Annie St-Hilaire

Validation of a French version of the impact of event scale-revised.

Objective: This report presents a French translation and validation of the Impact of Event Scale-Revised (IES-R) in a population of women exposed to a natural disaster during or preceding pregnancy. Method: A total of 223 francophone women who were either pregnant at the time of the 1998 ice storm or who became pregnant shortly thereafter completed the IES-R and other questionnaires 6 months after the disaster. Results: The French IES-R has good internal consistency, with alpha coefficients ranging from 0.81 to 0.93 for its 3 subscales and total score. The test–retest reliability of the scale, although examined with another sample, proved to be satisfactory, with correlation coefficients ranging from 0.71 to 0.76 for its 3 subscales and total score. Its convergent validity with perceived life threat and general psychiatric symptoms was judged to be marginally acceptable. Finally, a principal components analysis was conducted and a 3-factor solution, which explained 56% of the variance, was retained: a hyperarousal factor (7 items), an avoidance factor (6 items), and an intrusion factor (6 items). Conclusions: The French version of the IES-R has satisfactory internal validity and test–retest reliability. Further, the factor structure of the translation was similar to the proposed theoretical structure of the IES-R.

Life Events and High-Trait Reactivity Together Predict Psychotic Symptom Increases in Schizophrenia

Psychotic symptoms are exacerbated by stressful life events in schizophrenia patients as a group. Some individuals appear to be more vulnerable than others in this regard. This study tested whether schizophrenia patients are highly emotionally reactive compared with controls and whether the level of trait emotional reactivity in patients influences the degree to which they respond to life stressors with exacerbations of psychosis. Schizophrenic outpatients and nonpsychiatric controls were assessed for levels of trait emotional reactivity, arousability, and trait anxiety. Severity of symptoms was also rated in the patients. Patients were then followed up 9 months later, assessed for independent stressful life events occurring during the month before the follow-up session, and reassessed for symptom levels. The patients scored higher than the control subjects on all 3 measures of reactivity at the initial assessment. At follow-up, the occurrence of potentially stressful life events predicted increases in psychotic symptoms in patients, and there was a significant interaction between level of initial trait reactivity and the occurrence of life events in the prediction of these increases. High-trait-reactive patients showed increases in psychotic symptoms in response to life stressors, whereas low-trait-reactive patients did not. These findings support the idea that patients as a group have higher than normal levels of trait reactivity and also that patients with very high levels of trait reactivity are at elevated risk of psychotic relapse under stress. Such patients might benefit particularly from interventions designed to assist them in coping with potentially stressful life events and circumstances.

Attributional Style in Delusional Patients: A Comparison of Remitted Paranoid, Remitted Nonparanoid, and Current Paranoid Patients With Nonpsychiatric Controls

Many studies have found that people experiencing persecutory delusions have a marked tendency to use external-personal attributions when establishing the causes of negative events. Although nonclinical populations also tend to attribute negative events to external causes, those causes are typically believed to be universal in nature, rather than personal. The central goal of the present study was to investigate whether individuals with remitted persecutory delusions would display this external-personal bias regarding negative events, in comparison to remitted patients whose delusions were not paranoid in nature and to nonpsychiatric controls. Results indicate that currently paranoid patients were significantly more likely than all other groups, including the remitted paranoid group, to use external-personal attributions in negative events. Interestingly, all patient groups also were found to be significantly more likely than the controls to use internal-personal and internal-universal attributions when explaining negative events.

Understanding anhedonia in schizophrenia through lexical analysis of natural speech

Anhedonia is a negative prognostic indicator in schizophrenia. However, the underlying nature of this emotional deficit is unclear. Laboratory studies examining patients’ emotional reactions under controlled circumstances have failed to find evidence for a diminished hedonic response, instead finding that patients’ reactions to laboratory stimuli are characterised by high levels of negative emotion. The present study employed lexical analysis of natural speech in 52 patients and 49 non-patient controls while they discussed separate neutral, pleasant and unpleasant autobiographical memories. Patients with clinically rated anhedonia, versus other patients and controls, showed a dramatic increase in negative emotion expression when discussing pleasurable memories, but they showed no corresponding decrease in positive emotion. These findings provide further evidence that “anhedonia” is more reflective of negative emotional states than the absence of positive ones. These findings also raise questions about how positive and negative emotions can be simultaneously co-activated in patients with schizophrenia.

Emotion word use in the conversational speech of schizophrenia patients

Introduction. Many recent studies have found that, although schizophrenia patients tend to display diminished facial expressions of emotion, they report levels of emotional experiences that are similar to those of controls. Although these findings are very informative, it is unknown whether such dissociation exits for other modalities such as verbal expression of emotion. The purpose of this study was to investigate the association between the use of emotion words during a free speech task and subjective experience of emotion in schizophrenia patients and controls. Methods. Speech samples of 48 schizophrenia patients and 48 nonpsychiatric control individuals were compared on the type and amount of emotional words used, as well as on the level of self-reported stress experienced while providing descriptions of themselves. Results. Groups did not differ in the amount or type of emotion words uttered during the free speech task. Patients, however, found the task more stressful than controls. Emotion word use and subjective emotional experience were not related in either group. Conclusions. Results do not fully support prior findings, but are consistent with the notion of a lack of correspondence between the expression and experience of emotion.

Explaining variation in the premorbid adjustment of schizophrenia patients: the role of season of birth and family history

UNLABELLED Several studies have shown that patients with schizophrenia are more likely to be born in the winter and early spring than at any other time of the year. Furthermore, some studies have reported that winter-born patients differ from non-winter-born patients in terms of risk factors, symptoms, sensory abnormalities and brain morphology. Associations between season of birth and premorbid adjustment (PMA), however, are still unclear. OBJECTIVE The main purpose of this study was to determine whether winter-born and non-winter-born schizophrenia patients differ in terms of PMA and to examine how family history of schizophrenia-spectrum disorders may influence the association. METHOD Data on four PMA dimensions (attention, internalizing, externalizing and social problems) and family history were gathered from 37 schizophrenia patients (26 males and 11 females) and their mothers. RESULTS Non-winter-birth and a positive family history of schizophrenia-spectrum disorders were associated with worse PMA. Results suggest that, although no significant interaction was found, season of birth and family history appear to work together in explaining distinct dimensions of PMA.

Coping in parents of schizophrenia patients with differing degrees of familial exposure to psychosis.

Over the past 50 years, parents have become more involved in the care of their schizophrenic sons and daughters. Although such responsibility can be gratifying, parents frequently report feeling burdened and distressed. These feelings may affect parents’ coping strategies in times of stress. This study examined the effects of family history of psychosis on coping styles in parents of patients. Coping strategies of parents with and without additional first-degree relatives suffering from psychosis (besides the index son or daughter) and controls were compared. As predicted, more family history of psychosis was negatively related to coping ability in parents. Findings suggest that greater familial exposure to psychosis may have an adverse effect on their ability to deal with life stressors. Results are discussed in light of the possible influence of genetic and environmental factors.

Language reactivity and work functioning in schizophrenia

Some studies have found that the speech of certain schizophrenia patients becomes more disordered in stressful laboratory situations. It is unknown, however, whether affective reactivity of speech is associated with stress responsiveness of symptoms in the real world. This study examines whether language-reactive patients report more stress-related impairments in work functioning than language-nonreactive patients. Forty-six patients provided speech samples and completed a work history interview. It was found that the language-reactive patients were more likely than the language-nonreactive patients to endorse items pertaining to social anxiety and difficulty relating to others as reasons for their work difficulties. This suggests that language-reactive patients are more sensitive to social stressors than language-nonreactive patients.