Non-clinical Control Subjects Research Articles

Anxiety Symptoms Questionnaire (ASQ): development and validation

BackgroundThe Anxiety Symptoms Questionnaire (ASQ) is a brief self-report questionnaire which measures frequency and intensity of symptoms and was developed to improve assessment of anxiety symptoms in a clinical setting....

Treatment Controversies in Adult ADHD.

Treatment Controversies in Adult ADHD.

Validation of the Bipolar Disorder Etiology Scale Based on Psychological Behaviorism Theory and Factors Related to the Onset of Bipolar Disorder

ObjectivesThe aim of this study was to identify psychosocial factors related to the onset of bipolar I disorder (BD). To do so, the Bipolar Disorder Etiology Scale (BDES), based on psychological behaviorism, was developed and validated. Using the BDES, common factors related to both major depressive disorder (MDD) and BD and specific factors related only to BD were investigated.MethodThe BDES, which measures 17 factors based on psychological behaviorism hypotheses, was developed and validated. This scale was administered to 113 non-clinical control subjects, 30 subjects with MDD, and 32 people with BD. ANOVA and post hoc analyses were conducted. Subscales on which MDD and BD groups scored higher than controls were classified as common factors, while those on which the BD group scored higher than MDD and control groups were classified as specific factors.ResultsThe BDES has acceptable reliability and validity. Twelve common factors influence both MDD and BD and one specific factor influences only BD. Common factors include the following: learning grandiose self-labeling, learning dangerous behavior, reinforcing impulsive behavior, exposure to irritability, punishment of negative emotional expression, lack of support, sleep problems, antidepressant problems, positive arousal to threat, lack of social skills, and pursuit of short-term pleasure. The specific factor is manic emotional response.ConclusionsManic emotional response was identified as a specific factor related to the onset of BD, while parents’ grandiose labeling is a candidate for a specific factor. Many factors are related to the onset of both MDD and BD.

A study of theory of mind in paranoid schizophrenia: a theory or many theories?

Social cognitive psychologists (Frith, 1992; Hardy-Baylé et al., 2003) sought to explain the social problems and clarify the clinical picture of schizophrenia by proposing a model that relates many of the symptoms to a problem of metarepresentation, i.e., theory of mind (ToM). Given the differences in clinical samples and results between studies, and considering the wide range of what is considered to constitute ToM, one must ask if there a core function, or is ToM multifaceted with dissociable facets? If, there are dissociable dimensions or facets, which are affected in patients with paranoid schizophrenia? To answer these questions, a group of 21 individuals diagnosed with paranoid schizophrenia and 29 non-clinical control subjects, were tested on a battery of five different measures of ToM. The results confirmed that there was little difference in specificity of three of the tests in distinguishing between the clinical and non-clinical group, but there were important differences in the shared variance between the tests. Further analyses hint at two dimensions although a single factor with the same variance and the same contributing weights in both groups could explain the results. The deficits related to the attribution of cognitive and affective states to others inferred from available verbal and non-verbal information. Further analyses revealed that incorrect attributions of mental states including the attribution of threatening intentions to others, non-interpretative responses and incomplete answers, depending on the test of ToM.

Remediation of Deficits in Recognition of Facial Emotions in Children with Autism Spectrum Disorders

This study evaluated the efficacy of the Mind Reading interactive computer software to remediate emotion recognition deficits in children with autism spectrum disorders (ASD). Six unmedicated children with ASD and 11 unmedicated non-clinical control subjects participated in the study. The clinical sample used the software for five sessions. The control sample was evaluated only on pre- and post-test performance to assess practice effects. Results showed that participants with ASD scored significantly higher on the posttest than on the pretest. As level of emotion difficulty increased, mean scores on the pretest decreased, indicating that difficulty level had a valid effect. The Mind Reading computer software appears to significantly improve the emotion recognition abilities in children with ASD.

Thought–Action Fusion: Is it Present in Schizophrenia?

AbstractThought–action fusion (TAF) refers to the belief that thoughts and actions are linked. While ‘Moral’ TAF refers to the belief that unacceptable thoughts are morally equivalent to overt actions, ‘Likelihood’ TAF is the belief that certain thoughts can increase the probability of some events (related to self or others) to occur. The objective of this study was to compare the schizophrenic patients with nonclinical controls in terms of TAF Likelihood and TAF Moral after controlling for the effects of obsessive compulsive and depressive symptoms, magical ideation and schizotypy. The sample was composed of patients hospitalised for schizophrenia (n = 45) and nonclinical control subjects (n = 41). Thought–Action Fusion Scale, Maudsley Obsessive–Compulsive Inventory, Magical Ideation Scale, Schizotypal Personality Characteristics Subscale and Beck Depression Inventory were administered. Results revealed that after controlling the effects of obsessive–compulsive and depressive symptoms, magical ideation and schizotypy, patients still had higher scores on TAF Likelihood Others but not on Self. Patients also had a tendency to get higher scores on TAF Moral. It is concluded that the study shows the presence of TAF Likelihood Others in schizophrenia even after controlling for the effects of magical ideation, depressive and OCD symptoms and schizotypal characteristics.

Screening for social phobia in medical in- and outpatients with the German version of the Social Phobia Inventory (SPIN)

Objective To evaluate the German version of the Social Phobia Inventory (SPIN) as a screening device and to report corresponding cut-off scores for different populations. Method In Study 1, 2043 subjects from a representative sample completed the SPIN. Cut-off values were established on the basis of means and standard deviations. In Study 2, different aspects of validity were examined in a clinical sample comprising 164 subjects, including social phobic individuals, individuals with other anxiety disorders and depression, and non-clinical control subjects. Internal consistency was evaluated. Convergent and divergent validity were explored using several established measures. Finally, the sensitivity and specificity of the German SPIN with regard to social anxiety classification were investigated by means of receiver operating characteristics (ROC) analyses. Results In Study 1, mean scores and standard deviations were used to determine cut-off scores for the German SPIN. In Study 2, excellent internal consistency and good convergent and divergent validity were obtained. ROC analyses revealed that the German SPIN performed well in discriminating between social phobic individuals on the one hand and psychiatric and non-psychiatric controls on the other. A cut-off score of 25 represented the best balance between sensitivity and specificity. Conclusion Comparable to the original version, the German SPIN demonstrates solid psychometric properties and shows promise as an economic, reliable, and valid screening device.

Déjà vu experiences in patients with schizophrenia

To investigate whether déjà vu experiences are psychopathologic phenomena, we studied the frequency and characteristics of déjà vu experiences in patients with schizophrenia. One hundred thirteen patients with schizophrenia and 386 nonclinical control subjects were evaluated with the Inventory of Déjà vu Experiences Assessment. The frequency and features of déjà vu experiences were compared between the 2 groups. The patients with schizophrenia had déjà vu experiences less frequently (53.1%) than did the nonclinical subjects (76.2%). The frequency of déjà vu experiences did not correlate significantly with age at evaluation or education level among the patients with schizophrenia. Most characteristics of déjà vu experiences of the patients were comparable with those of the control subjects. However, the experiences of the patients tended to be longer and more monotonous. The patients often felt alert, oppressed, and disturbed by the experiences. They appeared to have the experiences under unpleasant mental or physical states. Their déjà vu experiences are not primarily different in nature from those of the nonclinical subjects. The decreased frequency of the experiences in the patients may suggest déjà vu experiences as nonpathologic phenomena.

Profile of neurocognitive impairments associated with female in-patients with anorexia nervosa

Although many studies have reported impairments of neurocognitive performance in patients with anorexia nervosa (AN), these have involved a wide range of assessment methods and some findings are inconsistent. Twenty-five female in-patients with a DSM-IV diagnosis of AN, identified from three units specializing in the treatment of eating disorders, volunteered for the study. Twenty-five non-clinical control subjects were recruited, matched for age, gender and estimated IQ. Subjects were assessed with a range of computer-administered neurocognitive tasks from the Cambridge Neuropsychological Test Automated Battery (CANTAB), which has been validated in many studies of neuropsychiatric disorders. The patient group showed significant but moderate impairments (i.e. less than one standard deviation below the mean performance of the control group) on tests of spatial recognition memory, a planning task and rapid visual information processing, while a subgroup of patients (n = 14) showed greater degrees of impairments on at least one of these tests. The degrees of impairments did not correlate with body mass index (BMI). No impairments were observed on tests of spatial span, pattern recognition memory, spatial working memory, matching-to-sample, paired associates learning and set-shifting. The findings, in relation to a mean BMI of 15.3, are compatible with, in general, subtle impairments in neurocognition in AN. However, in those patients with relatively severe degrees of impairments, these may have adverse effects on complex tasks of social and occupational functioning. Further research is needed on the nature of relevant causal mechanisms, including the effects of potentially confounding variables.

Échelle de peur de l’évaluation négative (FNE) : propriétés psychométriques de la traduction française

The Fear of Negative Evaluation scale (FNE: Watson and Friend, 1969) is the measure most commonly used to determine the degree to which people experience apprehension at the prospect of being negatively evaluated. Although the development of the FNE preceded the inclusion of social anxiety disorder (or social phobia) in the diagnostic classification system, it is widely used as a measure of cognitive symptoms because the feature tapped by this measure is at the core of recent cognitive models of social-anxiety. According to these models, socially anxious individuals divide their attention between the internal representations of their social self (negative images and "felt sense") and external cues that could be taken as a sign of negative evaluation by others. The FNE was validated in a student and patient population in English speaking countries. The English version demonstrates adequate empirical validity. It shows excellent internal consistency and one-factor structure. Test retest reliability is satisfying. It is proved to be sensible to change after treatment. It is well correlated with other measures of social anxiety demonstrating good convergent validity. However, divergent and discriminate validity have been a subject of controversy. The aim of the present study was to assess the psychometric properties of the French version of the FNE in order to obtain a valid instrument measuring the cognitive component of social anxiety. The social anxiety group consisted of 88 patients referred to our clinic for cognitive-behavioural group therapy. All met ICD-10 criteria for social phobia (generalized subtype) as determined by the Composite International Diagnostic Interview (social phobia section). Additional axis-I diagnostic information was obtained using the Mini International Neuropsychiatric Interview (MINI: Lecrubier et al., 1997) for ICD-10. The non-patient control group consisted of 80 participants who didn't respond to social anxiety CIDI criteria. All participants were rated by the assessor on the Liebowitz Social Anxiety Scale (LSAS) and completed the following self-report questionnaires: the Fear of Negative Evaluation questionnaire (FNE), the State-Trait-Anxiety Inventory (STAI A-B), and the Beck Depression Inventory (BDI 13). The internal consistency is very good with Kuder-Richardson 20 coefficient of 0,94 corresponding to coefficients found in the validity studies of the original version of the FNE. One factor Anova tests showed that our two groups of subjects differed significantly on the FNE [F (1.166)=282.26, p<0.001]. Patients had a mean score of 25.6 with a standard deviation of 4.1 and the non patient control subjects had a mean score of 12.1 with a standard deviation of 6.1. This result confirms the empirical validity of the instrument. In the patient sample, the FNE was significantly correlated with the LSAS total score (r=0.55; p<0.001). This result indicates good convergent validity. However, the FNE was also significantly correlated with the BDI-13 (r=0.48; p<0.001) and the STAI B (r=0.47; p<0.001). However because high levels of general anxiety and depression are common among patients with social anxiety disorder, substantial correlations between measures of social anxiety and measures of general anxiety and depression should be probably expected. A multiple regression analysis shows a significant association of the FNE with the LSAS (Beta=0.39, p<0.001) and the STAIB (Beta=0.28, p<0.01) We explored the unidimensionality of the scale by using a principal component analysis of tetrachoric correlation suitable for dichotomic items. One sole factor with an eigenvalue superior to 1 emerged. We deduce therefore that our results are in favour of the unidimensionality of the French version of the FNE. The present study shows that the French version of the FNE has good psychometric properties and differentiates social phobic patients from the non-clinical control subjects. Given the importance that models of social anxiety attribute to cognitive processes and the importance of cognitive techniques in its treatment, we consider that the French version of the FNE is an adequate and valid questionnaire to be used in research and therapy.

Characteristic neurocognitive profile associated with adult attention-deficit/hyperactivity disorder.

It is now accepted that attention-deficit/hyperactivity disorder (ADHD) often persists into adulthood. However, relative to the considerable literature concerning the profile of neurocognitive deficits associated with this disorder in childhood, equivalent investigations in adult populations have been less common. The current study examined cognitive function in adults diagnosed with ADHD employing well-validated neuropsychological tasks. Nineteen adult patients who satisfied DSM-IV criteria for ADHD and 19 matched (gender, age and verbal IQ), non-clinical control subjects were recruited. Patients were either unmedicated or had abstained from a psychostimulant medication regime for at least 24 h prior to neurocognitive assessment. A functionally wide-ranging test battery was administered. Relative to controls, ADHD adults performed significantly worse on spatial working memory, planning, and attentional-set shifting tests and were significantly slower to respond to target stimuli on the go/no-go task. In contrast, the two subject groups performed equivalently on decision-making and pattern/spatial recognition memory assessments. The demonstration of neuropsychological dysfunction in the adult ADHD cohort provides some support for the validity of this diagnosis in adulthood. In particular, there is broad consistency between the cognitive profile revealed in the current investigation and that previously demonstrated in a study of medication-naïve ADHD children. There is evidence that frontostriatal function is especially disrupted.

Attachment representation and illness behavior in somatoform disorders.

Somatoform disorders are characterized by high health care utilization and conflictual interactions with health care providers. The aim of the present study was to explore whether patterns of insecure attachment are a prominent feature of somatoform disorder. In addition, the links between insecure attachment and health care utilization were evaluated. Thirty-seven patients with an International Classification of Diseases, 10th Revision diagnosis of somatoform disorders and 20 healthy control subjects matched for age, sex, and education were administered the Adult Attachment Interview. Psychological symptoms and health care utilization were assessed using various self-report measures. There was a clearly higher incidence of insecure attachment in the somatoform group compared with the nonclinical control subjects. In the somatoform group, dismissing attachment occurred approximately twice as frequently as the preoccupied pattern of attachment. The results provide evidence for an association between health care utilization and insecure attachment. Insecure attachment in somatoform disorder may underlie problems in interpersonal functioning and in health care behavior.

Impulsivity in patients with borderline personality disorder

This study investigated features of impulsivity in patients with borderline personality disorder (BPD) using the self-report Attention-Deficit Scales for Adults (ADSA) and computer-administered neurocognitive tasks. Forty-one patients with DSM-III-R BPD and 35 nonclinical control subjects were assessed by the ADSA, the National Adult Reading Test, and two computerized tasks mediated by the frontal lobes. Mean scores for seven ADSA scales (six of which relate to aspects of impulsivity) were significantly higher in the patient group compared with the control group. Also, the ADSA ratings for impaired coordination were increased in the BPD patients. The findings indicate that a range of aspects of impulsivity, as well as impaired coordination, are associated with patients selected on the basis of BPD. Also, in the patient group, but not in the control group, associations of the neurocognitive tasks indicated that, first, performance on a planning task related to dorsolateral frontal lobe functioning is correlated with aspects of impulsivity reflected by ADSA scale III ratings (involving disorganisation and lack of perseverance) and, second, performance on a decision-making task related to orbitofrontal functioning is correlated with ratings of impaired coordination. Further work is needed to establish the specificity of the findings.

Family representations in relationship episodes of patients with a diagnosis of bulimia nervosa.

The influence of the family on the development and the maintenance of bulimia nervosa can be seen both biologically and psychosocially. Genetic influences are discussed, but their effects do not explain the aetiology exclusively. Clinical observations and research findings support the role of family dynamics, family environment, and family functioning. In particular, a low level of cohesion, a lower degree of expressiveness, and more conflicts seem to characterize the family of patients with a diagnosis of bulimia nervosa. The present study addresses the question of how patients suffering from bulimia differ from other patients in psychotherapy and from non-clinical control subjects in the way they perceive their ongoing and their past family relationships. The Core Conflictual Relationship Theme method is applied to narrative material from patients belonging to these three groups. Results show expected differences between patients and normal control subjects and virtually no differences between the group of patients with a diagnosis of bulimia nervosa and the group of patients with diagnoses different from bulimia.

The Validation of the Posttraumatic Stress Disorder Checklist Scale in Posttraumatic Stress Disorder and Nonclinical Subjects

Background: The Posttraumatic Stress Disorder Checklist Scale (PCLS) is a short self-report inventory for assessing the 3 main syndromes of Posttraumatic Stress Disorder (PTSD). The aim of this study was the validation of the French version of the PCLS in PTSD subjects and nonclinical subjects. Methods: One-hundred and thirteen outpatients suffering from PTSD according to DSM-IV were administered the PCLS. The patients’ scores on the PCLS were then compared to those of 31 nonclinical control subjects. Thirty-five of the patients were administered the PCLS twice over an interval of 1–2 weeks and also completed questionnaires measuring depression, phobia and anxiety. Results: The patients’ total score and subscores on the PCLS were found to be significantly higher than those of control subjects. The cutoff score of 44 on the French version PCLS distinguishes well between the PTSD group and control group with a high diagnostic efficacy (0.94). Factor analysis revealed 3 main factors corresponding to the reexperiencing, numbing and hyperarousal syndromes. The PCLS showed satisfactory test-retest reliability and internal consistency. Conclusions: The PCLS is therefore a valid and effective measurement of PTSD. It may be a useful tool for screening and assessing PTSD in psychiatric as well as in primary-care settings.

Specificity of generalized anxiety disorder symptoms and processes

This study's main goal is to test the broad specificity of generalized anxiety disorder (GAD) symptom and process variables. These variables were compared in four groups of participants: (1) 24 patients with primary GAD, (2) 24 patients with secondary GAD, (3) 38 other anxiety disorder patients, and (4) 20 nonclinical control subjects. Each participant received a structured diagnostic interview and a series of standardized questionnaires. The results show that DSM-IV GAD symptoms (worry, GAD physical symptoms, and interference due to worry and anxiety) distinguish GAD patients from those with other anxiety disorders. Two process variables, problem orientation and intolerance of uncertainty, also differentiated GAD patients from other anxiety disorder patients. Overall, these results support the DSM-IV definition of GAD and the broad specificity of problem orientation and intolerance of uncertainty as GAD process variables.

THE FRENCH VERSION OF THE SOCIAL INTERACTION SELF-STATEMENT TEST (SISST): A VALIDATION AND SENSITIVITY STUDY IN SOCIAL PHOBICS

The French version of the Social Interaction Self-Statement Test (SISST) was studied in 95 social phobia and 87 non-clinical subjects. Total scores on both positive and negative scales significantly discriminated social phobics from non-clinical control subjects. Social phobics had higher scores than controls on negative statements and lower scores on positive statements. The positive and negative subscales of the SISST for social phobic patients were correlated with anxiety, depression and avoidant behaviours. The negative subscale was significantly sensitive to change in patients with social phobia receiving cognitive behavioural therapy. Our findings showed good convergent and discriminant validity of the SISST and the sensitivity of the negative sub-scale to improvement after cognitive behavioural therapy.

A test of the cognitive model of panic: Primed lexical decision in panic disorder

The aim of the present study was to investigate whether individuals with panic disorder are characterised by an enhanced tendency to associate particular somatic sensations with threatening outcomes, compared with nonclinical controls. In order to test this prediction, a modified lexical decision task was employed. Panic disorder subjects and nonclinical control subjects made lexical decisions to neutral word pairs and threatening word pairs. Threatening word pairs consisted of combinations of somatic sensations and catastrophic outcomes (e.g., breathless-suffocate), which have been shown to be of salience to individuals with panic disorder. Semantic priming was found for both neutral and threatening word pairs, but was demonstrated equally by panic disorder subjects and nonclinical controls. The results did not provide support for cognitive models of panic disorder.

Development of the Body Dysmorphic Disorder Examination

The Body Dysmorphic Disorder Examination (BDDE) is a semi-structured clinical interview designed to diagnose body dysmorphic disorder and to measure symptoms of severely negative body image. It taps into preoccupation with and negative evaluation of appearance, self-consciousness and embarrassment, excessive importance given to appearance in self-evaluation, avoidance of activities, body camouflaging, and body checking. The BDDE had adequate internal consistency and test-retest and interrater reliability. It correlated with measures of body image, negative self-esteem, and psychological symptoms, and was sensitive to change following treatment of body dysmorphic disorder. The BDDE distinguished body dysmorphic disorder patients from clinical and non-clinical control subjects and agreed with other clinicians' diagnosis of body dysmorphic disorder. The BDDE provided unique information in predicting clinical status when controlling for psychological adjustment and other measures of body image.

Social phobia and social appraisal in successful and unsuccessful social interactions

32 generalized social phobic outpatients and 32 matched nonclinical control subjects participated in a dyadic ‘getting acquainted’ interaction with an experimental assistant who engaged in either positive or negative social behavior. The accuracy of social phobics' and control subjects' perceptions of themselves and their partners were compared in the two conditions. Relative to observers' ratings, the social phobics displayed a negative bias in their appraisals of some, but not all, aspects of their social performance. These results suggested that social phobics may have particular difficulty gauging the nonverbal aspects of their social behavior. The phobics discounted their social competence to the same extent in the positive interaction, where their behavior was more skilful, as in the negative interaction. The social phobics were also less accurate than nonclinical controls in their appraisals of their partners, however, these phobic subjects displayed a positive bias when appraising their partner's performance.