Pub Date : 2025-07-21DOI: 10.1016/j.scog.2025.100379
Sebastián Lema Spinelli , Juan Francisco Rodríguez-Testal , Álvaro Cabana , Sandra Romano , Leonel Gómez-Sena
Background
Negative symptoms (NS) are a core feature of schizophrenia spectrum disorders, yet their relationship with cognitive reserve (defined by educational attainment) and social cognition remains underexplored. This study examined whether education predicts NS and whether this relationship is mediated by social cognition, specifically emotional or inferential theory of mind Reading the Mind in the Eyes Test (RMET) vs. the Hinting Test.
Methods
A mediation model and multiple regression analysis were conducted within an ex-post-facto, cross-sectional design. The sample included 144 participants: 69 diagnosed with schizophrenia spectrum disorders and 75 healthy controls. Women comprised 52.8 % of the sample, with a mean age of 42.67 years (SD = 15.88). The average years of formal education were 8.37 (SD = 2.77) in the patient group and 8.62 (SD = 3.66) in the control group.
Results
The mediation model explained 67.57 % of the variance in NS, with age as a covariate. RMET showed a significant indirect effect (d = −0.22) in predicting NS, while HT did not (d = −0.12). In the patient group, multiple regression analysis explained 69.2 % of the variance, with education emerging as a significant predictor of NS.
Conclusions
Education, as an indicator of cognitive reserve, significantly predicts NS. This relationship is mediated by social cognition, with differential effects depending on the specific type of social cognition, either within the patient group or across the entire sample. These findings highlight the importance of cognitive reserve and social cognition in understanding and potentially mitigating NS in schizophrenia.
{"title":"Relationship between cognitive reserve (education), social cognition and negative symptoms","authors":"Sebastián Lema Spinelli , Juan Francisco Rodríguez-Testal , Álvaro Cabana , Sandra Romano , Leonel Gómez-Sena","doi":"10.1016/j.scog.2025.100379","DOIUrl":"10.1016/j.scog.2025.100379","url":null,"abstract":"<div><h3>Background</h3><div>Negative symptoms (NS) are a core feature of schizophrenia spectrum disorders, yet their relationship with cognitive reserve (defined by educational attainment) and social cognition remains underexplored. This study examined whether education predicts NS and whether this relationship is mediated by social cognition, specifically emotional or inferential theory of mind Reading the Mind in the Eyes Test (RMET) vs. the Hinting Test.</div></div><div><h3>Methods</h3><div>A mediation model and multiple regression analysis were conducted within an ex-post-facto, cross-sectional design. The sample included 144 participants: 69 diagnosed with schizophrenia spectrum disorders and 75 healthy controls. Women comprised 52.8 % of the sample, with a mean age of 42.67 years (<em>SD</em> = 15.88). The average years of formal education were 8.37 (<em>SD</em> = 2.77) in the patient group and 8.62 (<em>SD</em> = 3.66) in the control group.</div></div><div><h3>Results</h3><div>The mediation model explained 67.57 % of the variance in NS, with age as a covariate. RMET showed a significant indirect effect (<em>d</em> = −0.22) in predicting NS, while HT did not (<em>d</em> = −0.12). In the patient group, multiple regression analysis explained 69.2 % of the variance, with education emerging as a significant predictor of NS.</div></div><div><h3>Conclusions</h3><div>Education, as an indicator of cognitive reserve, significantly predicts NS. This relationship is mediated by social cognition, with differential effects depending on the specific type of social cognition, either within the patient group or across the entire sample. These findings highlight the importance of cognitive reserve and social cognition in understanding and potentially mitigating NS in schizophrenia.</div></div>","PeriodicalId":38119,"journal":{"name":"Schizophrenia Research-Cognition","volume":"42 ","pages":"Article 100379"},"PeriodicalIF":2.3,"publicationDate":"2025-07-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144670694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Effort allocation is a crucial component of amotivation in schizophrenia. This study investigates the hypothesis that schizophrenia is associated with impairments in dynamic cost/benefit decision-making processes.
Study design
We employed a modified version of the effort allocation task developed by Meyniel et al. (2013). Participants were asked to allocate effort during 30-s intervals to maximize their gains. We examined the effects of task difficulty and incentive levels on participants' effort allocation on a trial-by-trial basis.
Study results
Individuals with schizophrenia (N = 25) showed decreased capacity to adapt dynamically to task parameters, as compared to healthy controls (N = 25). (1) Both populations increased the duration of each effort based on difficulty. Only healthy controls decreased rest duration based on incentive. The magnitude of these adaptations was significantly decreased in people with schizophrenia (difficulty: d = 1.25, incentive: d = 0.91). (2) Both groups decreased effort re-initiations with increasing difficulty with significant differences in the magnitude of adaptation between groups. (3) Participants with schizophrenia spent less time exerting effort above the required threshold, resulting in lower overall gains compared to healthy controls (η2 = 0.17).
Conclusions
Individuals with schizophrenia exhibit a selective impairment in effort-cost decision-making. This deficit may contribute to maladaptive behavior patterns characterized by suboptimal effort allocation and reduced goal-direct activities.
{"title":"Impaired effort allocation in schizophrenia","authors":"Elodie Blouzard , Fabien Cignetti , Florent Meyniel , Arnaud Pouchon , Mircea Polosan , Julien Bastin , Clément Dondé","doi":"10.1016/j.scog.2025.100378","DOIUrl":"10.1016/j.scog.2025.100378","url":null,"abstract":"<div><h3>Background and hypothesis</h3><div>Effort allocation is a crucial component of amotivation in schizophrenia. This study investigates the hypothesis that schizophrenia is associated with impairments in dynamic cost/benefit decision-making processes.</div></div><div><h3>Study design</h3><div>We employed a modified version of the effort allocation task developed by Meyniel et al. (2013). Participants were asked to allocate effort during 30-s intervals to maximize their gains. We examined the effects of task difficulty and incentive levels on participants' effort allocation on a trial-by-trial basis.</div></div><div><h3>Study results</h3><div>Individuals with schizophrenia (<em>N</em> = 25) showed decreased capacity to adapt dynamically to task parameters, as compared to healthy controls (N = 25). (1) Both populations increased the duration of each effort based on difficulty. Only healthy controls decreased rest duration based on incentive. The magnitude of these adaptations was significantly decreased in people with schizophrenia (difficulty: d = 1.25, incentive: d = 0.91). (2) Both groups decreased effort re-initiations with increasing difficulty with significant differences in the magnitude of adaptation between groups. (3) Participants with schizophrenia spent less time exerting effort above the required threshold, resulting in lower overall gains compared to healthy controls (η<sup>2</sup> = 0.17).</div></div><div><h3>Conclusions</h3><div>Individuals with schizophrenia exhibit a selective impairment in effort-cost decision-making. This deficit may contribute to maladaptive behavior patterns characterized by suboptimal effort allocation and reduced goal-direct activities.</div></div>","PeriodicalId":38119,"journal":{"name":"Schizophrenia Research-Cognition","volume":"42 ","pages":"Article 100378"},"PeriodicalIF":2.3,"publicationDate":"2025-07-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144633120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
This study evaluated awareness, management, and the burden of cognitive impairment associated with schizophrenia (CIAS) in Japan. A non-interventional, cross-sectional study was conducted online between April and December 2023, involving 149 psychiatrists and 852 patients. Psychiatrists prioritized controlling positive symptoms in the acute phase of the illness, while improving social functioning was the top priority for the maintenance/stable phase. Management of CIAS was regarded as most important for the reintegration of patients into society. Psychiatrists reported higher occurrence of CIAS among inpatients than outpatients. While 72 % of psychiatrists assessed CIAS, only 15 % used the Brief Assessment of Cognition in Schizophrenia. Further, 58 % of them reported that ≤40 % of their patients received interventions for CIAS. Sixty-eight percent of patients reported current or previous experiences of CIAS. The most common CIAS-related burdens were “unable to perform tasks I could do before or they take longer” (65 %) and “unable to maintain concentration” (64 %). In patients not currently experiencing CIAS (n = 496), these burdens were reported by 52 % and 50 %, respectively. Although CIAS was generally recognized by psychiatrists, the use of appropriate assessment tools and interventions was not common. While many patients reported CIAS-related burdens, a substantial proportion of them were unaware of CIAS. These observations indicate that the greater awareness of CIAS may facilitate its management in clinical practice, thus enhancing the ability of patients to reintegrate into society.
{"title":"Awareness and management of cognitive impairment associated with schizophrenia in psychiatrists and patients: Results from a cross-sectional survey","authors":"Tomiki Sumiyoshi , Satoru Ikezawa , Kaori Inaba , Tatsuro Marumoto , Ichiro Kusumi , Kazuyuki Nakagome","doi":"10.1016/j.scog.2025.100375","DOIUrl":"10.1016/j.scog.2025.100375","url":null,"abstract":"<div><div>This study evaluated awareness, management, and the burden of cognitive impairment associated with schizophrenia (CIAS) in Japan. A non-interventional, cross-sectional study was conducted online between April and December 2023, involving 149 psychiatrists and 852 patients. Psychiatrists prioritized controlling positive symptoms in the acute phase of the illness, while improving social functioning was the top priority for the maintenance/stable phase. Management of CIAS was regarded as most important for the reintegration of patients into society. Psychiatrists reported higher occurrence of CIAS among inpatients than outpatients. While 72 % of psychiatrists assessed CIAS, only 15 % used the Brief Assessment of Cognition in Schizophrenia. Further, 58 % of them reported that ≤40 % of their patients received interventions for CIAS. Sixty-eight percent of patients reported current or previous experiences of CIAS. The most common CIAS-related burdens were “unable to perform tasks I could do before or they take longer” (65 %) and “unable to maintain concentration” (64 %). In patients not currently experiencing CIAS (<em>n</em> = 496), these burdens were reported by 52 % and 50 %, respectively. Although CIAS was generally recognized by psychiatrists, the use of appropriate assessment tools and interventions was not common. While many patients reported CIAS-related burdens, a substantial proportion of them were unaware of CIAS. These observations indicate that the greater awareness of CIAS may facilitate its management in clinical practice, thus enhancing the ability of patients to reintegrate into society.</div></div>","PeriodicalId":38119,"journal":{"name":"Schizophrenia Research-Cognition","volume":"42 ","pages":"Article 100375"},"PeriodicalIF":2.3,"publicationDate":"2025-06-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144502164","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Schizophrenia spectrum disorders (SSDs) significantly impact daily functioning, particularly through cognitive deficits like memory impairment. Traditionally attributed to neurobiological factors, recent evidence highlights the role of psychological processes like detachment, which may disrupt episodic memory encoding and retrieval by impairing feature binding. This study used a virtual reality (VR) paradigm to explore whether state detachment in SSDs is linked to impaired feature binding for adverse stimuli.
Methods
Twenty-five SSD patients from Dutch mental health centers and 25 individuals from the general population participated. Using an immersive VR paradigm, participants navigated a virtual shopping mall, interacted with 3D avatars, and identified their emotional facial expressions. Three memory tests followed: avatar identity recognition (basic memory), binding emotional expressions to avatars, and binding avatar identity to the encounter's temporal order. State detachment was measured using the Clinician-Administered Dissociative States Scale (CADSS).
Results
The SSD and comparison group did not display significant performance differences in any of the three feature binding tasks. However, across groups, results indicated that higher state detachment levels corresponded with worsened identity-emotion binding specifically for angry faces.
Conclusion
The present study provides tentative empirical support for the role of detachment in feature binding deficits for angry faces both in the patient and comparison group. Future studies should further explore the impact of psychological mechanisms like detachment on memory dysfunction, particularly regarding aversive stimuli.
{"title":"Feature binding and detachment in psychosis: A virtual reality study","authors":"A.J. (Ante) Schlesselmann , G.H.M. (Marieke) Pijnenborg , S.A. (Saskia) Nijman , W. (Wim) Veling , R.J.C. (Rafaele) Huntjens","doi":"10.1016/j.scog.2025.100376","DOIUrl":"10.1016/j.scog.2025.100376","url":null,"abstract":"<div><h3>Background</h3><div>Schizophrenia spectrum disorders (SSDs) significantly impact daily functioning, particularly through cognitive deficits like memory impairment. Traditionally attributed to neurobiological factors, recent evidence highlights the role of psychological processes like detachment, which may disrupt episodic memory encoding and retrieval by impairing feature binding. This study used a virtual reality (VR) paradigm to explore whether state detachment in SSDs is linked to impaired feature binding for adverse stimuli.</div></div><div><h3>Methods</h3><div>Twenty-five SSD patients from Dutch mental health centers and 25 individuals from the general population participated. Using an immersive VR paradigm, participants navigated a virtual shopping mall, interacted with 3D avatars, and identified their emotional facial expressions. Three memory tests followed: avatar identity recognition (basic memory), binding emotional expressions to avatars, and binding avatar identity to the encounter's temporal order. State detachment was measured using the Clinician-Administered Dissociative States Scale (CADSS).</div></div><div><h3>Results</h3><div>The SSD and comparison group did not display significant performance differences in any of the three feature binding tasks. However, across groups, results indicated that higher state detachment levels corresponded with worsened identity-emotion binding specifically for angry faces.</div></div><div><h3>Conclusion</h3><div>The present study provides tentative empirical support for the role of detachment in feature binding deficits for angry faces both in the patient and comparison group. Future studies should further explore the impact of psychological mechanisms like detachment on memory dysfunction, particularly regarding aversive stimuli.</div></div>","PeriodicalId":38119,"journal":{"name":"Schizophrenia Research-Cognition","volume":"42 ","pages":"Article 100376"},"PeriodicalIF":2.3,"publicationDate":"2025-06-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144480746","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-21DOI: 10.1016/j.scog.2025.100373
Amélie M. Achim , Elisabeth Thibaudeau , Frédéric Haesebaert , Audrey Cayouette , Caroline Cellard
Background
People with schizophrenia spectrum disorders (SSD) often present with impaired social cognition. Among the measures available to assess these deficits, the Combined stories test (COST) and the Social knowledge test (SKT), that respectively target theory of mind (ToM) and social knowledge, have shown promising psychometric properties in prior studies. Test-retest reliability was however only examined in the general population, and the acceptability of these tests was not previously examined. This study aimed to further document the psychometric properties of the COST and the SKT and the acceptability of these tests in people with SSD and community controls (CO).
Methods
Forty-four (44) participants with SSD and 49 CO were administered the COST and SKT twice, about 4 weeks apart, and were asked to rate the acceptability of the tests on a 0 (Very unpleasant) to 10 (Very pleasant) point scale at both timepoints.
Results
In both groups, the results revealed an excellent inter-rater reliability and a good test-retest reliability for both tests, though the control non-social reasoning measure included in the COST showed poorer test-retest reliability in the SSD group. Some practice effects were observed but the ToM score from the COST and the SKT total score showed no evidence of ceiling effects at either timepoints. The average acceptability scores ranged between 7.8/10 and 8.3/10 for the COST and between 6.8/10 and 7.9/10 for the SKT.
Conclusion
The SKT and the COST present with good psychometric properties, representing good options for future studies or for use in clinical practice.
{"title":"Psychometric properties of the Social knowledge test (SKT) and the Combined stories test (COST) in people with a schizophrenia spectrum disorder","authors":"Amélie M. Achim , Elisabeth Thibaudeau , Frédéric Haesebaert , Audrey Cayouette , Caroline Cellard","doi":"10.1016/j.scog.2025.100373","DOIUrl":"10.1016/j.scog.2025.100373","url":null,"abstract":"<div><h3>Background</h3><div>People with schizophrenia spectrum disorders (SSD) often present with impaired social cognition. Among the measures available to assess these deficits, the Combined stories test (COST) and the Social knowledge test (SKT), that respectively target theory of mind (ToM) and social knowledge, have shown promising psychometric properties in prior studies. Test-retest reliability was however only examined in the general population, and the acceptability of these tests was not previously examined. This study aimed to further document the psychometric properties of the COST and the SKT and the acceptability of these tests in people with SSD and community controls (CO).</div></div><div><h3>Methods</h3><div>Forty-four (44) participants with SSD and 49 CO were administered the COST and SKT twice, about 4 weeks apart, and were asked to rate the acceptability of the tests on a 0 (Very unpleasant) to 10 (Very pleasant) point scale at both timepoints.</div></div><div><h3>Results</h3><div>In both groups, the results revealed an excellent inter-rater reliability and a good test-retest reliability for both tests, though the control non-social reasoning measure included in the COST showed poorer test-retest reliability in the SSD group. Some practice effects were observed but the ToM score from the COST and the SKT total score showed no evidence of ceiling effects at either timepoints. The average acceptability scores ranged between 7.8/10 and 8.3/10 for the COST and between 6.8/10 and 7.9/10 for the SKT.</div></div><div><h3>Conclusion</h3><div>The SKT and the COST present with good psychometric properties, representing good options for future studies or for use in clinical practice.</div></div>","PeriodicalId":38119,"journal":{"name":"Schizophrenia Research-Cognition","volume":"42 ","pages":"Article 100373"},"PeriodicalIF":2.3,"publicationDate":"2025-06-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144329983","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-18DOI: 10.1016/j.scog.2025.100374
J.B. Schulze , F. Simnacher , T.J. Müller , J. Kirchebner , F. Quatela , C. Mikutta , S. Euler , R. von Känel , M.P. Günther
Introduction
Attention deficit hyperactivity disorder (ADHD) diagnosed in childhood is associated with a relative risk of 4.74 (95 % CI, 4.11–5.46) for developing schizophrenia spectrum disorder (SSD) later in life; if other comorbidities exist the risk is 2.1-fold higher. There is no guideline on treating ADHD in SSD and no research on the effect of this combination on length of inpatient treatment, type of pharmacotherapy and employment status. This study aims to further explore the role of ADHD in SSD.
Methods
Latent Class Analysis (LCA) uses no a priori assumptions in testing for homogeneous subgroups within a data sample of 2871 inpatient treatment cases of SSD from three psychiatric hospitals. Data was extracted from case files and statistical reports to the federal statistical office.
Results
Two subgroups are identified. One primarily consists of individuals with SSD and ADHD (estimated population size of 3 %). In comparison to the other subgroup with SSD and no ADHD (97 %), these individuals more frequently have other mental comorbidities, especially substance use disorders, are unemployed and about half are administered stimulants. All studied individuals were administered antipsychotics and length of inpatient stay was similar in both subgroups.
Conclusion
ADHD and SSD define a subgroup of individuals with specific treatment needs and additional burden of disease. ADHD is more than an initial misdiagnosis or random precursor disease of SSD. Treating psychiatrists seem to frequently administer stimulants.
{"title":"ADHD and schizophrenia: Mere prodromal variant or homogeneous subgroup?","authors":"J.B. Schulze , F. Simnacher , T.J. Müller , J. Kirchebner , F. Quatela , C. Mikutta , S. Euler , R. von Känel , M.P. Günther","doi":"10.1016/j.scog.2025.100374","DOIUrl":"10.1016/j.scog.2025.100374","url":null,"abstract":"<div><h3>Introduction</h3><div>Attention deficit hyperactivity disorder (ADHD) diagnosed in childhood is associated with a relative risk of 4.74 (95 % CI, 4.11–5.46) for developing schizophrenia spectrum disorder (SSD) later in life; if other comorbidities exist the risk is 2.1-fold higher. There is no guideline on treating ADHD in SSD and no research on the effect of this combination on length of inpatient treatment, type of pharmacotherapy and employment status. This study aims to further explore the role of ADHD in SSD.</div></div><div><h3>Methods</h3><div>Latent Class Analysis (LCA) uses no a priori assumptions in testing for homogeneous subgroups within a data sample of 2871 inpatient treatment cases of SSD from three psychiatric hospitals. Data was extracted from case files and statistical reports to the federal statistical office.</div></div><div><h3>Results</h3><div>Two subgroups are identified. One primarily consists of individuals with SSD and ADHD (estimated population size of 3 %). In comparison to the other subgroup with SSD and no ADHD (97 %), these individuals more frequently have other mental comorbidities, especially substance use disorders, are unemployed and about half are administered stimulants. All studied individuals were administered antipsychotics and length of inpatient stay was similar in both subgroups.</div></div><div><h3>Conclusion</h3><div>ADHD and SSD define a subgroup of individuals with specific treatment needs and additional burden of disease. ADHD is more than an initial misdiagnosis or random precursor disease of SSD. Treating psychiatrists seem to frequently administer stimulants.</div></div>","PeriodicalId":38119,"journal":{"name":"Schizophrenia Research-Cognition","volume":"42 ","pages":"Article 100374"},"PeriodicalIF":2.3,"publicationDate":"2025-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144306712","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-10DOI: 10.1016/j.scog.2025.100358
Anika Poppe , Leonie Bais , Daniëlle van Duin , Branislava Ćurčić-Blake , Gerdina Hendrika Maria Pijnenborg , Lisette van der Meer
Background and hypothesis
Cognitive impairments are commonly experienced by individuals with severe mental illness (SMI) and are associated with problems in everyday life. This pragmatic, randomized, controlled, pilot trial explored the acceptability, feasibility, and preliminary effects of cognitive remediation (CR) combined with transcranial direct current stimulation (tDCS) for cognitive and everyday functioning in individuals with SMI in long-term psychiatric clinical care. We hypothesized that combining CR and tDCS is feasible and acceptable to individuals with SMI.
Study design
Twenty-four individuals with SMI were randomized to either CR + active tDCS (n = 13) or CR + sham tDCS (n = 11) over 32 sessions (16 weeks). Acceptability was evaluated in semi-structured interviews. Cognitive and everyday functioning were evaluated at baseline, post-16 week waiting period, post-intervention, and 6-months post-intervention.
Study results
Overall, participants were positive about the training. Over 60 % of participants successfully finished at least 20 sessions, meeting the predefined criteria for feasibility. CR appeared to yield subjective improvements to participants, significant improvements in cognitive tests post-intervention and at follow-up and improved self-reported negative symptoms at follow-up. Observer-rated everyday functioning and cognition, and subjective cognitive complaints did not change following CR.
Conclusions
This study concludes that CR is an acceptable and feasible intervention for individuals with SMI in long-term psychiatric clinical care. The addition of tDCS requires further investigation to ascertain its potential benefits.
{"title":"Feasibility and acceptability of combining cognitive remediation and tDCS in long-term psychiatric clinical care","authors":"Anika Poppe , Leonie Bais , Daniëlle van Duin , Branislava Ćurčić-Blake , Gerdina Hendrika Maria Pijnenborg , Lisette van der Meer","doi":"10.1016/j.scog.2025.100358","DOIUrl":"10.1016/j.scog.2025.100358","url":null,"abstract":"<div><h3>Background and hypothesis</h3><div>Cognitive impairments are commonly experienced by individuals with severe mental illness (SMI) and are associated with problems in everyday life. This pragmatic, randomized, controlled, pilot trial explored the acceptability, feasibility, and preliminary effects of cognitive remediation (CR) combined with transcranial direct current stimulation (tDCS) for cognitive and everyday functioning in individuals with SMI in long-term psychiatric clinical care. We hypothesized that combining CR and tDCS is feasible and acceptable to individuals with SMI.</div></div><div><h3>Study design</h3><div>Twenty-four individuals with SMI were randomized to either CR + active tDCS (<em>n</em> = 13) or CR + sham tDCS (<em>n</em> = 11) over 32 sessions (16 weeks). Acceptability was evaluated in semi-structured interviews. Cognitive and everyday functioning were evaluated at baseline, post-16 week waiting period, post-intervention, and 6-months post-intervention.</div></div><div><h3>Study results</h3><div>Overall, participants were positive about the training. Over 60 % of participants successfully finished at least 20 sessions, meeting the predefined criteria for feasibility. CR appeared to yield subjective improvements to participants, significant improvements in cognitive tests post-intervention and at follow-up and improved self-reported negative symptoms at follow-up. Observer-rated everyday functioning and cognition, and subjective cognitive complaints did not change following CR.</div></div><div><h3>Conclusions</h3><div>This study concludes that CR is an acceptable and feasible intervention for individuals with SMI in long-term psychiatric clinical care. The addition of tDCS requires further investigation to ascertain its potential benefits.</div></div>","PeriodicalId":38119,"journal":{"name":"Schizophrenia Research-Cognition","volume":"42 ","pages":"Article 100358"},"PeriodicalIF":2.3,"publicationDate":"2025-06-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144253501","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-06-02DOI: 10.1016/j.scog.2025.100371
Noaz Cohen , Mark Weiser , Abraham Reichenberg , John M. Davis , Michael Davidson , Nomi Werbeloff
Background
Cognitive impairment, a core feature of schizophrenia, is often evident before the onset of illness. The current study aimed to quantify IQ decline following the onset of illness by conducting a meta-analysis of longitudinal studies that evaluated cognitive functioning both before and after the first psychotic episode. Consistency in measurement tools – i.e. whether the same measurement tool was used at both assessments – was considered a potential moderating variable.
Method
Eleven studies were included in the meta-analysis - seven using the same measurement tool at both time-points and four using different tools. In addition, meta-regression explored whether the magnitude of IQ decline was associated with age at baseline.
Results
The meta-analysis effect size was −0.343 (95 % CI: −0.503 to −0.184), equivalent to a decrease of 5 IQ points. Use of the same (SMD −0.321, 95 % CI: −0.501 to −0.142) vs different (SMD −0.427, 95 % CI: −0.777 to −0.077) measurement tools was not a moderator of IQ change (p = 0.279). The meta-regression results were not significant (p = 0.544).
Conclusion
The current meta-analysis indicates a slight cognitive decline from the premorbid stage to post-onset. The use of different measurement tools yielded a slightly larger effect size and greater heterogeneity, suggesting that employing the same assessment tool could lead to more accurate results. Future longitudinal studies should focus on determining the timeline of cognitive decline.
{"title":"Cognitive changes in schizophrenia before and after illness onset: A meta-analysis examining consistency in measurement tools as a moderator","authors":"Noaz Cohen , Mark Weiser , Abraham Reichenberg , John M. Davis , Michael Davidson , Nomi Werbeloff","doi":"10.1016/j.scog.2025.100371","DOIUrl":"10.1016/j.scog.2025.100371","url":null,"abstract":"<div><h3>Background</h3><div>Cognitive impairment, a core feature of schizophrenia, is often evident before the onset of illness. The current study aimed to quantify IQ decline following the onset of illness by conducting a meta-analysis of longitudinal studies that evaluated cognitive functioning both before and after the first psychotic episode. Consistency in measurement tools – i.e. whether the same measurement tool was used at both assessments – was considered a potential moderating variable.</div></div><div><h3>Method</h3><div>Eleven studies were included in the meta-analysis - seven using the same measurement tool at both time-points and four using different tools. In addition, meta-regression explored whether the magnitude of IQ decline was associated with age at baseline.</div></div><div><h3>Results</h3><div>The meta-analysis effect size was −0.343 (95 % CI: −0.503 to −0.184), equivalent to a decrease of 5 IQ points. Use of the same (SMD −0.321, 95 % CI: −0.501 to −0.142) vs different (SMD −0.427, 95 % CI: −0.777 to −0.077) measurement tools was not a moderator of IQ change (<em>p</em> = 0.279). The meta-regression results were not significant (<em>p</em> = 0.544).</div></div><div><h3>Conclusion</h3><div>The current meta-analysis indicates a slight cognitive decline from the premorbid stage to post-onset. The use of different measurement tools yielded a slightly larger effect size and greater heterogeneity, suggesting that employing the same assessment tool could lead to more accurate results. Future longitudinal studies should focus on determining the timeline of cognitive decline.</div></div>","PeriodicalId":38119,"journal":{"name":"Schizophrenia Research-Cognition","volume":"41 ","pages":"Article 100371"},"PeriodicalIF":2.3,"publicationDate":"2025-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144190157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-05-26DOI: 10.1016/j.scog.2025.100370
Lotte Veddum , Anette Faurskov Bundgaard , Andreas Færgemand Laursen , Sanciya Mano Perfalk , Maja Gregersen , Mette Falkenberg Krantz , Birgitte Klee Burton , Camilla Jerlang Christiani , Ditte Ellersgaard , Sinnika Birkehøj Rohd , Marta Schiavon , Doris Helena Bjarnadóttir Streymá , Jens Richardt Møllegaard Jepsen , Kerstin Plessen , Nicoline Hemager , Anne Amalie Elgaard Thorup , Merete Nordentoft , Ole Mors , Aja Neergaard Greve
Schizophrenia and bipolar disorder are associated with social cognitive impairments, but knowledge on social cognition in offspring of parents with these disorders is sparse. Moreover, investigations of the potential transgenerational transmission of social cognition in at-risk families are lacking. Therefore, we aimed to investigate social perception in parents with schizophrenia or bipolar disorder and their adolescent offspring and population-based controls (PBC).
This study is part of The Danish High Risk and Resilience Study, a prospective familial high-risk study of families with parental schizophrenia (n = 202) or bipolar disorder (n = 120) and PBC (n = 200). Social perception was assessed with The Awareness of Social Inferences Task, Part 2A, including a total score and the subscales sincere, simple sarcasm, and paradoxical sarcasm.
Parents with schizophrenia showed poorer performance on the total scale (p < 0.007, d = 0.33) and the paradoxical sarcasm subscale (p < 0.003, d = 0.35) compared with PBC parents. We found no difference between parents with bipolar disorder and PBC parents or between the adolescent offspring. We found no significant interaction effect of familial high-risk status on any association (p ≤ 0.093), but the parents' and their adolescent offspring's social perception was positively and significantly associated on the total scale (p < 0.001), the sincere subscale (p = 0.005), and the simple sarcasm subscale (p = 0.010), but not the paradoxical sarcasm subscale (p = 0.052).
Our findings of transgenerational transmission of social perception in families with parental schizophrenia or bipolar disorder and PBC call for further longitudinal research to determine how social cognitive deficits are transmitted from parents to their offspring.
{"title":"Social perception in parents with schizophrenia or bipolar disorder and their adolescent offspring – The Danish High Risk and Resilience Study","authors":"Lotte Veddum , Anette Faurskov Bundgaard , Andreas Færgemand Laursen , Sanciya Mano Perfalk , Maja Gregersen , Mette Falkenberg Krantz , Birgitte Klee Burton , Camilla Jerlang Christiani , Ditte Ellersgaard , Sinnika Birkehøj Rohd , Marta Schiavon , Doris Helena Bjarnadóttir Streymá , Jens Richardt Møllegaard Jepsen , Kerstin Plessen , Nicoline Hemager , Anne Amalie Elgaard Thorup , Merete Nordentoft , Ole Mors , Aja Neergaard Greve","doi":"10.1016/j.scog.2025.100370","DOIUrl":"10.1016/j.scog.2025.100370","url":null,"abstract":"<div><div>Schizophrenia and bipolar disorder are associated with social cognitive impairments, but knowledge on social cognition in offspring of parents with these disorders is sparse. Moreover, investigations of the potential transgenerational transmission of social cognition in at-risk families are lacking. Therefore, we aimed to investigate social perception in parents with schizophrenia or bipolar disorder and their adolescent offspring and population-based controls (PBC).</div><div>This study is part of The Danish High Risk and Resilience Study, a prospective familial high-risk study of families with parental schizophrenia (<em>n</em> = 202) or bipolar disorder (<em>n</em> = 120) and PBC (<em>n</em> = 200). Social perception was assessed with The Awareness of Social Inferences Task, Part 2A, including a total score and the subscales sincere, simple sarcasm, and paradoxical sarcasm.</div><div>Parents with schizophrenia showed poorer performance on the total scale (<em>p</em> < 0.007, <em>d</em> = 0.33) and the paradoxical sarcasm subscale (<em>p</em> < 0.003, <em>d</em> = 0.35) compared with PBC parents. We found no difference between parents with bipolar disorder and PBC parents or between the adolescent offspring. We found no significant interaction effect of familial high-risk status on any association (<em>p</em> ≤ 0.093), but the parents' and their adolescent offspring's social perception was positively and significantly associated on the total scale (<em>p</em> < 0.001), the sincere subscale (<em>p</em> = 0.005), and the simple sarcasm subscale (<em>p</em> = 0.010), but not the paradoxical sarcasm subscale (<em>p</em> = 0.052).</div><div>Our findings of transgenerational transmission of social perception in families with parental schizophrenia or bipolar disorder and PBC call for further longitudinal research to determine how social cognitive deficits are transmitted from parents to their offspring.</div></div>","PeriodicalId":38119,"journal":{"name":"Schizophrenia Research-Cognition","volume":"41 ","pages":"Article 100370"},"PeriodicalIF":2.3,"publicationDate":"2025-05-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144139674","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-05-24DOI: 10.1016/j.scog.2025.100368
H. Honcamp , L.K. Goller , M. Amorim , S.X. Duggirala , J.F. Johnson , M. Schwartze , A.P. Pinheiro , S.A. Kotz
Background
Previous research on the multidimensionality of hallucination-like experiences (HLEs) across the psychosis continuum highlights methodological disparities, emphasizing the need for a cautious interpretation of findings and transparent reporting of parameters used in the analysis.
Methods
This study aimed to refine the factorial structure of the 16-item Launay-Slade Hallucination Scale (LSHS), enhance methodological clarity, and improve the robustness of LSHS factor solutions. To this end, an Exploratory Factor Analysis (EFA) was performed on a heterogeneous sample (N = 278) with specified parameters (e.g., estimation procedure) that remain true to data characteristics and assumptions underlying EFA.
Results
The results revealed a four-factor structure including “Multisensory HLEs”, “Auditory daydreaming”, “Vivid thoughts and inner speech”, and “Personified HLEs”. Our investigation introduces a new factor specific to the perceived presence of another person or another voice. This aligns with theories on self-monitoring difficulties associated with an external attribution bias as hallucination proneness (HP) increases across the continuum.
Conclusion
The current results provide an opportunity for investigating neurophysiological and neurobehavioral correlates of HP considering highly differentiated individual profiles of HLEs. Future studies should focus on validating the robustness of the four-factor structure derived from this research across diverse samples of the general population (e.g., different age groups and cultural backgrounds). Specified composite scores underlying HLEs could be of additive value when assessing emerging clinical risk on the psychosis continuum.
{"title":"Multidimensionality of hallucination-like experiences: A factor structure refinement of the Launay-Slade Hallucination Scale","authors":"H. Honcamp , L.K. Goller , M. Amorim , S.X. Duggirala , J.F. Johnson , M. Schwartze , A.P. Pinheiro , S.A. Kotz","doi":"10.1016/j.scog.2025.100368","DOIUrl":"10.1016/j.scog.2025.100368","url":null,"abstract":"<div><h3>Background</h3><div>Previous research on the multidimensionality of hallucination-like experiences (HLEs) across the psychosis continuum highlights methodological disparities, emphasizing the need for a cautious interpretation of findings and transparent reporting of parameters used in the analysis.</div></div><div><h3>Methods</h3><div>This study aimed to refine the factorial structure of the 16-item Launay-Slade Hallucination Scale (LSHS), enhance methodological clarity, and improve the robustness of LSHS factor solutions. To this end, an Exploratory Factor Analysis (EFA) was performed on a heterogeneous sample (<em>N</em> = 278) with specified parameters (e.g., estimation procedure) that remain true to data characteristics and assumptions underlying EFA.</div></div><div><h3>Results</h3><div>The results revealed a four-factor structure including “Multisensory HLEs”, “Auditory daydreaming”, “Vivid thoughts and inner speech”, and “Personified HLEs”. Our investigation introduces a new factor specific to the perceived presence of another person or another voice. This aligns with theories on self-monitoring difficulties associated with an external attribution bias as hallucination proneness (HP) increases across the continuum.</div></div><div><h3>Conclusion</h3><div>The current results provide an opportunity for investigating neurophysiological and neurobehavioral correlates of HP considering highly differentiated individual profiles of HLEs. Future studies should focus on validating the robustness of the four-factor structure derived from this research across diverse samples of the general population (e.g., different age groups and cultural backgrounds). Specified composite scores underlying HLEs could be of additive value when assessing emerging clinical risk on the psychosis continuum.</div></div>","PeriodicalId":38119,"journal":{"name":"Schizophrenia Research-Cognition","volume":"41 ","pages":"Article 100368"},"PeriodicalIF":2.3,"publicationDate":"2025-05-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144123747","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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