Non-clinical Comparison Group Research Articles

Cardiac interoception in patients accessing secondary mental health services: A transdiagnostic study.

Abnormalities in the regulation of physiological arousal and interoceptive processing are implicated in the expression and maintenance of specific psychiatric conditions and symptoms. We undertook a cross-sectional characterisation of patients accessing secondary mental health services, recording measures relating to cardiac physiology and interoception, to understand how physiological state and interoceptive ability relate transdiagnostically to affective symptoms. Participants were patients (n=258) and a non-clinical comparison group (n=67). Clinical diagnoses spanned affective disorders, complex personality presentations and psychoses. We first tested for differences between patient and non-clinical participants in terms of cardiac physiology and interoceptive ability, considering interoceptive tasks and a self-report measure. We then tested for correlations between cardiac and interoceptive measures and affective symptoms. Lastly, we explored group differences across recorded clinical diagnoses. Patients exhibited lower performance accuracy and confidence in heartbeat discrimination and lower heartbeat tracking confidence relative to comparisons. In patients, greater anxiety and depression predicted greater self-reported interoceptive sensibility and a greater mismatch between performance accuracy and sensibility. This effect was not observed in comparison participants. Significant differences between patient groups were observed for heart rate variability (HRV) although post hoc differences were not significant after correction for multiple comparisons. Finally, accuracy in heartbeat tracking was significantly lower in schizophrenia compared to other diagnostic groups. The multilevel characterisation presented here identified certain physiological and interoceptive differences associated with psychiatric symptoms and diagnoses. The clinical stratification and therapeutic targeting of interoceptive mechanisms is therefore of potential value in treating certain psychiatric conditions.

A mixed methods investigation of reasons underlying fear of positive evaluation.

Fear of negative evaluation (FNE) is a hallmark feature of social anxiety disorder (SAD). There is also evidence that people with SAD fear receiving positive evaluation and that fear of positive evaluation (FPE) is distinct from FNE. However, researchers have speculated that concerns related to negative evaluation may actually underlie FPE. This study sought to advance our understanding of FPE by employing both quantitative and qualitative methods to assess the reasons underlying participants' endorsement of FPE on the Fear of Positive Evaluation Scale and the extent to which these reasons reflect FNE versus FPE in a sample of individuals with SAD (n = 47) and a nonclinical comparison group (n = 49). Results indicated that responses to the FPES items primarily reflected an underlying FNE. Consistent with contemporary cognitive-behavioural theories of SAD, fear of proximal or eventual negative judgement emerged as the most common reason for participants' responses on the FPES. However, participants reported other reasons that did not reflect FNE, such as fear of hurting people's feelings and uncertainty associated with positive evaluation. All of the reasons underlying participants' ratings on the FPES were reported by both the SAD group and the nonclinical comparison group; however, individuals with SAD endorsed each of the reasons to a greater extent. These findings suggest that the FPES does not exclusively assess FPE as intended; however, the emergence and endorsement of reasons other than FNE suggest that FPE exists as a distinct construct.

Hypermobile spectrum disorders symptoms in patients with functional neurological disorders and autism spectrum disorders: A preliminary study.

Autism spectrum disorders (ASDs) and functional neurological disorders (FNDs) share some clinical characteristics such as alexithymia, sensory sensitivity and interoceptive issues. Recent evidence shows that both the disorders present symptoms compatible with a diagnosis of hypermobile Ehlers-Danlos Syndrome and hypermobile spectrum disorders (hEDS/HSD), a heterogeneous group of heritable connective tissue disorders characterized by joint hypermobility, skin hyperextensibility, and tissue fragility. Here we compared the prevalence of hEDS/HSD-related symptoms in a group of patients with FNDs, of people with ASDs without intellectual disabilities, and a non-clinical comparison group (NC). Twenty patients with FNDs, 27 individuals with ASDs without intellectual disabilities and 26 NC were recruited and completed the Self-reported screening questionnaire for the assessment of hEDS/HSD-related symptoms (SQ-CH). We found that 55% of the patients with FNDs, 44.4% of the individuals with ASDs and 30.8% of NC scored above the cut-off at the SQ-CH; SQ-CH scores of both FNDs and ASDs group were significantly higher than the NC group's ones. In conclusion, both ASDs and FNDs individuals present hEDS/HSD-related symptoms in a higher number than the general population. Imputable mechanisms include (i) overwhelming of executive functions with consequent motor competence impairment for ASDs individuals, and (ii) exacerbation of FNDs symptoms by physical injury and chronic pain due to abnormal range of joint mobility. Moreover, we speculated that the amygdala and the anterior cingulate cortex circuitry might be responsible for the imbalances at the proprioceptive, interoceptive, and emotional levels.

Hypermobility in patients with functional seizures: Toward a pathobiological understanding of complex conditions

BackgroundFunctional seizures (FS), otherwise known as psychogenic nonepileptic seizures (PNES), are a common symptom presenting to neurology and epilepsy clinics. There is a pressing need for further research to understand the neurobiology of FS to develop mechanistically targeted treatments. Joint hypermobility is an expression of variation in connective tissue structure along a spectrum, and it has received increasing attention in functional neurological disorders, but there is lack of evidence of its relevance in FS. MethodsIn the present study, forty-two patients with FS and a non-clinical comparison group of 34 age/sex-matched controls were recruited. Joint hypermobility of all participants was quantified using the Beighton scale. ResultsIn our sample, 24 (57%) patients with FS, and 7 (21%) of the comparison group met criteria for joint hypermobility (p = 0.002). Our statistical model revealed that patients with FS showed a significant degree of hypermobility compared to the comparison group (odds ratio = 11.1; Confidence interval: 2.1–78.0, p = 0.008), even after controlling age, sex, anxiety, and depression. ConclusionWe found a significant association between FS and joint hypermobility, which was independent of anxiety and depression.

Another Perspective of the Miller Forensic Assessment of Symptoms Test – Part II: A Quantitative Review

Reference [1] presented pooled data for the specificity of the M-FAST cut-off, but ignored or excluded data based on poor justifications and used questionable analytic methods. The analyses here corrected the problems associated with [1]. No moderator substantively influenced sensitivity values. Therefore, sensitivity values were pooled across all studies (k = 25) to provide an overall estimate. Overall, the average sensitivity of the M-FAST cut-off was estimated to be 0.87, 95% CI [0.80, 0.91], and 80% of true sensitivity values were estimated to range from 0.63 to 0.96. Thus, there could be methodological scenarios when the M-FAST cut-off may not operate efficiently. Average specificity values for the M-FAST cut-off were moderated by one variable: the comparison group. On average, specificity values for clinical comparison (k = 15) groups (i.e., 0.80, 95% CI [0.73, 0.85]) were lower than specificity values for non-clinical comparison (k = 11) groups (i.e., 0.96, 95% CI [0.89, 0.99]). Unlike the CIs, the estimated distributions of true specificity values for the two subgroups overlapped, which suggests there could be scenarios when these subgroups share the same true specificity value. The M-FAST was designed to be a screener to detect potential feigning of psychiatric symptoms. An examinee is never to be designating as feigning or malingering psychiatric symptoms based on only a positive M-FAST result. As a screening instrument, the results here show that the M-FAST cut-off is operating adequately overall and negate the conclusions of [1].

Attention-deficit/hyperactivity disorder with developmental coordination disorder: 24-year follow-up of a population-based sample

BackgroundAlthough the body of research concerning neurodevelopmental disorders is vast, there is a scarcity of longitudinal studies beyond late adolescence, and of studies taking co-existing disorders into account. The present study aimed to investigate outcome in adulthood for children with attention-deficit/hyperactivity disorder (ADHD) combined with developmental coordination disorder (DCD) diagnosed at 6.6 years of age.MethodsOut of a screening-based population cohort of 589 individuals, 62 (10 female) diagnosed with ADHD+DCD at mean age 6.6 years naïve to stimulant treatment were followed into adulthood through national registries. Results were compared to a screen- and assessment negative population matched group from the same cohort (PM group, n = 51) and a registry-matched (RM group, n = 410) group of the same county and age.ResultsAt 30 to 31 years of age, five deaths had occurred; one in the ADHD+DCD group and two each in the comparison groups. In time to event analyses of the composite outcome of any psychiatric disorder, psychotropic prescription, sick pension or criminal sentence, events occurred at a significantly higher rate in the ADHD+DCD group (p = 0.0032, vs PM group p = 0.0115, vs RM group p = 0.0054). The ADHD+DCD group had significantly higher rates of psychiatric diagnoses, prescriptions of psychoactive medications and occurrence of sick pension than both comparison groups. Further, the ADHD+DCD group had significantly lower educational attainment compared to both comparison groups, more years with unemployment, and overall higher welfare recipiency. Rates of pain diagnoses and analgesic prescriptions did not separate the groups.ConclusionADHD+DCD entailed a less favorable outcome in adulthood compared to a non-clinical comparison group and a registry-matched population. Neurodevelopmental disorder diagnosed upon school entry is of prognostic utility with respect to function in adulthood, and warrants early identification and management.

Parent-child interactions and childhood OCD: Comparing OCD families with other clinical and non-clinical families

Background and objectivesFamily factors, such as family accommodation and parent-child characteristics, are hypothesised as important maintaining factors in paediatric OCD. There is limited research assessing parent and child behaviour amongst young people with OCD during family interactions. Thus, the current study sought to further explore parent-child interaction variables in OCD, using an observational design with three groups. Methods23 young people with OCD, 30 young people with other anxiety disorders, and 23 young people with no clinical problems, along with their primary caregiver, completed a brief problem-solving discussion task designed to assess family interaction variables. Groups were compared on observer-rated and self-rated parent and child behaviours. It was expected that OCD families would differ from both anxious and nonclinical families on some behavioural dimensions, for example, rating lower on warmth, confidence, and positive problem solving. ResultsResults showed that young people in the OCD group could be differentiated from young people in the clinical and nonclinical comparison groups based on observed behaviour. Young people in the OCD group showed less warmth during their interactions and less confidence in their ability to solve the problem. These children and adolescents also had higher levels of doubt and withdrawal during interactions with their parent. Interestingly, parent behaviour did not differ between the groups, suggesting that parent behaviours are a less reliable indicator of OCD symptomatology. ConclusionsDuring family interactions, young people with OCD behave in a different way to young people with another anxiety disorder as well as young people with no diagnosis. These findings provide interesting and important exploratory information relating to observed parent and child behaviour across different clinical and nonclinical groups. Limitations of this study are addressed and directions for future research are discussed.

Anorexia nervosa and perfectionism: A meta-analysis.

Despite the multitude of research surrounding anorexia nervosa (AN) and perfectionism, there is yet to be a thorough investigation comparing perfectionism in those diagnosed with AN and other eating disorders, and other psychiatric diagnoses. The current meta-analysis aimed to explore these comparisons. Following the Preferred Reporting Items or Systematic Reviews Meta Analyses (PRISMA) guidelines, we identified empirical studies that compared maladaptive and/or adaptive perfectionism scores in those diagnosed with AN and either a non-clinical comparison group, people diagnosed with a non-AN ED, or people diagnosed with another psychological disorder (i.e., other DSM diagnoses). In total, we identified 23 studies, comprising 3,561 participants who were all female. Comparison groups extracted from the studies were a non-clinical group, bulimia nervosa (BN) diagnosis group, and another psychological diagnostic group. When AN maladaptive perfectionism levels were compared against the comparison groups, the results showed that those diagnosed with AN were more perfectionistic compared to the non-clinical group (g = 1.00), and the other psychiatric diagnosis group (g = 0.41). People diagnosed with AN also had higher levels of adaptive perfectionism levels compared to the non-clinical group (g = 1.24). Comparisons between those diagnosed with AN and BN were statistically non-significant for maladaptive perfectionism. Although publication bias potentially affected the psychological diagnosis group comparisons, findings suggest that maladaptive perfectionism is a factor associated with both AN and BN.

Gender and Age Differences in Social Skills Among Children with ADHD: Peer Problems and Prosocial Behavior

Gender differences in peer problems and prosocial behavior among children with attention-deficit hyperactivity disorder (ADHD) were examined. Parents and teachers rated social functioning on the Strengths and Difficulties Questionnaire (SDQ) among 592 children (age 5–10 years) with ADHD and among 215 children (age 6–10 years) in a community sample. Results in the clinical group revealed significant interaction effects where older boys showed fewer peer problems than younger boys, but older girls had similar peer problems as younger girls. Teachers reported less prosocial behavior among younger girls than older girls. No gender differences in social problems emerged for the nonclinical comparison group.

Diagnostic Utility of the WISC-IV GAI > CPI Cognitive Score Profile for a Referred Sample of Children and Adolescents with Autism

Individuals with autism spectrum disorder (ASD) are hypothesized to exhibit relative strengths in verbal and non-verbal reasoning and weaknesses in working memory and speed of information processing. The purpose of the present investigation was to determine the degree to which this cognitive profile as measured by the Wechsler Intelligence Scale for Children—Fourth Edition (WISC-IV; Wechsler 2003a) cognitive proficiency index (CPI; measure of working memory and processing speed) and general ability index (GAI; measure of verbal and non-verbal reasoning) could accurately distinguish between a referred sample of 79 school-aged students diagnosed with ASD and two non-clinical comparison groups: (a) 2200 children in the WISC-IV standardization sample and (b) 216 school-aged students referred for psychoeducational testing whose school-based evaluations did not result in a diagnosis. Results indicated that the ASD sample exhibited significantly lower mean scores on the CPI when compared to the two control groups. However, diagnostic utility statistics indicated that a randomly selected participant from the ASD subgroup would exhibit a larger difference between the GAI and CPI than a randomly selected participant from the two control groups 51.9–66.0% of the time. Consequently, the GAI > CPI cognitive score profile exhibits low diagnostic accuracy for individuals with ASD. Psychologists who work in applied settings are cautioned against using group trends to guide decision-making for individual clients.

Assessing Autism in Adults: An Evaluation of the Developmental, Dimensional and Diagnostic Interview\u2014Adult Version (3Di-Adult)

We developed a brief, informant-report interview for assessing autism spectrum conditions (ASC) in adults, called the Developmental, Dimensional and Diagnostic Interview-Adult Version (3Di-Adult); and completed a preliminary evaluation. Informant reports were collected for participants with ASC (n = 39), a non-clinical comparison group (n = 29) and a clinical comparison group (n = 20) who had non-autistic mental health conditions. Mean administration time was 38 min (50 min for ASC). Internal consistency (αs ≥ 0.93) and inter-rater agreement (ICCs ≥ 0.99) were high. When discriminating ASC from non-ASC, the 3Di-Adult showed excellent sensitivity (95%) and specificity (92%). The 3Di-Adult shows promise as a psychometrically sound and time-efficient interview for collecting standardised informant reports for DSM-5 assessments of ASC in adults, in research and clinical practice.

Schémas précoces inadaptés et dimensions de la personnalité chez des adolescents consommateurs abusifs d’alcool

La présente étude vise à évaluer les schémas précoces inadaptés et les dimensions de la personnalité du modèle à cinq facteurs dans la consommation abusive d’alcool à l’adolescence. Pour mesurer les dimensions de la personnalité, nous avons utilisé le Big Five Inventory français (BFI-Fr), la version abrégée du questionnaire de Young (YSQ-S2) pour évaluer les schémas précoces inadaptés, ainsi que l’Alcohol Use Disorders Identification Test (AUDIT) pour la consommation d’alcool. Deux cents adolescents ayant préalablement complété ces questionnaires ont ensuite été répartis en trois groupes selon que leur consommation d’alcool était nulle (n = 33), occasionnelle (n = 78) ou abusive (n = 89). Les résultats montrent que les consommateurs abusifs obtiennent des scores significativement plus élevés que les consommateurs occasionnels et que les non-consommateurs sur le score global d’activation des schémas précoces inadaptés, ainsi que sur six schémas spécifiques (abandon, imperfection, vulnérabilité, contrôle émotionnel à outrance, grandeur, manque d’autocontrôle). Nos résultats montrent également des scores de Névrosisme significativement plus élevés chez les consommateurs abusifs, en comparaison aux consommateurs occasionnels et aux non-consommateurs. Les implications théoriques et pratiques de ces résultats sont discutées. Alcohol is the most widely consumed drug amongst adolescents and its misuse is a great public health concern. In France, regular alcohol consumption in this population has increased over the past decade (Spilka et al., 2015). This disturbing trend makes research on risk factors for alcohol misuse among adolescents particularly important. In the literature, early maladaptive schemas are considered as a possible risk factor in the onset and maintenance of psychopathology (Young, 1994; Ball, 1998). They are defined as broad pervasive patterns that are comprised of memories, emotions and cognitions regarding oneself and one's relationships with others, and are dysfunctional to a significant degree (Young et al., 2005). Theoretically, early maladaptive schemas begin to develop during early childhood from toxic experiences (Young, 1994). Although research has demonstrated that adult alcohol abusers report greater early maladaptive schema endorsement than a non-clinical comparison group (Decouvelaere et al., 2002; Roper et al., 2010), we are unaware of any research that has examined whether early maladaptive schemas are prevalent among adolescents alcohol abusers. Similarly, relationships between alcohol misuse and personality domains of the Five Factor Model (Costa and McCrae, 1992) have been widely examined in samples of adults (Kotov et al., 2010; Ruiz et al., 2008), yet only one study has raised this question among adolescents (Merenäkk et al., 2003). For these reasons, the present study aims to examine early maladaptive schemas and personality domains of the Five Factor Model in adolescent alcohol abusers. This research involved 286 adolescents recruited in high schools. Each participant completed five self-report questionnaires assessing (1) alcohol consumption [Alcohol Use Disorders Identification Test (AUDIT)], (2) cannabis consumption [Mini International Neuropsychiatric Interview (MINI)], (3) early maladaptive schemas [Young Schemas Questionnaire (YSQ-S2)], (4) personality domains [Big Five Inventory français (BFI-Fr)] and (5) depression [Beck Depression Inventory - Second Edition (BDI-II)]. Fifty-seven participants were excluded from this study due to the following criteria: suffering from depression (n = 13), excessive consumption of cannabis (n = 41) or use of a drug other than alcohol, tobacco or cannabis (n = 3). Twenty-nine adolescents were also excluded because their questionnaires were incomplete. Finally, 200 adolescents (124 boys and 76 girls) were divided into three groups according to their alcohol consumption: absent (n = 33), occasional (n = 78) or abuse (n = 89). An analysis of covariance (ANCOVA) was conducted on early maladaptive schemas and personality domains with age as covariate to explore the relationship between these dimensions and alcohol consumption among adolescents. The results indicated that alcohol abusers are significantly different from occasional users and non-users by (a) a global hyperactivation of early maladaptive schemas, (b) a hyperactivation of six specific schemas (abandonment, defectiveness, vulnerability, emotional inhibition, grandiosity, insufficient selfcontrol) and (c) significantly higher scores of Neuroticism. The data is coherent with the literature suggesting that early maladaptive schema could be a risk factor for the initiation and maintenance of substance abuse (Ball, 1998, 2007). In addition, this study suggests that Young's schema theory might constitute a valuable framework to understand alcohol abuse in adolescence. The results also show that alcohol abusers present low emotional stability and difficulties in feeling positive emotions, which is consistent with earlier studies among young adults (Mezquita et al., 2010; Ruiz et al., 2003). However, more research is needed to further understand the relationship between early maladaptive schemas, personality and alcohol abuse in adolescence. This could confirm the relevance of therapeutic programs targeting early maladaptive schemas and personality traits in this population.

On the context dependency of implicit self-esteem in social anxiety disorder

Background and objectivesCognitive models assume that negative self-evaluations are automatically activated in individuals with Social Anxiety Disorder (SAD) during social situations, increasing their individual level of anxiety. This study examined automatic self-evaluations (i.e., implicit self-esteem) and state anxiety in a group of individuals with SAD (n = 45) and a non-clinical comparison group (NC; n = 46). MethodsParticipants were randomly assigned to either a speech condition with social threat induction (giving an impromptu speech) or to a no-speech condition without social threat induction. We measured implicit self-esteem with an Implicit Association Test (IAT). ResultsImplicit self-esteem differed significantly between SAD and NC groups under the speech condition but not under the no-speech condition. The SAD group showed lower implicit self-esteem than the NC group under the speech-condition. State anxiety was significantly higher under the speech condition than under the no-speech condition in the SAD group but not in the NC group. Mediation analyses supported the idea that for the SAD group, the effect of experimental condition on state anxiety was mediated by implicit self-esteem. LimitationsThe causal relation between implicit self-esteem and state anxiety could not be determined. ConclusionThe findings corroborate hypotheses derived from cognitive models of SAD: Automatic self-evaluations were negatively biased in individuals with SAD facing social threat and showed an inverse relationship to levels of state anxiety. However, automatic self-evaluations in individuals with SAD can be unbiased (similar to NC) in situations without social threat.

Does the interpersonal–Psychological theory of suicide provide a useful framework for understanding suicide risk among eating disorder patients? A test of the validity of the IPTS

The current study tested whether the Interpersonal-Psychological Theory of Suicide (IPTS) provides a useful framework for understanding elevated suicide rates among individuals with eating disorders (EDs). Based on predictions of the IPTS, we tested whether the combination of thwarted belongingness and perceived burdensomeness was associated with suicidal desire, and whether the combination of thwarted belongingness, perceived burdensomeness, and fearlessness about death was associated with past suicide attempts in an ED sample (n = 100). We also compared these IPTS constructs in an ED sample versus general psychiatric inpatients (n = 85) and college students (i.e., non-clinical comparison group; n = 93). Within the ED sample, no hypothesized interactions were found, but perceived burdensomeness was associated with suicidal desire, and perceived burdensomeness and fearlessness about death were associated with past suicide attempts. The ED and psychiatric samples had greater thwarted belongingness, perceived burdensomeness, and suicidal desire than the non-clinical comparison group. The IPTS constructs of perceived burdensomeness and fearlessness about death appear to explain some facets of suicidality among people with EDs, but overall, support for the IPTS was limited. Future research on EDs and suicidality should look beyond the IPTS and consider other biological and sociocultural factors for suicide. © 2016 Wiley Periodicals, Inc. (Int J Eat Disord 2016; 49:1082-1086).

Cognitive Effects of Stimulant, Guanfacine, and Combined Treatment in Child and Adolescent Attention-Deficit/Hyperactivity Disorder

Psychostimulants are partially effective in reducing cognitive dysfunction associated with attention-deficit/hyperactivity disorder (ADHD). Cognitive effects of guanfacine, an alternative treatment, are poorly understood. Given its distinct action on α2A receptors, guanfacine may have different or complementary effects relative to stimulants. This study tested stimulant and guanfacine monotherapies relative to combined treatment on cognitive functions important in ADHD. Children with ADHD (n= 182; aged 7-14 years) completed an 8-week, double blind, randomized, controlled trial with 3 arms: d-methylphenidate (DMPH), guanfacine (GUAN), or combination treatment with DMPH and GUAN (COMB). A nonclinical comparison group (n= 93) had baseline testing, and a subset was retested 8 weeks later (n= 38). Analyses examined treatment effects in 4 cognitive domains (working memory, response inhibition, reaction time, and reaction time variability) constructed from 20 variables. The ADHD group showed impaired working memory relative to the nonclinical comparison group (effect size=-0.53 SD unit). The treatments differed in effects on working memory but not other cognitive domains. Combination treatment improved working memory more than GUAN but was not significantly betterthan DMPH alone. Treatment did not fully normalize the initial deficit in ADHD relative to the comparison group. Combined treatment with DMPH and GUAN yielded greater improvements in working memory than placebo or GUAN alone, but the combined treatment was not superior to DMPH alone and did not extend to other cognitive domains. Although GUAN may be a useful add-on treatment to psychostimulants, additional strategies appear to be necessary to achieve normalization of cognitive function in ADHD. Single Versus Combination Medication Treatment for Children With Attention Deficit Hyperactivity Disorder; http://clinicaltrials.gov/; NCT00429273.

Seeing things differently: An experimental investigation of social cognition and interpersonal behavior in anorexia nervosa.

Interpersonal difficulties among individuals with anorexia nervosa (AN) may stem in part due to misperceiving social cues. The current study investigated social functioning by comparing interpersonal self-efficacy, perceptions of dominance/submission (i.e., agency) and coldness/warmth (i.e., communion), and hypothetical behavioral reactions among individuals with and without AN. Seventy-seven women (AN/Other Specified Feeding or Eating Disorder OSFED-AN n = 41, nonclinical comparison group n = 36) completed questionnaires assessing mood symptoms and interpersonal self-efficacy, followed by an experimental video-rating task in which they received critical feedback from job supervisors varying in degrees of agency and communion. AN respondents perceived more coldness overall, even after adjusting for differences in depression and anxiety symptoms, and tended to respond with coldness even to videos that they perceived as being warm. However, perceptual accuracies for agency were similar across groups. Interpersonal self-efficacy moderated the relationship between diagnostic status and behavioral responses: among those who felt competent being cold-submissive, AN respondents selected cold-submissive responses more frequently than did the nonclinical comparison group. Among those with AN symptoms, there may be a tendency toward social perceptual inaccuracies regarding communion and non-complementary cold behavioral responses. Results suggest that improving social perceptions may be a fruitful intervention target for enhancing interpersonal functioning among individuals with AN. © 2015 Wiley Periodicals, Inc. (Int J Eat Disord 2016; 49:499-506).

Comparing time use in individuals at different stages of psychosis and a non-clinical comparison group

Social functioning difficulties are a common and disabling feature of psychosis and have also been identified in the prodromal phase. However, debate exists about how such difficulties should be defined and measured. Time spent in structured activity has previously been linked to increased psychological wellbeing in non-clinical samples and may provide a useful way of assessing social functioning in clinical settings.The current study compared hours in structured activity, assessed with the Time Use Survey, in three clinical groups at different stages of psychosis: individuals with at-risk mental states (N=199), individuals with first-episode psychosis (N=878), and individuals with delayed social recovery following the remission of psychotic symptoms (N=77). Time use in the three clinical groups was also compared with norms from an age-matched non-clinical group (N=5686) recruited for the Office for National Statistics UK 2000 Time Use Survey. Cutoff scores for defining social disability and recovery were examined.All three clinical groups spent significantly fewer hours per week in structured activity than individuals in the non-clinical group. Reduced activity levels were observed before the onset of psychosis in individuals with at-risk mental states. Additional reductions in activity were observed in the first-episode psychosis and delayed recovery groups compared to the at-risk mental state group. Assessing time spent in structured activity provides a useful way to assess social disability and recovery across the spectrum of psychosis.

Subjective Cognitive Complaints in Schizophrenia: Relation to Antipsychotic Medication Dose, Actual Cognitive Performance, Insight and Symptoms

BackgroundSubjective cognitive complaints are prevalent in those affected by functional psychoses and a variety of possible associated factors have been investigated. However, few studies have examined these potential factors within single studies or analyses.MethodsPatients with a history of a schizophrenia spectrum disorder (n = 115) and a non-clinical comparison group (n = 45) completed the Subjective Scale to Investigate Cognition in Schizophrenia (SSTICS) and the Brief Assessment of Cognition in Schizophrenia (BACS). The patient group also completed the Positive and Negative Syndromes Scale (PANSS), the Birchwood Insight Scale (IS), and the Hospital Anxiety and Depression Scale (HADS).ResultsThe BACS and SSTICS scores were associated in the non-clinical comparison group, but not in the patient group. In the patient group worse subjective cognition was associated positively with good insight, greater dysphoria and greater positive symptoms. Linear regression revealed that, once other variables had been accounted for, dysphoria (HADS anxiety and depression factor) was the only significant predictor of SSTICS scores.ConclusionsSubjective cognitive impairment in patients with psychosis in the absence of formal testing should not be taken as evidence of impaired cognitive functioning. Mood should be investigated when patients present with subjective cognitive complaints.

Attributional Style and Theory of Mind in People with Alzheimer Disease and Persecutory Delusions

<h3>Objective</h3> Between 7% and 40% of people with Alzheimer disease (AD) experience persecutory delusions (PDs) during the course of their dementia. Although attributional style and theory of mind processes have been linked with PDs in people with psychosis, they have not yet been examined in those with AD and PDs. The objective of this study was, hence, to explore the role of these cognitive processes in groups of participants with AD with and without PDs, as well as a nonclinical comparison group. <h3>Method</h3> Measures of attributional style and theory of mind were administered to three groups: people with AD and PDs (n = 22), people with AD without PDs (n = 22), and a nonclinical group (n = 23). <h3>Results</h3> Although no clear differences in attributional style between the three groups were found, the group with AD and PDs were found to perform worse on the first-order (but not second-order) theory of mind task than the other two groups. <h3>Conclusions</h3> Interventions designed to enhance theory of mind skills might be beneficial for individuals with AD and PDs.

Early maladaptive schemas among young adult male substance abusers: A comparison with a non-clinical group

Early maladaptive schemas are rigidly held cognitive and behavioral patterns that guide how individuals encode and respond to stimuli in their environments (J. E. Young, 1994). Research has examined the early maladaptive schemas of substance abusers, as schemas are believed to underlie, perpetuate, and maintain problematic substance use. To date, research has not examined whether young adult male substance abuse treatment seekers (ages 18 to 25) report greater early maladaptive schema endorsement than a non-clinical comparison group. The current study extended the research on substance use and schemas by comparing the early maladaptive schemas of young adult male residential substance abuse patients (n=101) and a group of non-clinical male college students (n=175). Results demonstrated that the substance abuse group scored higher than the non-clinical comparison group on 9 of the 18 early maladaptive schemas. Implications of these findings for future research and substance use treatment programs are discussed.