Psychic Experiences Research Articles

O11.3. A LONGITUDINAL ANALYSIS OF THE EFFECTS OF NEUROTICISM AND EXTRAVERSION ON SUBJECTIVE WELL-BEING IN PATIENTS WITH SCHIZOPHRENIA

BackgroundOne in five patients with a psychotic disorder has a persistent low subjective well-being over three years. This group has a poorer prognosis for social functioning. This presentation reports on the first longitudinal study evaluating whether neuroticism and extraversion influence subjective well-being (SWB) in patients with a schizophrenia spectrum disorder. SWB is generally defined as ‘the subjective experience, as constituting aspects of mental or physical state, which patients report regardless of etiological attributions’. It is an independent determinant for recovery in patients with a psychotic disorder. Two cross-sectional studies on quality of life in schizophrenia suggest that personality traits are associated with the way patients value life. If personality traits predict the trajectories of subjective well-being, our results would provide a clinical reference point for patients at risk for a persistent low subjective well-being.MethodsWe included 186 patients and 126 healthy control subjects from the Dutch Genetic Risk and Risk and Outcome of Psychosis cohort. SWB was measured with the Subjective Well-being under Neuroleptics-20 (SWN) scale. Assessments took place at baseline, three years and six years follow-up. We used the Five-Factor Inventory to assess neuroticism and extraversion. Positive, negative and depressive symptoms in patients were assessed by the Positive and Negative Symptoms Scale. For controls we used the Community Assessment of Psychic Experiences for investigating subclinical symptoms. By using linear mixed model analyses we investigated the relation between SWB and the personality traits, including the moderating associations of positive, negative, depressive symptoms and a range of psychosocial indicators (among which antipsychotic use and smoking cannabis). An exploratory analysis in the patient sample, investigated the predictive values of personality traits and symptoms at baseline on the course of SWB over 3 and 6 years. Patients were accounted to one of three SWB-trajectories ‘stable low’, ‘low start and improving’ and ‘stable high’.ResultsMixed model analyses revealed that in patients, high scores of neuroticism and low scores of extraversion were associated with lower SWN-scores: at 3 years: t = - 3.07 and t = 4.34 for p < 0.05 and at 6 years: t = -2.62, p = 0.009 and t = 3.51, p = 0.001. We found no interaction effect of time and personality traits. Neuroticism and extraversion were related to SWB to the same extent in the control group.Regarding trajectories over time, we found a stable low SWB in 15.1% of the patients, forming the ‘stable low’ trajectory group. This group scored highest on neuroticism and lowest on extraversion compared to patients with an increase in SWB or a stable high SWB: neuroticism scores showed post hoc compared mean differences (MD) of 4.25, p = 0.03 for the ‘low start increasing’-group and MD 10.75, p <0.001 for the ‘stable high’-group).DiscussionWe found an association between personality traits and subjective well-being regardless of (subclinical) psychotic or depressive symptoms. Extraversion can be regarded as a resilience factor, whereas neuroticism is associated with a persistent low well-being. In patient with a schizophrenia spectrum disorder, neuroticism could be a focus for therapeutic interventions that diminish negative affectivity. Additionally, an assessment of neuroticism and extraversion early in the process of treatment could be considered.

F132. IDENTIFICATION OF PATIENTS WITH RECENT ONSET PSYCHOSIS IN KWAZULU NATAL, SOUTH AFRICA: A PILOT STUDY WITH TRADITIONAL HEALTH PRACTITIONERS AND DIAGNOSTIC INSTRUMENTS

BackgroundThere is considerable variation in epidemiology and clinical course of psychotic disorders across social and geographical contexts. To date, very little data is available of low- and middle-income countries (LMICs). Obtaining valuable evidence from under-represented regions such as Sub-Saharan Africa holds the promise of advancing our knowledge and understanding of psychosis and will provide a strong basis for redressing inequities in service provision for people with psychotic disorders living in LMICs. Many patients in these countries remain undetected and untreated, partly due to lack of formal health care facilities. This study in rural South Africa aimed to investigate if it is possible to identify patients with recent onset psychosis in collaboration with traditional health practitioners (THPs).MethodsWe developed a strategy to engage with THPs. Key to the collaboration between psychiatry, THPs and the local community, was the building of trust by recognizing and acknowledging local authorities, mutual respect for health constructs, taking time to find common ground, and adaptation of the procedures to sociocultural norms. Fifty THPs agreed to collaborate and were asked to refer help-seeking clients with recent onset psychosis to the study. At referral, the THPs rated probability of psychosis (“maybe disturbed” or “disturbed”). A two-step diagnostic procedure was conducted, including the self-report Community Assessment of Psychic Experiences (CAPE) as screening instrument, and a semi-structured interview using the Schedules for Clinical Assessment in Neuropsychiatry (SCAN). Accuracy of THP referrals, and test characteristics of the THP rating and the CAPE were calculated.ResultsIn six months, 149 help-seeking clients were referred by THPs, of which 44 (29.5%) received a SCAN DSM-IV diagnosis of psychotic disorder. The positive predictive value of a THP “disturbed” rating was 53.8%. Test characteristics of the CAPE were poor.DiscussionThis pilot study in rural South Africa found that it is possible to identify patients with recent onset psychosis in collaboration with THPs. THPs not only grasped the concept of psychosis, they recognized “being disturbed” as a condition that is often difficult to treat and for which collaboration with psychiatric mental health care might be beneficial. By contrast, the CAPE performed poorly as a screening instrument. Collaboration with THPs is a promising approach to improve detection of patients with psychosis in LMIC.

S1. THE ASSOCIATION BETWEEN WAR-RELATED STRESS, PTSD SYMPTOMS, AND SUB-CLINICAL PSYCHOSIS: A CROSS-CULTURAL POPULATION-BASED STUDY AMONG PALESTINIAN AND ISRAELI YOUNG ADULTS

BackgroundSub-clinical or attenuated psychosis symptoms (APS) in the general population has become a focus of considerable research interest over the past two decades, as they appear to index an increased risk for psychotic outcomes. Recent data from several community-based studies around the world provide convincing support for an association of APS with traumatic stress that is likely moderated by familial genetic risk and gender. However, relatively little is known about the degree to which APS are associated with terror/war-related stress. Moreover, relatively little is known about the degree to which cultural/religious factors moderate this association. Hence, the overarching goal of this study was to address this lacuna in the literature by examining the relationship between exposure to terror/war-related events, PTSD symptoms and familial genetic risk among Palestinian and Israeli youth.MethodsExposure to terror/war-related trauma, presence and severity of PTSD symptoms, perceived ability to cope with trauma, familial genetic-risk, and APS were assessed in a representative sample of 530 Israeli and 1100 Palestinian (451 from Israel, 264 from the West Bank, and 385 from the Gaza Strip) young adults with a mean age of 36.7 (SD=8.4). PTSD symptoms were assessed with the Post-traumatic Disorder Scale (PDS), perceived ability to cope with trauma with the Perceived Ability To Cope With Trauma Scale (PACT), and APS with the Community Assessments of Psychic Experiences (CAPE).ResultsAs hypothesized, there was a significant three-way interaction effect of exposure to terror-war-related trauma, religion, and familial genetic-risk on APS. The highest level of APS was among Palestinians who live in the Gaza strip, with no significant differences between Jews and Palestinians who live in Israel or in the West Bank. Also, consistent with our hypotheses, the three-way association between exposure to trauma, familial genetic risk and religion was mediated by PTSD symptoms and perceived ability to cope with trauma.DiscussionThese findings provide further support for the link between exposure to trauma, familial genetic-risk, and APS. Also, it provides further support for the mediating role that PTSD symptoms play in this link. Finally, it suggests that religious background moderates the link between exposure to trauma and APS.

F82. COGNITIVE BIASES IN PATIENTS WITH SCHIZOPHRENIA AND HIGH SCHOOL STUDENTS: ASSOCIATION WITH PSYCHOPATHOLOGICAL SYMPTOMS

BackgroundSome cognitive biases, mainly the “jumping to conclusions” and attributional styles, play a key role in the formation and maintenance of delusions. Other thinking errors include dichotomous thinking, emotionally based reasoning, and catastrophising. The aim of our study was to assess the relationship between cognitive biases and psychopathological symptoms (positive, negative, depressive) in a clinical sample of patients with schizophrenia and a population sample of high school students.MethodsThe clinical sample included 35 patients with schizophrenia (35.6 ± 10.8 years, 40% women) attending to the Department of Mental Health from Parc Taulí Hospital Universitari (Sabadell, Spain) and 45 high school students (16.6 ± 0.9 years) located in the same province.Cognitive biases were assessed with the Cognitive Biases Questionnaire, that covers 5 types of biases (intentionalising [I]; catastrophizing [C]; dichotomous thinking [DT]; jumping to conclusions [JTC]; and emotional reasoning [ER]) and also gives a total score. Psychopathological symptoms in patients were assessed with the Positive and Negative Syndrome Scale (PANSS) and the Calgary Depression Scale for Schizophrenia (CDSS). Psychopathological symptoms in high school students were assessed with the Community Assessment of Psychic Experiences (CAPE).Statistical analyses were performed with SPSS version 21.0. CBQ scores between groups were compared with Student’s T-test. The association between dimensions of the CBQ and scores of psychopathological scales was tested with Spearman’s correlations. Significance level was set at p<0.05 (two-tailed).ResultsCBQ total scores did not differed between patients with schizophrenia (45.3 ± 8.2) and high school students (44.2 ± 6.7). No significant differences between groups were found in any of the five cognitive biases.When exploring the relationship between cognitive biases and psychopathological symptoms in patients with schizophrenia, total CBQ scores were associated with CDSS scores (r= 0.65, p<0.001). In relation to particular cognitive biases, depressive symptoms were associated with all cognitive biases (I: r= 0.43, p= 0.017; C: r= 0.62, p<0.001; DT: r= 0.42, p= 0.020; JTC: r= 0.46, p= 0.012; ER: r= 0.57, p= 0.001), positive symptoms with ER (r= 0.43, p= 0.009) and general psychopathology symptoms of the PANSS with C (r= 0.34, p= 0.044), DT (r= 0.35, p= 0.041) and ER (r= 0.45, p= 0.007).In high school students, CBQ total scores were associated with positive (r= 0.43, p= 0.003) and depressive (r= 0.35, p= 0.020) symptoms. In relation to particular cognitive biases, depressive symptoms were associated with DT (r= 0.47, p= 0.001) whereas positive symptoms were associated with DT (r= 0.31, p= 0.036) and ER (r= 0.30, p= 0.047).DiscussionAlthough we did not find significant differences in the presence of cognitive biases when comparing two different samples, similar associations were found when exploring the relationship between cognitive biases and psychopathology symptoms. Our results are in accordance previous studies reporting the role of some cognitive biases on the risk of developing psychotic symptoms. On the other hand, a clear association between cognitive biases was found for depressive symptoms in both patients with schizophrenia and high school students. Our study highlights the importance of identifying and treating cognitive biases with appropriate therapies (e.g. metacognitive training) for improving the outcome of psychoses in both patients and people at risk for developing a psychotic disorder in the future.

O12.8. LOWER FAMILY INCOME PREDICTS PSYCHOTIC EXPERIENCES IN A COMMUNITY SAMPLE OF YOUTHS IN BRAZIL: RESULTS FROM A 3-YEAR FOLLOW-UP STUDY

BackgroundUp to 17% of community youths, from 9 to 12 years old, report subthreshold psychotic experiences (PE). Besides increasing conversion risk to psychotic disorders, PE also predicted suicide attempts and were associated with more severe general psychopathology. Understanding predisposing factors to PE during development can inform on risk to mental disorders, a crucial step to future prevention interventions. Adversity in early life has been associated with psychotic symptoms, and low socioeconomic status (SES) is an established environmental risk factor for several mental disorders. However, few studies investigated the effect of low SES on PE risk in youths, prospectively. This topic is highly relevant in underprivileged countries like Brazil, where large populations are exposed to poverty. We hypothesized that low income at baseline would predict later report of PEs.MethodsWe analyzed data from the Brazilian High Risk Cohort Study for Psychiatric Disorders (HRC), in which 2,512 youths (6–12 years old, mean age at baseline 9.7 years, SD = 1.92; 53,1% male) completed the baseline assessment and 2,012, the 3-year follow-up (T1). PE were assessed at each time-point through two sources of information: parental report, using the Child Behavior Checklist (CBCL), and youth self-report, using the positive dimension of the Community Assessment of Psychic Experiences (CAPE). A single latent variable for each time-point was created to encompass both sources of information using Confirmatory Factor Analysis, yielding good model fit. Total family income (T0) was correlated to the psychotic latent variable (T1), controlling for age, gender and baseline report of PE. Then, we investigated how any mental disorder diagnosis and exposure to trauma, two possible confounding factors, affected the results. The Development and Well-Being Assessment (DAWBA) was used to investigate mental disorders diagnoses. No conversion to psychotic disorder was observed at the follow-up. A latent variable encompassing parental and youths reports, measured by Childhood Trauma Questionnaire (CTQ), was used as trauma exposure.ResultsThe mean family income reported was approximately US$ 394 per month (p25 = US$ 195, p50 = US$ 307, p75 = US$ 516). Income (baseline) and PE (T1) had a negative significant correlation (pcorr = -0.064; df = 2004; p = 0.004). Subjects with any mental disorder reported PE more frequently, either at baseline or at the follow-up. Low income inversely correlated with trauma, whereas trauma was strongly associated with PE and having any mental disorder at both time points. The correlation between income and PE did not remain significant, after controlling for any mental disorder (T1) (pcorr = -0.049; df = 1597; p = 0.050) or trauma exposure (T0) (pcorr = -0.043; df = 2003; p = 0.053).DiscussionOther studies have previously reported a positive correlation between adversity and PE, but few have described a specific association between family income and psychotic experiences. Our additional analyses suggest that this is not specific, considering the influence of non-psychotic mental disorders, and mediated by low-income related exposures, i.e. childhood trauma. Even not surviving multivariate analyses, income could work as a proxy for adversity exposures and may be useful as a tool to define populations at risk for psychotic and non-psychotic mental disorders. We expect that the longer follow-up assessments help us answer the questions raised.

T132. ASSESSMENT OF CROSS-NATIONAL EQUIVALENCE OF THE COMMUNITY ASSESSMENT OF PSYCHIC EXPERIENCES (CAPE)

BackgroundThe Community Assessment of Psychic Experiences (CAPE) is a self-report questionnaire that has been developed to measure the dimensions of psychosis in the general population. The cross-national equivalence of a questionnaire allows the comparability of a scale across different populations in different countries, i.e., using different versions of the scale according to the considered language. In this study, our aim was to investigate the equivalence of the CAPE across different countries.MethodsData were drawn from the European Union Gene-Environment Interaction (EU-GEI) study. Participants (incident case of psychotic disorder, controls and siblings of cases) were recruited across in six countries: United Kingdom, the Netherlands, Italy, Spain, Brazil and France. To analyse the cross-national equivalence of the dichotomised version of the CAPE, we used the multigroup categorical confirmatory factory analysis (MCCFA). The cross-national equivalence can be stated after the establishment of three invariances characterised by increased constraints: the configural invariance, the metric invariance and the scalar invariance across the multiples groups.ResultsThe configural invariance model fits well, providing evidence for identical factor structure across countries. The assumption that factor loadings are identical across countries is granted based on the negligible change in the fit indices in the metric invariance model. Moreover, the fit indices suggest that the CAPE shows scalar invariance across countries.DiscussionThese findings suggest that comparisons across countries of factor and observed means of the CAPE are possible. Thus, differences observed in scores between samples from different countries can be considered as different levels of psychosis.

S28. THE ROLE OF COPING IN THE ASSOCIATION BETWEEN SUBCLINICAL PSYCHOTIC EXPERIENCES AND DAILY FUNCTIONING: EVIDENCE FROM TWO INDEPENDENT ADOLESCENT SAMPLES FROM THE GENERAL POPULATION

BackgroundSubclinical psychotic experiences (attenuated, brief, or limited psychotic-like experiences) are present in approximately 5% of adults and 7.5% of adolescents from the general population. Whilst the majority of these experiences are transitory, individuals who report subclinical psychotic experiences are at greater risk developing psychotic spectrum disorders, as well as other adverse outcomes. It is now well established that there is an inverse association between psychosocial functioning and (subthreshold) psychotic experiences in both clinical and non-clinical populations, however the mechanisms which drive this association are unclear. Adolescents with subclinical psychotic experiences are more likely to use maladaptive coping strategies and less likely to use adaptive ones. Given that coping styles are potentially modifiable, clarifying how coping may mediate the association between subclinical psychotic experiences and functioning could provide an important avenue for psychosocial intervention. In the current study we aimed to determine whether the association between subclinical psychotic experiences and psychosocial functioning is mediated by coping style. We conducted a within study replication in two large adolescent samples from the general populations of Australia and the United Kingdom.Methods723 adolescents from Melbourne, Australia, and 239 adolescents from Birmingham, UK, took part in the study. Subclinical positive psychotic experiences were measured using the Community Assessment of Psychic Experiences (CAPE). The Coping Inventory for Stressful Situations (CISS) assessed three different coping styles; task oriented (adaptive) styles and emotion and avoidance oriented (maladaptive) styles. Functioning was measured via the Multidimensional Assessment of Functioning Scale (MAFS), which assesses general, family, and peer functioning. Mediation analysis was conducted using the PROCESS macro for SPSS.ResultsSubclinical psychotic experiences were strongly associated with reduced general and family functioning, and to a lesser extent with reduced peer functioning. Higher subclinical psychotic experiences were associated with lower task (adaptive) and avoidance (maladaptive) oriented coping and increased emotion (maladaptive) oriented coping. Task and emotion oriented coping were found to significantly mediate the relationship between subclinical psychotic experiences and all three types of functioning in both the Melbourne and the Birmingham samples. Avoidance oriented coping was found to significantly mediate subclinical psychotic experiences and peer functioning in the Melbourne sample only. Avoidance oriented coping was not found to mediate subclinical psychotic experiences with general or peer functioning in either sample.DiscussionGiven that 17% of children and 7.5% of adolescents experience subclinical psychotic experiences and that these experiences are associated with reduced functioning, high levels of distress, and suicidal ideation, introducing classroom based learning about coping strategies in schools may encourage the adoption of more positive coping strategies earlier. Additionally, the findings of the present study have important clinical treatment implications, as they suggest that techniques which increase levels of adaptive coping and reduce levels of maladaptive coping (in particular emotion-oriented styles) may help to break the cycle between subclinical psychotic experiences, functional decline, and eventual need for care.

Can an experimental white noise task assess psychosis vulnerability in adult healthy controls?

BackgroundThis is an extension of a paper published earlier. We investigated the association between the tendency to detect speech illusion in random noise and levels of positive schizotypy in a sample of 185 adult healthy controls.Materials and methodsSubclinical positive, negative and depressive symptoms were assessed with the Community Assessment of Psychic Experiences (CAPE); positive and negative schizotypy was assessed with the Structured Interview for Schizotypy-Revised (SIS-R).ResultsSpeech illusions were associated with positive schizotypy (OR: 4.139, 95% CI: 1.074–15.938; p = 0.039) but not with negative schizotypy (OR: 1.151, 95% CI: 0.183–7.244; p = 0.881). However, the association of positive schizotypy with speech illusions was no longer significant after adjusting for age, sex and WAIS-III (OR: 2.577, 95% CI: 0.620–10.700; p = 0.192). Speech illusions were not associated with self-reported CAPE measures.ConclusionsThe association between schizotypy and the tendency to assign meaning in random noise in healthy controls may be mediated by cognitive ability and not constitute an independent trait.

Are Psychotic Experiences Related to Poorer Reflective Reasoning?

Background: Cognitive biases play an important role in the formation and maintenance of delusions. These biases are indicators of a weak reflective mind, or reduced engaging in reflective and deliberate reasoning. In three experiments, we tested whether a bias to accept non-sense statements as profound, treat metaphorical statements as literal, and suppress intuitive responses is related to psychotic-like experiences.Methods: We tested deliberate reasoning and psychotic-like experiences in the general population and in patients with a former psychotic episode. Deliberate reasoning was assessed with the bullshit receptivity scale, the ontological confabulation scale and the cognitive reflection test (CRT). We also measured algorithmic performance with the Berlin numeracy test and the wordsum test. Psychotic-like experiences were measured with the Community Assessment of Psychic Experience (CAPE-42) scale.Results: Psychotic-like experiences were positively correlated with a larger receptivity toward bullshit, more ontological confabulations, and also a lower score on the CRT but not with algorithmic task performance. In the patient group higher psychotic-like experiences significantly correlated with higher bullshit receptivity.Conclusion: Reduced deliberate reasoning may contribute to the formation of delusions, and be a general thinking bias largely independent of a person's general intelligence. Acceptance of bullshit may be facilitated the more positive symptoms a patient has, contributing to the maintenance of the delusions.

Freud's ‘transference’: Clinical technique in the ‘Rat Man’ case and theoretical conceptualization compared

A considerable gap exists between clinical psychoanalytic concepts and psychoanalytic practice. It can be traced back to the early beginnings of psychoanalysis and to Freud's own handling of concepts that he had developed himself. Focusing on the concept of ‘transference’ that Freud in several steps coined so precisely from his experiences with hysteric patients and especially from his understanding of the ‘Dora’ case, it can be shown that he – seen from today – could not fully apply the meaning of his own concept in the later treatment of the so‐called ‘Rat Man’. Freud's ‘Original record of the case’ is used to scrutinize his way of understanding and handling the transference with this patient. To a substantial extent transference as well as counter‐transference was rather enacted than understood in this case, partly due to Freud's own personal and scientific interests and to his ambitions to use this case as a demonstration of his therapeutic approach. In order to show this, it is unavoidable to correct several blurry or even misleading passages of Strachey's translation. Findings from numerous workshops using ‘comparative clinical methods’ indicate that up till now we analysts – like Freud – have great difficulties in applying Freud's incredible insight that “a whole series of former psychic experiences comes alive not as the past but as the present relationship to the person of the physician” (Freud, 1905c [1901], p. 279/280, my translation).

Rule induction algorithms for classification of psychotic disorders involving social vulnerability features

This article presents rule induction algorithms for identify and evaluate variables related to social vulnerability risk factors of the individual that influence the diagnosis of psychotic disorders. 213 variables were analyzed: sociodemographic, psychic experiences in the community, traumas in childhood, bullying, and use of marijuana, tobacco, and alcohol. Four subsets were constructed and with them, we reach an attribute reduction of 80%. In development, an accuracy of approximately 80% was maintained. About the number of rules there was a reduction of 90% of possibilities generated, simplifying the representation of the model. Thus, the results proved promising for the use of this approach as a basis in the construction of decision support systems in the area and in the deepening of studies for the incorporation of new variables in psychiatric diagnosis, increasing the reliability and validity of the diagnostic process.

Experiência e sentido no pensamento de Carl Gustav Jung: um percurso pelo Livro Vermelho

The attempt to comprehend the psychic experience is a constancy in Jung’s work, the basis according to which his clinical practice and theoretical constructs were developed. The inner experience thus acquires both the status of cause and aim of the psychic fact. Within this context, The Red Book represents an important source for research, because of its biographical character and by what it presents as indications of important theoretical concepts. In this essay, we will address Jung’s approaches to the question of sense (Sinn) and meaning (Bedeutung) in The Red Book and how these themes intertwine in the psychic experience.

El constructo de “límite” y experiencias anómalas en psíquicos

This study aims at distinguishing self-named psychics (or clairvoyant) from a control group (non-psychics) considering the variable “ frequency of unusual perceptual experiences” (anomalous perception), and the psychological construct “limit”. Participants were divided into psychics and non-psychics (people who had psychic experiences but no extrasensory capacities). Both psychics (N = 87) and the control group (N = 112) completed the Cardiff Anomalous Perceptions Scale (CAPS), the Revised Transliminality Scale (RTS), the Limits Questionnaire, and a scale to measure their psychic abilities. All the hypotheses were confirmed: psychics had higher scores on transliminality, anomalous perception and “fine limit” in comparison with non-psychics. In addition, the variable “anomalous experiences” was the best predictor for the psychics group (β = .073; p = .03), followed by the variable “fine limit”. Psychics would be those who were able to pass the “continuity hypothesis” of Hartmann’s limit due to their familiarity with their own capacity to alter their conscience.

Affectively salient signal to random noise might be used to identify psychosis vulnerability in severe mental disorders

BackgroundSubclinical psychotic symptoms are present in the general population. Furthermore, they are quite common in diagnostic categories beyond psychosis, such as BPD patients. MethodsWe want to assess the differences between 3 groups: BPD (n = 68), FEP (n = 83) and controls (n = 203) in an experimental paradigm measuring the presence of speech illusions in white noise. The Positive and Negative Syndrome Scale was administered in the patient group, the Structured Interview for Schizotypy-Revised, and the Community Assessment of Psychic Experiences in the control and BPD group. The white noise task was also analysed within a signal detection theory (SDT) framework. Logistic regression analyses and the general linear models were used to analyse the adjusted differences between groups. ResultsDifferences were more prevalent in signals that were perceived as affectively salient in patients groups (9.6% in FEP vs 5.9% in BPD and 1% in controls; OR: 10.7; 95%CI: 2.2–51.6, p = 0.003 in FEP; OR: 6.3; 95%CI: 1.1–35.0, p = 0.036 in BPD). Besides, we found a worse general performance and more false alarms in the task for FEP group using SDT framework. ConclusionsExperimental paradigms indexing the tendency to detect affectively salient signals in noise may be used to identify liability to psychosis in people with vulnerability. Its predictable value in other diagnostic categories and general population requires further research.

Think Piece: Intersectional Resonance and the Multiplicity of Being in a Polarised World

Understandings of collective learning and change agency often conjure up an image of a particular group or community identifying important concerns and finding the momentum to learn together to address them. In reality, gaining consensus around what issues need to be addressed is a complex process in polarised societies. It requires an attentiveness to different standpoints and experiences of the social dynamics at play, and the ways in which ecological, political, socio-economic and psychic experiences manifest themselves within different contexts, generating disparate and connected views on what is missing and what is needed to create a more just society. This paper asks questions about what it means to learn in-between and through complex and interrelated societal dynamics amongst a community of change drivers. By highlighting the individual, communal and collective learning of a diverse group of change drivers in a very polarised South Africa, we can begin to ask questions about the following: 1) how different embodied experiences or ‘a multiplicity of being’, as referred to in this paper, are essential in the pursuit of a sustainable society; and 2) why we need to learn in ways that can foster a sense of ‘intersectional resonance’ between and amongst change drivers in a polarised world.

Features of borderline personality disorder as a mediator of the relation between childhood traumatic experiences and psychosis-like experiences in patients with mood disorder

BackgroundPsychosis-like experiences (PEs) are common in patients with non-psychotic disorders. Several factors predict reporting of PEs in mood disorders, including mood-associated cognitive biases, anxiety and features of borderline personality disorder (BPD). Childhood traumatic experiences (CEs), often reported by patients with BPD, are an important risk factor for mental disorders. We hypothesized that features of BPD may mediate the relationship between CEs and PEs. In this study, we investigated the relationships between self-reported PEs, CEs and features of BPD in patients with mood disorders. MethodsAs part of the Helsinki University Psychiatric Consortium study, McLean Screening Instrument (MSI), Community Assessment of Psychic Experiences (CAPE-42) and Trauma and Distress Scale (TADS) were filled in by patients with mood disorders (n = 282) in psychiatric care. Correlation coefficients between total scores of scales and their dimensions were estimated, multiple regression and mediation analyses were conducted. ResultsTotal scores of MSI correlated strongly with scores of the CAPE-42 dimension “frequency of positive symptoms” (rho = 0.56; p ≤ 0.001) and moderately with scores of TADS (rho = 0.4; p ≤ 0.001). Total score of MSI and its dimension “cognitive symptoms”, including identity disturbance, distrustfulness and dissociative symptoms, fully mediated the relation between TADS and CAPE-42. Each cognitive symptom showed a partial mediating role (dissociative symptoms 43% (CI = 25–74%); identity disturbance 40% (CI = 30-73%); distrustfulness 18% (CI = 12-50%)). ConclusionsSelf-reported cognitive-perceptual symptoms of BPD fully mediate, while affective, behavioural and interpersonal symptoms only partially mediate the relationships between CEs and PEs. Recognition of co-morbid features of BPD in patients with mood disorders reporting PEs is essential.

Two case studies from a virtual reality intervention for delusions: feasibility and preliminary evidence

AbstractThe use of virtual reality (VR) interventions for psychosis is on the rise. As information-processing biases such as overconfidence in memory are likely to be involved in the formation and maintenance of delusions, VR could also be used to correct cognitive distortions and in turn ameliorate delusions. The present study illustrates two case studies in which a VR intervention was employed to reduce delusions by means of correcting experiences. Participants navigated four virtual environments via a head-mounted display (HMD) and computer and were asked to recollect previously seen faces and objects and to rate their response confidence. The scenarios were created to elicit false memories. Immediately after each response, they received feedback to correct possible overconfidence in false memories. We present two case studies to illustrate individual differences. Both participants benefited from the intervention: delusions were reduced from pre- to post-assessment (after 3 weeks) as measured with the Positive and Negative Syndrome Scale and Psychotic Symptom Scale. This was corroborated by results on the Paranoia Checklist and the Community Assessment of Psychic Experiences collected immediately after the session. Immediate effects also showed a reduction in delusion conviction rate. The present study provides preliminary evidence that delusions may be ameliorated by a VR paradigm designed to correct memory overconfidence. Cybersickness emerged as a problem in one of the patients.

The effects of cannabidiol on persecutory ideation and anxiety in a high trait paranoid group.

Previous studies have suggested that cannabidiol has anxiolytic and antipsychotic properties, raising hopes that cannabidiol will translate to the psychiatric clinic. Cannabidiol may be particularly useful for anxiety and paranoia in those at-risk of major mental illness. Immersion in a controlled 3D virtual-reality scenario was used to assay persecutory ideation and anxiety in a sample of non-clinical volunteers ( n=32) pre-selected for high paranoid traits. Participants were randomised to receive oral cannabidiol (600 mg) or placebo 130 min prior to entering virtual-reality. Well-validated rating scales were used to assay persecutory thinking and anxiety. Salivary cortisol concentration, heart rate and blood pressure were measured over the course of the experimental session. Immersion in the virtual-reality session elicited anxiety as indexed by the Beck's anxiety inventory ( p<0.005), and increased cortisol concentration ( p=0.05), heart rate ( p<0.05) and systolic blood pressure ( p<0.05). However, cannabidiol had no impact upon any of these effects, except for a strong trend to increase anxiety ( p=0.09). Cannabidiol had no effect on persecutory ideation as assayed by the Community Assessment of Psychic Experiences questionnaire or the State Social Paranoia Scale. In contrast to previous studies, there was no evidence of any benefits of cannabidiol on anxiety or persecutory ideation in healthy volunteers with high trait paranoia. However, a larger sample will be required for a definitive study.

The Latent Taxonicity of Schizotypy in Biological Siblings of Probands With Schizophrenia.

If schizotypy is a taxonic liability for schizophrenia with a general population prevalence of ~10%, it should also be taxonic among biological siblings of probands with schizophrenia. Moreover, assuming this is so, siblings' schizotypy class membership should be predicted by probands' familial load for psychotic disorder and clinical severity, consistent with a multifactorial polygenic threshold model of schizophrenia. We tested these hypotheses in the Genetic Risk and Outcome of Psychosis (GROUP) Study where siblings of probands (n = 792) and unaffected controls (n = 559) provided self-report ratings on the Community Assessment of Psychic Experiences (CAPE). Maximum covariance analyses of control group ratings led to the identification of CAPE items sensitive to nonredundant positive and negative schizotypy classes in the control group (prevalence = 7.9% and 11.1%, respectively). When the same taxonic solution was applied to siblings' CAPE rating, taxometric analyses yielded evidence for larger positive and negative schizotypy classes among siblings (prevalence = 14.1% and 21.8%, respectively). Whereas probands' familial loads for bipolar disorder or drug use disorders did not predict siblings' membership in the schizotypy classes, probands' familial load for psychotic disorder did. Siblings were more likely to be members of the positive schizotypy class where their probands were more severely affected. The pattern of findings is consistent with Meehl's argument that schizotypy reflects liability for schizophrenia.

Influence of depressive symptoms on distress related to positive psychotic-like experiences in women

The Community Assessment of Psychic Experiences (CAPE) is an effective instrument for detection of the presence of psychotic symptoms and associated distress in the general population. However, little research has studied distress associated with positive psychotic-like experiences (PLEs). Our aim is to study PLE-related distress using the CAPE. In this study we analysed factors associated with differences in PLE-related distress in a sample of 200 non-clinical participants recruited by snowball sampling. Presence of PLEs and related psychological distress was measured using the CAPE questionnaire. The influence of age, gender, educational level and drug use was studied. In univariate analysis we found that gender and CAPE positive, depressive and negative scores, were associated with CAPE positive distress. Using multiple linear regression, we found that only the effect of gender, and the interaction between frequency of depression and gender, remained statistically significant. In our sample interaction between gender and depressive symptoms is a determining factor in distress associated with positive PLEs. The results of this study may be useful for the implementation of prevention programs.