Shanna Cooper

Evidence for an emotion maintenance deficit in schizophrenia

Research has indicated that people with schizophrenia have deficits in reward representation and goal-directed behavior, which may be related to the maintenance of emotional experiences. Using a laboratory-based study, we investigated whether people with schizophrenia were able to maintain an emotional experience when given explicit instructions to do so. Twenty-eight people with schizophrenia and 19 people without completed a behavioral task judging their emotional experience of pictures held over a three second delay. This emotion maintenance task was compared to a subsequent in-the-moment emotion experience rating of each picture. In addition, all participants completed an analogous brightness experience maintenance and rating task, and patients completed a standardized visual working memory task. Participants with schizophrenia showed normal in-the-moment emotion experience of the emotion pictures; however, they showed decreased performance on emotion maintenance (for both positive and negative emotion) compared to participants without schizophrenia, even after controlling for brightness maintenance. The emotion maintenance deficit was not associated with visual brightness performance nor with performance on the visual working memory task; however, negative emotion maintenance was associated with an interview-based rating of motivation. These findings suggest that some aspects of impaired emotion maintenance in schizophrenia may be related to deficits in motivated behavior.

Assessing motivation orientations in schizophrenia: Scale development and validation

Motivation deficits are common in several disorders including schizophrenia, and are an important factor in both functioning and treatment adherence. Self-Determination Theory (SDT), a leading macro-theory of motivation, has contributed a number of insights into how motivation is impaired in schizophrenia. Nonetheless, self-report measures of motivation appropriate for people with severe mental illness (including those that emphasize SDT) are generally lacking in the literature. To fill this gap, we adapted and abbreviated the well-validated General Causality Orientation Scale for use with people with schizophrenia and with other severe mental disorders (GCOS-clinical populations; GCOS-CP). In Study 1, we tested the similarity of our measure to the existing GCOS (using a college sample) and then validated this new measure in a schizophrenia and healthy control sample (Study 2). Results from Study 1 (N=360) indicated that the GCOS-CP was psychometrically similar to the original GCOS and provided good convergent and discriminant validity. In Study 2, the GCOS-CP was given to individuals with (N=44) and without schizophrenia (N=42). In line with both laboratory-based and observer-based research, people with schizophrenia showed lower motivational autonomy and higher impersonal/amotivated orientations. Additional applications of the GCOS-CP are discussed.

Attenuated positive psychotic symptoms and social anxiety: Along a psychotic continuum or different constructs?

Social anxiety commonly occurs across the course of schizophrenia, including in the premorbid and prodromal phases of psychotic disorders. Some have posited that social anxiety may exist on a continuum with paranoia; however, empirical data are lacking. The study aim was to determine whether attenuated positive psychotic symptoms are related to social anxiety. Young adults (N=1378) were administered the Prodromal Questionnaire (PQ), which measures attenuated positive psychotic symptoms (APPS), and the Social Phobia Scale (SPS), which measures a subset of social anxiety symptoms. Confirmatory factor analyses were conducted to address the extent to which social anxiety and APPS tap distinct dimensions. Confirmatory factor analyses support the existence of a separate social anxiety factor scale and four separate, though interrelated, APPS factor domains (unusual thought content, paranoia/suspiciousness, disorganized thinking, and perceptual abnormalities). Additionally, social anxiety was significantly, but not differently related to each APPS domain, although the magnitude was reduced between social anxiety and distressing APPS. The current study suggests that social anxiety and attenuated positive psychotic symptoms are separable constructs, but are significantly associated with each other.

Coping as a mediator of stress and psychotic-like experiences

BACKGROUND There is evidence that individuals along the whole psychosis continuum have increased responsiveness to stress; however, coping responses to stressors have not been extensively explored in subthreshold psychotic symptoms. METHODS In 454 undergraduates, psychotic-like experiences (PLEs) were evaluated using the positive items of the Prodromal Questionnaire. Perceived stress and traumatic life events were assessed using the Life Events Checklist and Perceived Stress Scale, and coping was measured using the Brief COPE. We also examined whether different coping styles mediated the relationship between perceived stress and PLEs, as well as whether different coping styles mediated the relationship between traumatic life events and PLEs. RESULTS Both number of traumatic life events and current level of perceived stress were significantly associated with PLEs. These relationships were both mediated by higher levels of maladaptive coping. CONCLUSIONS Results have the potential to inform treatment strategies, as well as inform targets for exploration in longitudinal studies of those at risk for psychosis.

The association between traumatic life events and psychological symptoms from a conservative, transdiagnostic perspective

Exposure to traumatic life events (TLEs) is strongly linked to the onset and exacerbation of an array of psychological sequelae. While studies yield minimal evidence of specificity for one disorder emerging in the aftermath of TLEs versus another, most studies do not adopt a conservative approach in controlling for multiple psychological symptoms linked to TLEs. The present study explored the association between TLEs and eight psychological constructs before and after adjusting for concurrent symptomatology in a diverse sample of 2342 undergraduates. We predicted three symptom domains would withstand conservative adjustments in their relationship to TLEs: posttraumatic stress disorder (PTSD), borderline personality disorder (BPD), and attenuated positive psychotic symptoms (APPS). Results indicated that exposure to at least one TLE, but especially four or more TLEs, was significantly associated with PTSD and BPD symptoms even after controlling for concurrent symptoms. Additionally, the association between four or more TLEs and APPS persisted despite adjusting for covariates. Findings underscore the critical role that TLE histories play in posttraumatic stress, borderline personality, and attenuated psychotic symptom expression. The relationship between TLEs and depression, cannabis and other drug use, generalized anxiety, and social anxiety disappeared after adjusting for comorbid symptoms.

Subjective aspects of working memory performance: Memoranda-related imagery

Although it is well accepted that working memory (WM) is intimately related to consciousness, little research has illuminated the liaison between the two phenomena. To investigate this under-explored nexus, we used an imagery monitoring task to investigate the subjective aspects of WM performance. Specifically, in two experiments, we examined the effects on consciousness of (a) holding in mind information having a low versus high memory load, and (b) holding memoranda in mind during the presentation of distractors (e.g., visual stimuli associated with a response incompatible with that of the memoranda). Higher rates of rehearsal (conscious imagery) occurred in the high load and distractor conditions than in comparable control conditions. Examination of the temporal properties of the rehearsal-based imagery revealed that, across subjects, imagery events occurred evenly throughout the delay. We hope that future variants of this new imagery monitoring task will reveal additional insights about WM, consciousness, and action control.

White matter alterations in individuals experiencing attenuated positive psychotic symptoms

Diffusion tensor imaging (DTI) studies suggest that reduced fractional anisotropy (FA) in the inferior longitudinal fasciculus (ILF) and superior longitudinal fasciculus (SLF) occurs among schizophrenia patients and those at risk for psychosis. Nevertheless, there is a dearth of knowledge investigating white matter fibre pathways in non‐help‐seeking individuals who endorse attenuated positive psychotic symptoms (APPS) across a range of mental disorders. The aim of the current study was to determine if alterations in ILF and SLF microstructures were specific to distressing APPS related to risk for psychosis or to APPS symptoms occurring in multiple mental disorders, which would suggest a shared phenotype among disorders.

Attenuated Positive Psychotic Symptoms in Relation to Cigarette Smoking in a Nonclinical Population.

Introduction: This study explored the association between cigarette smoking and attenuated positive psychotic symptoms in a young adult nonclinical sample. Methods: Undergraduates (N = 930), aged 18–35 years (26.3% male), completed a battery of self-report measures assessing subthreshold psychotic symptoms, cigarette smoking behavior/dependence, and drug use. Results: Individuals endorsing a greater number of attenuated positive psychotic symptoms were more likely to be smokers. Exploratory analyses indicated that the odds of being a smoker were two times greater for those at potential higher risk for psychosis compared with individuals at lower risk. Results were consistent after adjusting for sex and other drug use. Conclusions: In line with findings from psychotic populations, results suggest that attenuated positive psychotic symptoms, particularly those endorsed as distressing in a nonclinical, undergraduate population, are related to cigarette smoking. Implications: Even in nonclinical, undergraduate populations, subthreshold psychotic symptoms are related to cigarette smoking, and cigarette smokers are twice as likely to be considered at potentially higher risk for psychosis compared with noncigarette smokers. In summary, there may be a threshold whereby psychotic symptoms confer increased risk for nicotine consumption, with endorsement of a greater number of distressing subthreshold psychotic symptoms increasing the likelihood of cigarette use.

Attenuated positive psychotic symptoms and the experience of anhedonia

Deficits in anticipatory pleasure have been consistently shown among chronic, first‐episode, and clinical high risk for psychosis populations, but much less attention has been given to non‐clinical individuals experiencing attenuated positive psychotic symptoms (APPS).

Traumatic life event exposure and psychotic-like experiences: A multiple mediation model of cognitive-based mechanisms

Several cognitive mechanisms have been proposed to account for the relationship between exposure to traumatic life events (TLEs) and the entire psychosis spectrum. However, only few of these mechanisms have been empirically tested and those that have been tested have not considered multiple mechanisms simultaneously. The purpose of this study was to examine whether perceived stress, dissociation, negative self-schemas, negative other-schemas, and/or external locus of control mediated the association between TLEs and psychotic-like experiences (PLEs). An undergraduate sample of 945 individuals completed a battery of self-report questionnaires. We found significant indirect effects from TLE exposure to PLEs through perceived stress, dissociation, external locus of control, negative self-schemas, and negative other-schemas. When controlling for comorbid psychological symptoms, only the indirect effect from TLE exposure to PLEs through dissociation continued to be significant. Targeting stress sensitivity, maladaptive schemas, dissociative tendencies, and externalizing attributional styles may prove useful in the amelioration of risk for various psychopathologies (e.g., mood, psychosis) in the aftermath of TLE exposure. Findings underscore the importance of targeting trauma-related cognitions in the prevention or reduction of psychotic-like experiences or disorders.