Abstract
BackgroundAberrant salience is the incorrect assignment of salience, significance, or value to different innocuous stimuli that might precede the onset of psychotic symptoms. The present study aimed to perform a preliminary evaluation of potentially different correlations between the Aberrant Salience Inventory (ASI) score and dimensional or categorical diagnostic approaches.Methods168 adult outpatients with a current psychiatric diagnosis were consecutively enrolled. Patients were evaluated using different psychometric scales. ASI was used to evaluate aberrant salience, and to evaluate the association between ASI scores and first rank symptoms (FRS), and/or with a psychiatric diagnosis. Principal dichotomic clusters of ASI were identified using the Chi-square automatic interaction detection (CHAID) method.ResultsCurrent (16.76 ± 6.02 vs 13.37 ± 5.76; p = 0.001), lifetime (15.74 ± 6.08 vs 13.16 ± 5.74; p = 0.005) and past (15.75 ± 6.01 vs 13.33 ± 5.80; p = 0.009) FRS were the main clusters dichotomizing ASI. The average ASI score did not significantly differ among patients with different diagnoses.ConclusionsASI could be used as a tool to identify psychopathological dimensions, rather than the categorical diagnoses, in the schizophrenic spectrum.
Highlights
The concept of salience was described by Kapur as “a process whereby objects and representations, through the process of association, come to be attention-grabbing and capture thought and behavior” [1]
196 patients were effectively involved in the study, but 28 participants did not fill one or more items of the Aberrant Salience Inventory (ASI). 168 subjects completed the entire study protocol, and they were included in our analyses
The present study showed that ASI values were higher in patients with first rank symptoms (FRS), but they did not differ in patients with any specific psychiatric diagnosis
Summary
The concept of salience was described by Kapur as “a process whereby objects and representations, through the process of association, come to be attention-grabbing and capture thought and behavior” [1]. According to Kapur [5], patients with aberrant salience over-attribute the meanings of otherwise neutral stimuli, typical in the prodromal stages of psychoses At this stage the onset of apprehension and anguish is common for a world that has become uncertain and full of new meanings: This “delusional atmosphere” has been described by Jaspers as “a change which envelops everything with a subtle, pervasive and strangely uncertain light” [10]. This hypothesis might link the aberrant signaling of motivational salience, through the dysregulated dopamine transmission [11], to psychotic symptoms, bridging the gap between neurobiology and phenomenology [1]. Conclusions: ASI could be used as a tool to identify psychopathological dimensions, rather than the categorical diagnoses, in the schizophrenic spectrum
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