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Self-other boundary under social threat in schizophrenia 精神分裂症患者社交威胁下的 "自我-他者 "界限
IF 3.6 2区 医学 Q1 PSYCHIATRY Pub Date : 2024-09-26 DOI: 10.1016/j.schres.2024.09.018
Spatial representation of the self plays a vital role constructing our sense of bodily self-boundary that distinguishes the self from others. This perceptual border, known as the peripersonal space (PPS), has been suggested to be altered in individuals with schizophrenia (SZ). PPS represents a protective defensive zone that triggers alarm signals upon threat detection; thus disrupted PPS could lead to social interactional difficulties. However, very little is known about the impact of threat on PPS.
To address this gap, a visual-tactile response-time (RT) experiment was conducted in immersive virtual reality (VR) for SZ and matched controls (CO). Participants were asked to detect a tactile vibration on their hand while an avatar (either threatening or neutral) approached them. Avatars were presented at different distance from the participants. PPS size and slope were estimated by identifying significant RT drop at the hypothesized self-other boundary. We also examined the relationship between PPS parameters, clinical symptoms and social disconnection.
There was no overall group difference in PPS size. Perceived social threat posed in the avatars sharpened the self-boundary in CO but not in SZ. In SZ, shallower PPS slope was associated with delusion, persecution, negative symptoms and loneliness but not in CO.
These results show that the regulation of self-other boundary in response to impending social threat may be maladaptive in SZ. Further research is needed on the causal mechanisms between self-disturbance and social impairments.
自我的空间表征在构建我们的身体自我边界感(将自我与他人区分开来)方面起着至关重要的作用。这种感知边界被称为 "周身空间"(PPS),有人认为精神分裂症(SZ)患者的这种感知边界会发生改变。PPS 代表了一种保护性防御区域,在发现威胁时会触发警报信号;因此,PPS 的破坏可能会导致社交互动困难。为了填补这一空白,我们在沉浸式虚拟现实(VR)中为精神分裂症患者和匹配对照组(CO)进行了一项视觉-触觉反应时间(RT)实验。实验要求参与者在头像(威胁性或中性)向其靠近时检测手上的触觉振动。头像与参与者的距离不同。PPS 的大小和斜率是通过识别假定的自我-他人边界处显著的 RT 下降来估算的。我们还研究了 PPS 参数、临床症状和社交断裂之间的关系。化身所带来的社会威胁增强了 CO 的自我边界,但没有增强 SZ 的自我边界。这些结果表明,对即将到来的社会威胁做出反应的自我-他者边界的调节在 SZ 中可能是不适应的。关于自扰与社交障碍之间的因果机制,还需要进一步研究。
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引用次数: 0
Associations of sexual orientation with symptom profiles in first-episode schizophrenia spectrum disorders 性取向与首发精神分裂症谱系障碍症状特征的关系
IF 3.6 2区 医学 Q1 PSYCHIATRY Pub Date : 2024-09-26 DOI: 10.1016/j.schres.2024.09.027
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引用次数: 0
The depiction of people with schizophrenia in news media: A cross-national analysis 新闻媒体对精神分裂症患者的描述:跨国分析
IF 3.6 2区 医学 Q1 PSYCHIATRY Pub Date : 2024-09-23 DOI: 10.1016/j.schres.2024.09.016

Background

Though people with schizophrenia have been habitually stigmatized in the media, the past two decades have seen a substantial rise in public awareness and anti-stigma intervention plans.

Aims

In this comprehensive cross-national study, we examine the portrayal of people with schizophrenia in the news media across four countries: the U.S., the U.K., Russia, and Israel.

Methods

We employed thematic content analysis to analyze 80 articles from four prominent middle-market and tabloid news media outlets.

Results

Findings suggest people with schizophrenia were routinely depicted in the news media as violent and dangerous perpetrators who were typically young adult white males.

Conclusions

Though some differences existed between venues in different countries, this study suggests that despite the rise in public awareness and anti-stigma intervention plans, the media overall - regardless of country origin - mostly failed to deliver the desired anti-stigma results.
背景尽管精神分裂症患者在媒体中一直被习惯性地污名化,但在过去的二十年中,公众意识和反污名化干预计划大幅提高、方法我们采用了主题内容分析法,分析了来自四家著名的中等市场和小报新闻媒体的 80 篇文章。结果研究结果表明,精神分裂症患者在新闻媒体中通常被描绘成暴力和危险的犯罪者,他们通常是年轻的成年白人男性。结论尽管不同国家的新闻媒体之间存在一些差异,但本研究表明,尽管公众意识和反污名化干预计划有所提高,但总体而言,无论来自哪个国家,媒体大多未能达到预期的反污名化效果。
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引用次数: 0
Corrigendum to “Natural language processing for defining linguistic features in schizophrenia: A sample from Turkish speakers” [Schizophr. Res. 266 (2024) 183–189] 对 "定义精神分裂症语言特征的自然语言处理:来自土耳其语使用者的样本"[Schizophr. Res. 266 (2024) 183-189] 更正
IF 3.6 2区 医学 Q1 PSYCHIATRY Pub Date : 2024-09-23 DOI: 10.1016/j.schres.2024.09.017
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引用次数: 0
Arousal responses to personal space intrusions in psychotic illness: A virtual reality study 精神病患者对个人空间侵入的唤醒反应:虚拟现实研究
IF 3.6 2区 医学 Q1 PSYCHIATRY Pub Date : 2024-09-20 DOI: 10.1016/j.schres.2024.09.004

Background

Prior studies have found that individuals with schizophrenia often have an enlarged “personal space”. However, the neurocognitive mechanisms underlying this consistent finding remain unknown.

Methods

The well-validated Stop Distance Procedure was used to measure the personal space preferences of individuals with psychotic disorders (PD, N = 22) and demographically-matched healthy controls (HC, N = 20) in response to human and virtual (avatar) intruders. Physiological arousal and subjective discomfort were measured during intrusions into personal space and modeled across different interpersonal distances. Additionally, participants were interviewed to assess their subjective awareness of their personal space preferences.

Results

Personal space measurements with humans and avatars were highly correlated and reliable over repeated trials, and influenced by the displayed emotion and gender of the intruders, in both groups. The PD group exhibited a larger personal space than the HC group (all p < 0.028), and the size of personal space with avatar intruders was significantly correlated with positive symptom severity in the PD subjects. Moreover, the magnitude of arousal responses to personal space intrusions was proportional to a power (exponent) of the distance between subjects and intruders, with a significantly smaller exponent in the PD (compared to the HC) for both human (p = 0.026) and avatar (p = 0.011) intruders, indicating a less steep function. Lastly, much of the participants' qualitative impressions of their personal space behaviors were consistent or correlated with the quantitative findings, reflecting some awareness of the determinants of personal space.

Conclusions

These findings reveal both intact and altered aspects of personal space regulation in psychotic disorders, and the potential utility of personal space measurements, given their high reliability, to serve as objective targets of interventions.

背景先前的研究发现,精神分裂症患者的 "个人空间 "通常比较大。方法采用经过充分验证的 "停止距离程序"(Stop Distance Procedure)来测量精神障碍患者(PD,22 人)和人口统计学上匹配的健康对照组(HC,20 人)对人类和虚拟(虚拟化身)入侵者的个人空间偏好。在入侵个人空间时测量生理唤醒和主观不适感,并在不同的人际距离上进行建模。此外,还对受试者进行了访谈,以评估他们对自己个人空间偏好的主观意识。结果两组受试者对人类和虚拟化身的个人空间测量结果在重复试验中具有高度相关性和可靠性,并受到入侵者所显示的情绪和性别的影响。与 HC 组相比,PD 组表现出更大的个人空间(所有 p 均为 0.028),并且与头像入侵者的个人空间大小与 PD 受试者的阳性症状严重程度显著相关。此外,对个人空间入侵的唤醒反应程度与受试者和入侵者之间距离的幂指数(指数)成正比,对于人类入侵者(p = 0.026)和头像入侵者(p = 0.011),PD 组(与 HC 组相比)的指数明显较小,这表明函数的陡度较低。最后,大部分参与者对其个人空间行为的定性印象与定量研究结果一致或相关,反映出他们对个人空间的决定因素有一定的认识。结论这些研究结果揭示了精神障碍患者个人空间调节的完整和改变方面,以及个人空间测量的潜在效用,由于其可靠性高,可作为干预的客观目标。
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引用次数: 0
Suicidality among clients in a network of coordinated specialty care (CSC) programs for first-episode psychosis: Rates, changes in rates, and their predictors 初发精神病协调专科护理(CSC)计划网络中客户的自杀率:自杀率、自杀率的变化及其预测因素
IF 3.6 2区 医学 Q1 PSYCHIATRY Pub Date : 2024-09-19 DOI: 10.1016/j.schres.2024.07.054

Background

People experiencing their first episode of psychosis have high risk of suicide, and programs specializing in early psychosis have not always achieved reduced risk. The present study analyzes patterns of suicide ideation, self-harm, and suicide attempts within the Connection Learning Healthcare System of 23 early psychosis programs in Pennsylvania and Maryland that follow the Coordinated Specialty Care treatment model.

Method

People with first episode psychosis (n = 1101) were assessed at admission and every six months using a standardized battery that included self-reported past-month ideation and clinician-reported past-six-month ideation, self-harm, and suicide attempts.

Results

At admission, there were 28 % rates of self-reported past-month suicide ideation and 52 % rates clinician-reported past-six-month suicide ideation, 23 % rate of clinician-reported self-harm, and 15 % rate of attempts. After the first six months of treatment there were significantly lower rates of clinician-reported suicidality (with reductions of at least 77 %), and after the first year of treatment there was significantly lower self-reported ideation (with approximately 54 % reporting lower past-month ideation). Changes were not accounted for by differential early discharge. A range of psychosocial variables predicted within- and between-subject variability in suicidality. Social and role functioning, depressive symptom severity, and a sense of recovery were significant within-subject predictors of all four measures of suicidality.

Conclusions

Compared to admission, we observed substantially lower rates of suicidality within the first year of treatment for clients with first episode psychosis in Coordinated Specialty Care. Reductions were predicted by some of the variables targeted by the treatment model.

背景首次发作的精神病患者有很高的自杀风险,而专门针对早期精神病的项目并不总能降低自杀风险。本研究分析了宾夕法尼亚州和马里兰州 23 个早期精神病治疗项目中的自杀意念、自残和自杀未遂的模式。方法对首次发病的精神病患者(n = 1101)在入院时进行评估,并每六个月使用一次标准化电池,其中包括自我报告的过去一个月的意念、临床医生报告的过去六个月的意念、自残和自杀未遂。治疗头六个月后,临床医生报告的自杀率明显降低(至少降低 77%),治疗第一年后,自我报告的自杀意念明显降低(约 54% 报告过去一个月的自杀意念降低)。提前出院的差异并不能解释这些变化。一系列社会心理变量预测了自杀倾向在受试者内部和受试者之间的变化。社会和角色功能、抑郁症状严重程度以及康复感是所有四项自杀行为测量指标的显著受试者内预测因素。结论与入院时相比,我们观察到接受协调专业护理的首次发作精神病患者在治疗第一年内的自杀率大幅降低。治疗模式所针对的一些变量可以预测自杀率的降低。
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引用次数: 0
Automated linguistic analysis in youth at clinical high risk for psychosis 对精神病临床高危青少年进行自动语言分析
IF 3.6 2区 医学 Q1 PSYCHIATRY Pub Date : 2024-09-17 DOI: 10.1016/j.schres.2024.09.009

Identifying individuals at clinical high risk for psychosis (CHRP) is crucial for preventing psychosis and improving the prognosis for schizophrenia. Individuals at CHR-P may exhibit mild forms of formal thought disorder (FTD), making it possible to identify them using natural language processing (NLP) methods. In this study, speech samples of 62 CHR-P individuals and 45 healthy controls (HCs) were elicited using Thematic Apperception Test images. The evaluation involved various NLP measures such as semantic similarity, generic, and part-of-speech (POS) features. The CHR-P group demonstrated higher sentence-level semantic similarity and reduced mean image-to-text similarity. Regarding generic analysis, they demonstrated reduced verbosity and produced shorter sentences with shorter words. The POS analysis revealed a decrease in the utilization of adverbs, conjunctions, and first-person singular pronouns, alongside an increase in the utilization of adjectives in the CHR-P group compared to HC. In addition, we developed a machine-learning model based on 30 NLP-derived features to distinguish between the CHR-P and HC groups. The model demonstrated an accuracy of 79.6 % and an AUC-ROC of 0.86. Overall, these findings suggest that automated language analysis of speech could provide valuable information for characterizing FTD during the clinical high-risk phase and has the potential to be applied objectively for early intervention for psychosis.

识别精神病临床高危人群(CHRP)对于预防精神病和改善精神分裂症的预后至关重要。CHR-P患者可能会表现出轻微的形式思维障碍(FTD),这使得使用自然语言处理(NLP)方法识别他们成为可能。在这项研究中,我们使用主题感知测试图像采集了 62 名 CHR-P 患者和 45 名健康对照者(HCs)的语音样本。评估涉及各种 NLP 测量方法,如语义相似性、通用性和语音部分(POS)特征。CHR-P 组的句子语义相似性更高,图像到文本的平均相似性更低。在通用分析方面,他们减少了口头禅,并用较短的单词写出了较短的句子。POS 分析显示,与 HC 相比,CHR-P 组的副词、连词和第一人称单数代词的使用率有所下降,而形容词的使用率有所上升。此外,我们还开发了一个基于 30 个 NLP 衍生特征的机器学习模型,用于区分 CHR-P 组和 HC 组。该模型的准确率为 79.6%,AUC-ROC 为 0.86。总之,这些研究结果表明,语音的自动语言分析可以为临床高危阶段的 FTD 特征描述提供有价值的信息,并有可能客观地应用于精神病的早期干预。
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引用次数: 0
Rates and predictors of service disengagement in first episode psychosis: Results from a 2-year follow-up study in an Italian real-world care setting 首次发病的精神病患者脱离服务的比率和预测因素:意大利真实世界护理环境中的两年随访研究结果
IF 3.6 2区 医学 Q1 PSYCHIATRY Pub Date : 2024-09-17 DOI: 10.1016/j.schres.2024.09.015

Aim

Service disengagement is a major problem for “Early Intervention in Psychosis” (EIP). Understanding predictors of engagement is also crucial to increase effectiveness of mental health treatments, especially in young people with First Episode Psychosis (FEP). No Italian investigation on this topic has been reported in the literature to date. The goal of this research was to assess service disengagement rate and predictors in an Italian sample of FEP subjects treated within an EIP program across a 2-year follow-up period.

Methods

All patients were young FEP help-seekers, aged 12–35 years, recruited within the “Parma Early Psychosis” (Pr-EP) program. At baseline, they completed the Positive And Negative Syndrome Scale (PANSS) and the Global Assessment of Functioning (GAF) scale. Univariate and multivariate Cox regression analyses were carried out.

Results

489 FEP subjects were enrolled in this study. Across the follow-up, a 26 % prevalence rate of service disengagement was found. Particularly strong predictors of disengagement were living with parents, poor treatment adherence at entry and a low baseline PANSS “Disorganization” factor score.

Conclusion

More than a quarter of our FEP individuals disengaged the Pr-EP program during the first 2 years of intervention. A possible solution to reduce disengagement and to facilitate re-engagement of these young patients might be to offer the option of low-intensity monitoring and support, also via remote technology and tele-mental health care.

目的脱离服务是 "思觉失调早期干预"(EIP)的一个主要问题。了解参与的预测因素对于提高精神健康治疗的有效性也至关重要,尤其是对于首次发病的精神病(FEP)青少年。迄今为止,文献中还没有关于这一主题的意大利调查报告。本研究的目的是评估意大利样本中接受 EIP 项目治疗的 FEP 患者在两年随访期间的服务脱离率和预测因素。方法所有患者均为 12-35 岁的年轻 FEP 求助者,在 "帕尔马早期精神病"(Pr-EP)项目中招募。基线时,他们填写了阳性和阴性综合征量表(PANSS)和全球功能评估量表(GAF)。研究进行了单变量和多变量考克斯回归分析。在整个随访过程中,发现服务脱离率为 26%。与父母同住、入组时治疗依从性差、基线 PANSS "无组织 "因子得分低是导致脱离的主要预测因素。要减少这些年轻患者的退出并促进其重新参与,一个可行的解决方案可能是通过远程技术和远程心理保健,为其提供低强度的监测和支持。
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引用次数: 0
Lower levels of kainate receptors, but not AMPA or NMDA receptors, in Brodmann's area (BA) 9, but not BA 10, from a subgroup of people with schizophrenia who have a marked deficit in cortical muscarinic M1 receptors 布罗德曼第 9 区(BA)(而非第 10 区)的 kainate 受体(而非 AMPA 或 NMDA 受体)水平较低,而这些受体来自皮质毒蕈碱 M1 受体明显缺乏的精神分裂症患者亚群。
IF 3.6 2区 医学 Q1 PSYCHIATRY Pub Date : 2024-09-17 DOI: 10.1016/j.schres.2024.09.014

In a previous study on ionotropic glutamate receptors, we have shown that [3H]kainate, but not [3H]AMPA or [3H]NMDA, receptor binding was lower in Brodmann's area (BA) 9 from people with schizophrenia. Subsequently, we defined a subgroup within the syndrome of schizophrenia who are termed the Muscarinic Receptor Deficit subgroup of Schizophrenia (MRDS) as they have markedly lower levels of [3H]pirenzepine binding to the muscarinic M1 receptor. The previous glutamate receptor study did not contain enough people with MRDS and other forms of schizophrenia (non-MRDS) to study any subgroup-specific differences. Hence, in this study we first measured [3H]pirenzepine binding to the muscarinic M1 receptor to confirm the MRDS subgroup, then measured [3H]kainate, [3H]AMPA and [3H]NMDA receptor binding using autoradiography in BA 9 from people with MRDS, non-MRDS and controls. We also measured binding in BA 10 as our gene expression study indicated that BA 10 is disproportionally affected by the molecular pathology of schizophrenia. As expected, due to case-selection criteria, [3H]pirenzepine binding to the M1 receptor was lower in BA 9 and BA 10 from people with MRDS, although more profound in BA 10. [3H]kainate receptor binding was lower only in BA 9 from people with MRDS, while [3H]AMPA and [3H]NMDA receptor binding was not altered in either region. Muscarinic M1 receptors and kainate receptors are both located on glutamatergic pyramidal neurons so a perturbation in both receptors could indicate altered excitatory neurotransmission in BA 9 from people with MRDS.

在之前一项关于离子型谷氨酸受体的研究中,我们发现精神分裂症患者的布罗德曼区(BA)9 中[3H]kainate 受体结合率较低,而[3H]AMPA 或[3H]NMDA 受体结合率较低。随后,我们定义了精神分裂症综合征中的一个亚组,他们被称为精神分裂症毒蕈碱受体缺乏亚组(MRDS),因为他们的[3H]哌仑西平与毒蕈碱 M1 受体的结合水平明显较低。之前的谷氨酸受体研究没有包含足够多的 MRDS 患者和其他形式的精神分裂症患者(非 MRDS),因此无法研究任何亚组特异性差异。因此,在本研究中,我们首先测量了[3H]哌仑西平与毒蕈碱 M1 受体的结合,以确认 MRDS 亚组,然后使用自显影法测量了 MRDS 患者、非 MRDS 患者和对照组 BA 9 中的[3H]凯恩酸盐、[3H]AMPA 和[3H]NMDA 受体的结合。我们还测量了 BA 10 的结合情况,因为我们的基因表达研究表明,BA 10 受精神分裂症分子病理学的影响尤为严重。正如预期的那样,由于病例选择标准的原因,[3H]哌仑西平与MRDS患者BA 9和BA 10中M1受体的结合率较低,但在BA 10中结合率更高。只有在 MRDS 患者的 BA 9 中,[3H]kainate 受体的结合率较低,而[3H]AMPA 和[3H]NMDA 受体的结合率在这两个区域均无变化。毒蕈碱 M1 受体和 kainate 受体都位于谷氨酸能锥体神经元上,因此这两种受体的干扰可能表明 MRDS 患者 BA 9 中的兴奋性神经传递发生了改变。
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引用次数: 0
Retinal electrophysiological alterations are associated with cognition in early course psychosis 视网膜电生理改变与早期精神病的认知能力有关
IF 3.6 2区 医学 Q1 PSYCHIATRY Pub Date : 2024-09-17 DOI: 10.1016/j.schres.2024.09.013

Retinal electrophysiological alterations are implicated in psychosis, but their relationship with cognition in early course psychosis (ECP) is understudied. The Brief Assessment of Cognition (BAC) and flash electroretinography (fERG) were conducted in 24 controls (HC) and 27 ECP individuals. Partial Spearman correlations were performed between fERG and BAC. Lower Photopic-1b and Scotopic-3b amplitudes were identified in ECP vs. HCs. Correlations were significant (p<0.05) between BAC Composite score and a-wave S3a and S2a and b-wave S2b and S3b conditions. Thus, ECP was characterized by lower ERG responses, and lower rod/cone/bipolar cell responses were related to poorer cognition.

视网膜电生理改变与精神病有关,但它们与早期精神病(ECP)认知能力的关系还未得到充分研究。我们对 24 名对照组(HC)和 27 名 ECP 患者进行了认知简要评估(BAC)和闪光视网膜电图(fERG)检查。fERG 与 BAC 之间存在部分斯皮尔曼相关性。发现 ECP 与 HC 相比,光视-1b 和视锥-3b 波幅较低。BAC 综合评分与 a 波 S3a 和 S2a 以及 b 波 S2b 和 S3b 条件之间存在明显相关性(p<0.05)。因此,ECP 的特征是较低的 ERG 反应,而较低的杆/锥/双极细胞反应与较差的认知能力有关。
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引用次数: 0
期刊
Schizophrenia Research
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