Joel O. Goldberg

Performance of psychiatric inpatients and intellectually deficient individuals on a task that assesses the validity of memory complaints.

A brief psychological screening test, devised by Rey (1964), was developed to assess the validity of memory complaints. Although Rey hypothesized that malingerers would be mislead to perform poorly while even individuals with severe concentration problems could succeed, a review of the literature did not reveal any empirical reports that examined the actual performance of nonmalingering though disturbed patients. Therefore, Reys test was administered to samples of acutely disturbed psychiatric patients (N = 50) and intellectually deficient individuals (N = 16). The results confirmed the criterion proposed by Lezak (1983) and suggested that malingering should be considered among individuals who deny remembering at least 9 of the 15 times of the Rey test.

Regional EEG alpha power, coherence, and behavioral symptomatology in autism spectrum disorder

OBJECTIVE Although distinct patterns of resting brain electrical activity (EEG) and functional connectivity are believed to distinguish individuals with autism spectrum disorders (ASD) from their unimpaired peers, researchers have only recently begun to link patterns of brain activity and connectivity to behavior in ASD. METHOD We examined regional eyes-closed and eyes-open EEG alpha power and coherence at rest in relation to self-reported perceptual and social behavior in 15 adults diagnosed with ASD and a matched comparison group of 16 unimpaired adults. RESULTS The groups did not differ on eyes-closed EEG alpha power or coherence, but adults with ASD showed less alpha suppression for the eyes-open condition than did controls. In the ASD group, preferential attention to detail (perceptual domain) was associated with lower levels of alpha activity and reduced coherence in posterior regions. No relations between social interaction difficulties (social domain) and alpha measures were found for either group alone. CONCLUSIONS These relations suggest that the processing of perceptual details may be carried out by relatively less synchronized neuronal units in adults with ASD, and may be relatively automatic. SIGNIFICANCE Findings are discussed in relation to recent models of narrow minicolumnar brain structure and reduced functional neural connectivity in ASD.

Shyness, sociability, and social dysfunction in schizophrenia

Recent bio-developmental models of shyness traits (Schmidt, L.A., Fox, N.A., 1998. The development and outcomes of childhood shyness. Annals of Child Development 13, 1--20; Schmidt, L.A. Fox, N.A., 1999. Conceptual, biological, and behavioural distinctions among different types of shy children. In: Schmidt, L.A., Schulkin, J. (Eds.), Extreme Fear, Shyness, and Social Phobia: Origins, Biological Mechanisms, and Clinical Outcomes. Oxford University Press, New York, pp. 47--66) have proposed that childhood shyness and early sociability troubles may be a precursor to pervasive social dysfunction in adulthood. An important question in testing the vulnerability model is to determine the severity of shyness among adults who have a serious social dysfunction, such as individuals diagnosed with schizophrenia. The Cheek and Buss Shyness and Sociability Scales (Cheek, J.M., Buss, A.H., 1981. Shyness and sociability. Journal of Personality and Social Psychology 41, 330--339) and the Reznick Retrospective Self-report of Inhibition (Reznick, J.S., Hegeman, I.N., Kaufman, E.R., Woods, S.W., Jacobs, M., 1992. Retrospective and concurrent self-report of behavioural inhibition and their relation to adult mental health. Development and Psychopathology 4, 301--321) were administered to 23 schizophrenia outpatients and 23 control subjects matched for age and sex. The results indicated that individuals with schizophrenia showed significantly more shyness (P<0.004), lower sociability (P<0.02) and more recollections of childhood social troubles (P<0.007) compared with the control group. Within the schizophrenia group, both shyness traits (P<0.04) and limited sociability (P<0.01) were clearly associated with interpersonal dysfunction, while significant correlations were also found between troubled sociability and negative symptoms (P<0.05). The findings of shyness traits, impaired sociability and more recollections of childhood social difficulties among stable outpatients diagnosed with schizophrenia are consistent with predictions based on a bio-developmental shyness vulnerability model.

Autonomic predictors of Stroop performance in young and middle-aged adults.

Although changes in autonomic activity have been extensively examined as responses to cognitive challenges, relatively few studies have used individual differences in autonomic parameters to predict executive performance in healthy adults. Here we examined baseline and task-related changes in heart rate and heart rate variability (measured by respiratory sinus arrhythmia (RSA)) to predict performance of a pictorial Stroop task in a group of 81 healthy adults aged 17-55. Greater autonomic reactivity (increased heart rate and reduced RSA for task performance) was associated with faster colour naming of faces in the Stroop task. Dividing the group by median age revealed that middle-aged adults reduced RSA to a greater degree than their younger counterparts in the context of equivalent performance across groups. Findings suggest that performance of executive function tasks that evoke attentional control may depend in part on the responsiveness of autonomic control parameters via age-dependent mechanisms.

Predictors of medication competence in schizophrenia patients

Competence in self-administration of a drug regimen is related to both treatment adherence and functional outcome. Previous research with middle-aged and older schizophrenia patients suggests a central role for cognitive performance in predicting this competence. We examined the relative and joint contributions of demographic, clinical and cognitive predictors of medication management ability in an age-representative group of patients. The study participants comprised 147 patients with schizophrenia or schizoaffective disorder ranging from 21 to 65 years of age. Measures included demographic variables, current symptoms, subjective treatment response and a battery of cognitive tests. Competence in medication management was indexed with the Medication Management Ability Assessment (MMAA). Multiple regression analyses revealed that cognitive variables accounted for a significant proportion of the variance in MMAA scores over and above the contribution of all other variables. Measures of word recognition and pronunciation, auditory working memory and verbal learning yielded unique contributions to prediction. Positive and negative symptoms and subject treatment evaluations did not independently predict medication competency. This study documents a considerable range in MMAA scores across a demographically broad schizophrenia sample and supports the unique contribution of specific cognitive factors in predicting medication competence.

Benefits of switching from typical to atypical antipsychotic medications: A longitudinal study in a community-based setting

Objective: This study examines the clinical and resource utilization effects of switching stable outpatients with schizophrenia from a typical to an atypical antipsychotic medication. Method: We monitored 43 schizophrenia patients from a community mental health program who tolerated switching from typical to atypical antipsychotic medications. We used the Positive and Negative Syndrome Scale (PANSS), Lehman Quality of Life Interview (QOL), and service utilization data for 2 years before and 2 years after the switch. Results: The switch to atypical antipsychotics was associated with significant improvements in positive symptoms, in general psychopathology, and in quality of life. Resource requirements, including case-management and crisis services and hospitalization days, were significantly reduced. We observed no changes in the samples already low levels of negative symptoms. Conclusions: In stable outpatients with schizophrenia in a real-world setting, switching to an atypical antipsychotic can result in sustained, significant improvement in clinical response and quality of life, as well as in reduced need for hospitalization and community support,.

An event-related source localization study of response monitoring and social impairments in autism spectrum disorder.

A number of studies suggest anterior cingulate cortex (ACC) abnormalities in autism spectrum disorder (ASD), which might underlie response monitoring and social impairments exhibited by children and adolescents with ASD. The goal of the present study was to extend this work by examining error and correct response monitoring using event-related potentials (ERN, Pe, CRN) and LORETA source localization in high functioning adults with ASD and controls. Adults with ASD showed reduced ERN and Pe amplitudes and reduced rostral ACC activation compared with controls. Adults with ASD also showed less differentiation between error and correct ERP components. Social impairments and higher overall autism symptoms were related to reduced rostral ACC activity at the time of the ERN, particularly in adults with ASD. These findings suggest that reduced ACC activity may reflect a putative brain mechanism involved in the origins and maintenance of social impairments and raise the possibility of the presence of stable brain-behavior relation impairment across development in some individuals with ASD.

What's in a name? The MMPI-2 PTSD scales

The MMPI-2 post-traumatic stress disorder scales (PK and PS) were examined with a sample of 96 outpatient anxiety disorder and 97 outpatient traffic accident subjects. PK and PS correlated .96 and showed highly similar correlations with MMPI-2 validity, clinical, content and supplementary scales for both groups, which indicated that these scales are indices of MMPI first-factor variance. This was supported by separate principal components analyses for each group, in which PK and PS contributed the most variance to the first component. Although the groups showed different MMPI-2 mean profiles, neither PK nor PS contributed to discriminant function classification of group members. It is suggested that PK and PS are indices of general emotional distress and maladjustment; implications for their use in diagnosing post-traumatic stress disorder were discussed.

Self-Stigma of Mental Illness in High School Youth

Despite the prevalence of mental health problems, society continues to stigmatize and discriminate against people with mental illness and in particular, schizophrenia. Among the negative consequences of stigma, is that some individuals with mental illness internalize negative stereotypes about themselves, referred to as self-stigma, which is associated with a reluctance to seek needed treatment. The challenge to overcome mental illness stigma has led to the development of global anti-stigma initiatives, which effectively engage young people in school-based programs. The present study examines the effectiveness of a single-session anti-stigma intervention with high school youth (n = 254). The findings replicate and extend previous work demonstrating that a brief anti-stigma initiative can produce significant improvements in knowledge, social distance, and self-stigma. Self-stigma was found to be associated with low self-esteem and factors affecting self-disclosure were identified. Implications for school curricula, mental health policy, and future research are discussed.

WAIS-IV Profile of Cognition in Schizophrenia

The Wechsler Adult Intelligence Scale (WAIS) has been used extensively to study impairment across a range of cognitive domains in schizophrenia. However, cognitive performance among those with the illness has yet to be examined using the newest edition of this measure. Hence, the current study aims first, to provide WAIS-IV normative data for Canadian individuals with schizophrenia of low average intelligence; second, to examine schizophrenia performance on all WAIS-IV subtest, index and general intelligence scores relative to healthy comparison subjects; and third, to revalidate the pattern of impairment identified in this clinical group using the WAIS-III, where processing speed (PS) was most affected, followed by working memory (WM), perceptual reasoning (PR) and verbal comprehension (VC). The WAIS-IV was administered to outpatients with schizophrenia and their performance compared with age, gender, and education matched controls. WAIS-IV schizophrenia performance data are provided. Analyses revealed significant impairment on several tasks, including the new Cancellation subtest and the VC supplemental subtest, Comprehension. At the index score level, group differences in PS were significantly larger than those observed in all other cognitive domains. Impairments were also observed in WM amid relatively preserved performance in VC, thereby confirming the pattern of impairment identified using the WAIS-III.