoses in Youth.

We compared 2 rating scales with different manic symptom items on diagnostic accuracy for detecting pediatric bipolar spectrum disorder (BPSDs) in outpatient mental health clinics. Participants were 681 parents/guardians of eligible children (465 male, mean age = 9.34) who completed the Parent General Behavior Inventory-10-item Mania (PGBI-10 M) and mania subscale of the Child and Adolescent Symptom Inventory-Revised (CASI-4R). Diagnoses were based on KSADS interviews with parent and youth. Receiver operating characteristic (ROC) analyses and diagnostic likelihood ratios (DLRs) determined discriminative validity and provided clinical utility, respectively. Logistic regressions tested for incremental validity in the CASI-4R mania subscale and PGBI-10 M in predicting youth BPSD status above and beyond demographic and common diagnostic comorbidities. Both CASI-4R and PGBI-10 M scales significantly distinguished BPSD (N = 160) from other disorders (CASI-4R: Area under curve (AUC) = .80, p < 0.0005; PGBI-10 M: AUC = 0.79, p < 0.0005) even though scale items differed. Both scales performed equally well in differentiating BPSDs (Venkatraman test p > 0.05). Diagnostic likelihood ratios indicated low scores on either scale (CASI: 0-5; PGBI-10 M: 0-6) cut BPSD odds to 1/5 of those with high scores (CASI DLR- = 0.17; PGBI-10 M DLR- = 0.18). High scores on either scale (CASI: 14+; PGBI-10 M: 20+) increased BPSD odds about fourfold (CASI DLR+ = 4.53; PGBI-10 M DLR+ = 3.97). Logistic regressions indicated the CASI-4R mania subscale and PGBI-10 M each provided incremental validity in predicting youth BPSD status. The CASI-4R is at least as valid as the PGBI-10 M to help identify BPSDs, and can be considered as part of an assessment battery to screen for pediatric BPSDs.