Psychiatry Research RSS feed: Current Issue. The journal provides very rapid publication of short but complete research reports in the field of psychiatry. The scope of the journal encompasses: (1) Biochemical, physiological, genetic, psychological, and social determinants of human behavior; (2) assessment of human behavior and subjective state; (3) evaluation of somatic and non-somatic psychiatric treatments. In addition, reports of clinically related basic studies in the fields of neuropharmacology, neurochemistry, neuroendocrinology, electrophysiology, psychology, genetics, and brain imaging are published. Significant methodological advances such as instrumentation, clinical scales, and assays directly applicable to psychiatric research are also appropriate. Brief reviews, theoretical contributions, and letters to the editor will be considered. http://www.psy-journal.com/?rss=yesElsevier Inc.en © 2012 Published by Elsevier Inc. All rights reserved. Psychiatry Research0165-1781196130 March 2012 © 2012 Published by Elsevier Inc. All rights reserved. healthpermissions@elsevier.comhttp://www.psy-journal.com/article/PIIS0165178112001655/abstract?rss=yesEditorial Board10.1016/S0165-1781(12)00165-5Psychiatry Research 196, 1 (2012)2012-03-30Psychiatry Research2012-03-301961S0165-1781(12)X0005-2IFCIFChttp://www.psy-journal.com/article/PIIS0165178112001138/abstract?rss=yesAbstract: Dysfunctions in social cognition are implicated in the pathogenesis of schizophrenia and have been extensively replicated over the years. For memory research, the administration of cognitive tasks with metacognitive aspects like confidence ratings has deepened our insight into how impairments contribute to symptoms of the disorder. A total of 76 patients with schizophrenia or schizoaffective disorder and a sample of 30 healthy participants were tested with the Reading the Mind in the Eyes test (Eyes-test). The Eyes-test was complemented with a rating scale requesting response confidence and was administered along with paradigms tapping neuropsychological parameters and cognitive insight. Schizophrenia patients showed impaired abilities on mental state perception. In addition, they committed more high-confidence errors and at the same time made fewer high-confidence correct responses. Impairments were most pronounced in patients with formal thought disorder. The patients displayed a decreased metacognitive awareness for their deficits. The results suggest that adding confidence ratings to the investigation of social cognition promises to advance our understanding of social cognition in schizophrenia. Patients not only show severe impairments in social cognition, but are overconfident in their judgments and lack cognitive insight into their deficits. The results highlight the need for metacognitive therapeutic approaches for the treatment of this population.“Don't give me that look” — Overconfidence in false mental state perception in schizophreniaUlf Köther, Ruth Veckenstedt, Francesca Vitzthum, Daniela Roesch-Ely, Ute Pfueller, Florian Scheu, Steffen Moritz10.1016/j.psychres.2012.03.004Psychiatry Research 196, 1 (2012)2012-04-09Psychiatry Research2012-04-091961S0165-1781(12)X0005-2Schizophrenia18http://www.psy-journal.com/article/PIIS0165178111006603/abstract?rss=yesAbstract: Cigarette smoking rates remain remarkably high in schizophrenia relative to smoking in other psychiatric groups. Impairments in the reward system may be related to elevated rates of nicotine dependence and lower cessation rates in this psychiatric group. Smokers with schizophrenia and schizoaffective disorder (SWS; n=15; Mage=54.87, S.D.=6.51, 100% male) and a non-psychiatric control group of smokers (NCL; n=16; Mage=50.38, S.D.=11.52; 93.8% male) were administered a computerized signal detection task to measure reward-based learning. Performance on the signal detection task was assessed by response bias, discriminability, reaction time, and hit rate. Clinician-assessed and self-reported measures of smoking and psychiatric symptoms were completed. SWS exhibited similar patterns of reward-based learning compared to control smokers. However, decreased reward-based learning was associated with increased levels of nicotine dependence in SWS, but not among control smokers. Nicotine withdrawal and urge to smoke were correlated with anhedonia within the SWS group. Among SWS, reduced reward responsiveness and increased anhedonia were associated with and may contribute to greater co-occurring nicotine dependence. These findings emphasize the importance of targeting reward system functioning in smoking cessation treatment for individuals with schizophrenia.The relationship between reward-based learning and nicotine dependence in smokers with schizophreniaChristopher G. AhnAllen, Gabrielle I. Liverant, Kristin L. Gregor, Barbara W. Kamholz, James J. Levitt, Suzy Bird Gulliver, Diego A. Pizzagalli, Vamsi K. Koneru, Gary B. Kaplan10.1016/j.psychres.2011.09.011Psychiatry Research 196, 1 (2012)2012-02-20Psychiatry Research2012-02-201961S0165-1781(12)X0005-2Schizophrenia914http://www.psy-journal.com/article/PIIS0165178111006093/abstract?rss=yesAbstract: Individuals with schizophrenia often lack insight or awareness. Resulting impairment has been observed in various cognitive domains and, recently, linked to problems in emotion-based learning. The Iowa Gambling Task (IGT) has been used to assess emotion-based decision-making in patients with schizophrenia, but results have been inconclusive. The current study further investigates emotion-based decision-making in schizophrenia by elucidating the unique contribution of awareness. Twenty-five patients with schizophrenia and 24 healthy controls were assessed with a modified version of the IGT recording awareness at regular intervals. Symptom assessment, medication and medical history were recorded for the clinical group. Patients with schizophrenia underperformed on the IGT compared to controls. Subjective awareness levels were significantly lower in the schizophrenia group and were associated with hallucination severity. Cognitive decision modelling further indicated that patients with schizophrenia had impaired attention to losses, compared to controls. This parameter was positively correlated with awareness. We also found that positive symptoms altered awareness levels and suggest that this disruption may contribute to sub-optimal decision-making. Overall, a lack of awareness may be an important aspect in understanding impaired social cognitive functioning and emotion-based learning observed in schizophrenia.Cognitive decision modelling of emotion-based learning impairment in schizophrenia: The role of awarenessMatteo Cella, Simon Dymond, Andrew Cooper, Oliver H. Turnbull10.1016/j.psychres.2011.08.015Psychiatry Research 196, 1 (2012)2012-02-20Psychiatry Research2012-02-201961S0165-1781(12)X0005-2Schizophrenia1519http://www.psy-journal.com/article/PIIS0165178111006846/abstract?rss=yesAbstract: Previous schizophrenia research suggests poor cognitive control is associated with schizophrenia speech symptoms. However, cognitive control is a broad construct. Two important cognitive control components are poor goal maintenance and poor verbal working memory storage. In the current research, people with schizophrenia (n=45) performed three cognitive tasks that varied in their goal maintenance and verbal working memory storage demands. Speech symptoms were assessed using clinical rating scales, ratings of disorganized speech from typed transcripts, and self-reported disorganization. Overall, alogia was associated with both goal maintenance and verbal working memory tasks. Objectively rated disorganized speech was associated with poor goal maintenance and with a task that included both goal maintenance and verbal working memory storage demands. In contrast, self-reported disorganization was unrelated to either amount of objectively rated disorganized speech or to cognitive control task performance, instead being associated with negative mood symptoms. Overall, our results suggest that alogia is associated with both poor goal maintenance and poor verbal working memory storage and that disorganized speech is associated with poor goal maintenance. In addition, patients' own assessment of their disorganization is related to negative mood, but perhaps not to objective disorganized speech or to cognitive control task performance.Cognitive control components and speech symptoms in people with schizophreniaTheresa M. Becker, David C. Cicero, Nelson Cowan, John G. Kerns10.1016/j.psychres.2011.10.003Psychiatry Research 196, 1 (2012)2012-02-24Psychiatry Research2012-02-241961S0165-1781(12)X0005-2Schizophrenia2026http://www.psy-journal.com/article/PIIS0165178111006032/abstract?rss=yesAbstract: Expressed emotion (EE) is a measure of the family environment reflecting the amount of criticism and emotional over-involvement expressed by a key relative towards a family member with a disorder or impairment. Patients from high EE homes have a poorer illness prognosis than do patients from low EE homes. Despite EE's well-established predictive validity, questions remain regarding why some family members express high levels of EE attitudes while others do not. Based on indirect evidence from previous research, the current study tested whether shame and guilt/self-blame about having a relative with schizophrenia serve as predictors of EE. A sample of 72 family members of patients with schizophrenia completed the Five Minute Speech Sample to measure EE, along with questionnaires assessing self-directed emotions. In line with the hypotheses, higher levels of both shame and guilt/self-blame about having a relative with schizophrenia predicted high EE. Results of the current study elucidate the EE construct and have implications for working with families of patients with schizophrenia.Shame and guilt/self-blame as predictors of expressed emotion in family members of patients with schizophreniaStephanie Wasserman, Amy Weisman de Mamani, Giulia Suro10.1016/j.psychres.2011.08.009Psychiatry Research 196, 1 (2012)2012-02-22Psychiatry Research2012-02-221961S0165-1781(12)X0005-2Schizophrenia2731http://www.psy-journal.com/article/PIIS016517811100672X/abstract?rss=yesAbstract: Administrative health care databases are increasingly used for health services and comparative effectiveness research. When comparing outcomes between different treatments, interventions and exposures, the ability to adjust for differences in the risk of the outcome occurring between treatment groups is important. There is a paucity of validated methods to ascertain comorbidities for risk-adjustment in ambulatory populations of subjects with schizophrenia using administrative health care databases. Our objective was to examine the ability of th\e Johns Hopkins' Aggregated Diagnosis Groups (ADGs) to predict 1-year mortality in a population-based cohort of subjects with schizophrenia. We used a retrospective cohort constructed using population-based administrative data that consisted of all 94,466 residents of Ontario, Canada between the ages of 20 and 100years who were alive on January 1, 2007 and who had been diagnosed with schizophrenia prior to this date. Subjects were randomly divided into derivation and validation samples. A logistic regression model consisting of age, sex, and indicator variables for 14 of the 32 ADG categories had excellent discrimination: the c-statistic (equivalent to the area under the ROC curve) was 0.845 and 0.836 in the derivation and validation samples, respectively. Furthermore, the model demonstrated very good calibration.Using the Johns Hopkins Aggregated Diagnosis Groups (ADGs) to predict mortality in a population-based cohort of adults with schizophrenia in Ontario, CanadaPeter C. Austin, Alice Newman, Paul A. Kurdyak10.1016/j.psychres.2011.09.023Psychiatry Research 196, 1 (2012)2012-02-27Psychiatry Research2012-02-271961S0165-1781(12)X0005-2Schizophrenia3237http://www.psy-journal.com/article/PIIS0165178111006159/abstract?rss=yesAbstract: This study sought to characterize the psychosis phenotype, contrasting cognitive features within traditional diagnosis and psychosis dimension in a family sample containing both schizophrenia and psychotic bipolar I disorder. Seventy-six probands with psychosis [44 probands with schizophrenia, 32 probands with psychotic bipolar I disorder] and 55 first-degree relatives [30 relatives of schizophrenia probands, 25 relatives of bipolar probands] were recruited. Standardized clinical and neuropsychological measures were administered. No differences in cognitive performance emerged between probands with schizophrenia and probands with psychotic bipolar disorder, or between relatives of probands with schizophrenia and relatives of probands with bipolar disorder in the domains of working and declarative memory, executive function and attention. Relatives overall showed higher cognitive performance compared to probands, as expected. However, when we segmented the probands and relatives along a psychosis dimension, independent of diagnostic groups, results revealed lower cognitive performance in probands compared to relatives without psychosis spectrum disorders, whereas relatives with psychosis spectrum disorders showed an intermediate level of performance across all cognitive domains. In this study, cognitive performance did not distinguish either probands or their first-degree relatives within traditional diagnostic groups (schizophrenia and psychotic bipolar disorder), but distinguished probands and relatives with and without lifetime psychosis manifestations independent of diagnostic categories. These data support the notion that schizophrenia and psychotic bipolar disorder present a clinical continuum with overlapping cognitive features defining the psychosis phenotype.Cognitive endophenotypes of psychosis within dimension and diagnosisElena I. Ivleva, David W. Morris, Julian Osuji, Amanda F. Moates, Thomas J. Carmody, Gunvant K. Thaker, Munro Cullum, Carol A. Tamminga10.1016/j.psychres.2011.08.021Psychiatry Research 196, 1 (2012)2012-02-20Psychiatry Research2012-02-201961S0165-1781(12)X0005-2Psychotic disorders3844http://www.psy-journal.com/article/PIIS0165178111007207/abstract?rss=yesAbstract: Adequate adherence to medication confers benefits on patients with psychotic illness, but is difficult to achieve. Efficacy of medication influences adherence in patients in advanced phases of illness and may have a similar influence on patients with a first episode of psychosis (FEP). We assessed medication adherence and efficacy in 216 FEP patients at program entry and at 3 and 6months later. “Efficacy” was evaluated as the ability of medication to reduce positive or negative symptoms to below established thresholds for clinical remission at each evaluation. Adherence was defined as adequate (>75%) or not. Resolution of negative symptoms by month 3 of treatment was associated with inadequate adherence at months 3 and 6. In contrast, rapid resolution of positive symptoms showed no relationship to adherence. In a multivariate analysis taking into account other determinants of adherence in FEP, the role of early negative symptom remission was confirmed, and we found that a 3-month sustained remission of positive symptoms was associated with adequate adherence. Medication efficacy may promote adherence if it produces sustained remission of positive symptoms. However, many patients who benefit from medication, particularly those with rapid improvement of negative symptoms, fail to adhere to the treatment.Impact of symptom resolution on medication adherence in first episode psychosisKatherine A. Steger, Clifford Cassidy, Mark Rabinovitch, Ridha Joober, Ashok Malla10.1016/j.psychres.2011.10.015Psychiatry Research 196, 1 (2012)2012-02-29Psychiatry Research2012-02-291961S0165-1781(12)X0005-2First episode psychosis4551http://www.psy-journal.com/article/PIIS0165178112000674/abstract?rss=yesAbstract: Studies show that individuals with psychotic illnesses and their families want information about psychosis risks for other relatives. However, deriving accurate numeric probabilities for psychosis risk is challenging, and people have difficulty interpreting probabilistic information; thus, some have suggested that clinicians should use risk descriptors, such as “moderate” or “quite high”, rather than numbers. Little is known about how individuals with psychosis and their family members use quantitative and qualitative descriptors of risk in the specific context of chance for an individual to develop psychosis. We explored numeric and descriptive estimations of psychosis risk among individuals with psychotic disorders and unaffected first-degree relatives. In an online survey, respondents numerically and descriptively estimated risk for an individual to develop psychosis in scenarios where they had: A) no affected family members; and B) an affected sibling. Participants comprised 219 affected individuals and 211 first-degree relatives participated. Affected individuals estimated significantly higher risks than relatives. Participants attributed all descriptors between “very low” and “very high” to probabilities of 1%, 10%, 25% and 50%+. For a given numeric probability, different risk descriptors were attributed in different scenarios. Clinically, brief interventions around risk (using either probabilities or descriptors alone) are vulnerable to miscommunication and potentially negative consequences—interventions around risk are best suited to in-depth discussion.Descriptive and numeric estimation of risk for psychotic disorders among affected individuals and relatives: Implications for clinical practiceJehannine C. Austin, Catriona Hippman, William G. Honer10.1016/j.psychres.2012.02.005Psychiatry Research 196, 1 (2012)2012-03-16Psychiatry Research2012-03-161961S0165-1781(12)X0005-2Genetic counseling and perceptions of risk of psychotic disorder5256http://www.psy-journal.com/article/PIIS0165178112000455/abstract?rss=yesAbstract: Treatment of bipolar disorder often results in patients taking several drugs in an attempt to alleviate residual depressive symptoms, which can lead to an accumulation of side effects. New treatments for bipolar depression that do not increase the side effect burden are needed. One nonpharmacological treatment with few side effects, bright light therapy, has been shown to be an effective therapy for seasonal affective disorder, yet has not been extensively studied for other forms of depression. Forty-four adults with bipolar disorder, depressed phase were randomized to treatment with bright light therapy, low-density or high-density negative ion generator for 8 weeks. The primary measure of efficacy was the Structured Interview Guide for the Hamilton Depression Rating Scale with Atypical Depression Supplement (SIGH-ADS). Adverse events were assessed using the Young Mania Rating Scale (YMRS) and Systematic Assessment for Treatment Emergent effects (SAFTEE). All outcome variables were statistically analyzed using a mixed model repeated measure analysis of variance (ANOVA). The results showed no statistically significant differences between groups in any outcome measures at study end point; adverse events, including switches into hypomania, were rare. Further research is needed to determine the efficacy of bright light therapy in this population.Controlled trial of safety and efficacy of bright light therapy vs. negative air ions in patients with bipolar depressionDeborah Rozenn Dauphinais, Joshua Zev Rosenthal, Michael Terman, Holly Marie DiFebo, Catherine Tuggle, Norman Edward Rosenthal10.1016/j.psychres.2012.01.015Psychiatry Research 196, 1 (2012)2012-03-16Psychiatry Research2012-03-161961S0165-1781(12)X0005-2Affective disorders5761http://www.psy-journal.com/article/PIIS0165178112000145/abstract?rss=yesAbstract: Identifying predictors of antidepressant response will facilitate the successful treatment of patients suffering from depression. Scopolamine produces robust antidepressant responses in unipolar and bipolar depression. Here we evaluate the potential for baseline self-ratings to predict treatment response to scopolamine. Fifty-one unipolar and bipolar patients participated in a double-blind, placebo-controlled crossover trial. Following a single-blind placebo session, participants randomly received P/S or S/P (P=3 placebo; S=3 scopolamine (4μg/kg) sessions). Mood-state self-ratings (Profile of Mood State (POMS) and Visual Analog Scales (VAS)) and depression severity (Montgomery–Åsberg Depression Rating Scale (MADRS)) were obtained before each infusion. Day 1 (baseline/placebo) self-ratings were used in a discriminant function analysis to identify linear combinations of individual items that predict response. The discriminant analysis significantly separated responders from non-responders in both the unipolar and bipolar diagnostic subgroups. The discriminant functions accurately classified over 85% of patients as responders/non-responders. The POMS depression subscale significantly correlated with clinical response, as did the VAS restlessness, sad, and irritated scales. These results indicate that self-report mood-ratings obtained before treatment can predict response outcome to scopolamine, and suggest that a constellation of mood-state features may be related to clinical response.Baseline mood-state measures as predictors of antidepressant response to scopolamineMaura L. Furey, Allison C. Nugent, Andrew M. Speer, David A. Luckenbaugh, Elana M. Hoffman, Erica Frankel, Wayne C. Drevets, Carlos A. Zarate10.1016/j.psychres.2012.01.003Psychiatry Research 196, 1 (2012)2012-02-20Psychiatry Research2012-02-201961S0165-1781(12)X0005-2Affective disorders6267http://www.psy-journal.com/article/PIIS016517811100761X/abstract?rss=yesAbstract: Increased levels of antibodies to gliadin, which is derived from the wheat protein gluten, have been reported in schizophrenia and bipolar disorder in cross-sectional studies. We examined longitudinally the levels of antibody reactivity to gliadin in acute mania. The sample included 60 individuals assessed during a hospital stay for acute mania, 39 at a 6-month follow-up, and a sample of 143 non-psychiatric controls. Antibodies to gliadin were measured by enzyme immunoassay. The relationship of the antibodies to the clinical course of mania was analyzed by the use of regression models. Individuals with mania had significantly increased levels of IgG antibodies to gliadin, but not other markers of celiac disease, at baseline compared with controls in multivariate analyses. However, these levels were not significantly different from those of controls at the six month follow-up. Among the individuals with mania, elevated levels at follow-up were significantly associated with re-hospitalization in the 6-month follow-up period. The monitoring and control of gluten sensitivity may have significant effects on the management of individuals hospitalized with acute mania.Markers of gluten sensitivity in acute mania: A longitudinal studyFaith Dickerson, Cassie Stallings, Andrea Origoni, Crystal Vaughan, Sunil Khushalani, Robert Yolken10.1016/j.psychres.2011.11.007Psychiatry Research 196, 1 (2012)2012-03-05Psychiatry Research2012-03-051961S0165-1781(12)X0005-2Affective disorders6871http://www.psy-journal.com/article/PIIS0165178111007244/abstract?rss=yesAbstract: The aim of the current study was to investigate whether the ability to distinguish genuine from non-genuine (neutral or posed) facial expressions of emotion (happiness, sadness, fear and disgust) is impaired in depression, and whether improvement in this ability occurs with treatment response. Sixty-eight depressed inpatients and 50 matched healthy controls performed the Emotion Categorisation Task three times over 6 weeks. All participants showed some sensitivity to the meaningful differences between genuine and non-genuine expressions of emotion, with an increasing percentage of faces labelled as genuinely feeling the emotion from neutral to posed to genuine presentations. Depressed patients showed significantly less sensitivity in differentiating non-genuine from genuine expressions of sadness, compared with healthy controls. Performance on the Emotion Categorisation Task did not change over time in treatment responders compared with treatment non-responders. These findings have implications for understanding why depressed individuals may have difficulties in social interactions.Sensitivity to posed and genuine facial expressions of emotion in severe depressionKatie M. Douglas, Richard J. Porter, Lucy Johnston10.1016/j.psychres.2011.10.019Psychiatry Research 196, 1 (2012)2012-02-27Psychiatry Research2012-02-271961S0165-1781(12)X0005-2Affective disorders7278http://www.psy-journal.com/article/PIIS0165178111007864/abstract?rss=yesAbstract: Preliminary evidence suggests that 3 hours of behavior therapy can reduce fear responses to phobic stimuli. Most of this research, however, has relied on self-reports and clinician assessments, and failed to include a comparison group. To extend this literature, with 32 adults with spider phobia, we investigated the effects of a single hour of in vivo exposure on subjective and electrophysiological aspects of fear; comparisons were made to a wait-list control group. Pre- and post-assessments included phobia-relevant questionnaires and startle reflex responses to spider, negative, neutral and positive stimuli. Compared to the control group, our one-hour treatment reduced self-reported and physiological responses to spider stimuli. These data provide preliminary support for the ability of affective startle modulation to be changed by very brief exposure therapy.Can a one-hour session of exposure treatment modulate startle response and reduce spider fears?Todd B. Kashdan, Leah Adams, Juliana Read, Larry Hawk10.1016/j.psychres.2011.12.002Psychiatry Research 196, 1 (2012)2012-03-06Psychiatry Research2012-03-061961S0165-1781(12)X0005-2Anxiety disorders7982http://www.psy-journal.com/article/PIIS0165178111006950/abstract?rss=yesAbstract: This study examined differences in clinical presentation and functional impairment in youth with obsessive-compulsive disorder (OCD) with or without comorbid depressive disorders and sought to determine the predictors of youth-reported depressive symptoms. One-hundred and sixty youth were reliably diagnosed with OCD and comorbid disorders using the Anxiety Disorders Interview Schedule for DSM-IV: Parent version (Silverman and Albano, 1996) and confirmed by an experienced clinician. Sixteen percent (n = 25) had a comorbid diagnosis of a current depressive disorder (DD). Significantly more females than males had a DD. Those with a DD showed increased OCD symptom severity, OCD-related functional impairment, and family accommodation relative to those without a comorbid DD. Depressive symptoms were significantly positively correlated with years of age, degree of OCD symptom severity, measures of OCD-related functional impairment, and non-OCD anxiety symptoms. Hierarchical regression analyses showed that age, gender, functional impairment, and non-OCD anxiety were significant predictors of depressive symptoms, even when OCD symptom severity was controlled. Notably, functional impairment was a partial mediator of the relationship between OCD symptom severity and depression levels, suggesting depression levels are the product of both degree of symptoms and amount of day-to-day impairment. Results are discussed in terms of implications for assessment and treatment.Depression in youth with obsessive-compulsive disorder: Clinical phenomenology and correlatesEric A. Storch, Adam B. Lewin, Michael J. Larson, Gary R. Geffken, Tanya K. Murphy, Daniel A. Geller10.1016/j.psychres.2011.10.013Psychiatry Research 196, 1 (2012)2012-02-27Psychiatry Research2012-02-271961S0165-1781(12)X0005-2Anxiety disorders8389http://www.psy-journal.com/article/PIIS0165178111007669/abstract?rss=yesAbstract: Growing epidemiological evidence suggests that premorbid participation in cognitive leisure activities (CLA) reduces the risk of dementia by increasing cognitive reserve. We investigated the differential effect of CLA, education, and socioeconomic status (SES) on the development of mild cognitive impairment (MCI) and Alzheimer's disease (AD). Participants in the prospective population-based ILSE study (*1930–1932; 12-year follow-up) were examined in three examination waves (t1:1993/94; t2:1997/98; t3:2005/07). In total, 381 subjects of the original cohort (n=500) were re-examined at t3. Of these subjects 29% received the diagnosis of MCI and 7% of AD. Subjects participated in a thorough psychogeriatric examination and neuropsychological testing. Moreover, they took part in a detailed autobiographical interview and completed questionnaires including socio-demographic data and current frequency of participation in CLA. Subjects who were highly cognitively active at t1 had a significantly reduced risk of developing MCI/AD at t3 (scores adjusted for education, SES, gender, and depressive symptoms). Additionally, high education and high SES separately reduced the risk of MCI and AD. Our results confirm the hypothesis that a high level of CLA acts as a protective factor against the development of MCI and AD by increasing cognitive reserve. This effect is not accounted for by important potential confounders.Cognitive activity, education and socioeconomic status as preventive factors for mild cognitive impairment and Alzheimer's diseaseChristine Sattler, Pablo Toro, Peter Schönknecht, Johannes Schröder10.1016/j.psychres.2011.11.012Psychiatry Research 196, 1 (2012)2012-03-06Psychiatry Research2012-03-061961S0165-1781(12)X0005-2Mild cognitive impairment and dementia9095http://www.psy-journal.com/article/PIIS0165178111006226/abstract?rss=yesAbstract: The current study aimed to assess dysphoric states among 290 patients with borderline personality disorder (BPD) and 72 non-borderline axis II comparison subjects other personality disorders, (OPD) over a 10-year course of prospective follow-up. Additionally, we assessed the severity of these states among borderline patients who had and had not recovered both symptomatically and psychosocially. The Dysphoric Affect Scale (DAS) – a 50-item self-report measure of affective and cognitive states thought to be common among borderline patients and specific to the disorder – was administered at five waves of prospective follow-up. Affective and cognitive DAS items were separately analyzed, yielding respective subscores. Borderline patients reported more severe dysphoric states compared to OPD subjects at baseline. However, the severity of affective and cognitive states declined significantly for both groups taken together over 10 years of follow-up. Within the BPD group, recovered subjects reported less severe dysphoric states compared to non-recovered subjects at baseline. Results also showed a significant decline in DAS scores over time, but at a greater rate for recovered subjects. In sum, while the severity of dysphoric states declines significantly over time, inner distress remains an area of vulnerability for borderline subjects. Additionally, the severity and pervasiveness of these states may affect recovery over time.The course of dysphoric affective and cognitive states in borderline personality disorder: A 10-year follow-up studyLawrence Ian Reed, Garrett Fitzmaurice, Mary C. Zanarini10.1016/j.psychres.2011.08.026Psychiatry Research 196, 1 (2012)2012-02-13Psychiatry Research2012-02-131961S0165-1781(12)X0005-2Personality and personality disorder96100http://www.psy-journal.com/article/PIIS0165178111006901/abstract?rss=yesAbstract: A range of executive function (EF) deficits have been associated with Borderline Personality (BPD), a disorder characterized by high rates of suicide. However, the role of EF and suicide risk in BPD has not been examined. This exploratory study compared working memory, Stroop interference, motor inhibition (SSRT) and Iowa Gambling Task (IGT) decision making performance in 42 women with BPD and 41 healthy controls. The sensitivity of EF to suicidal risk as assessed by the Suicide Behaviour Questionnaire-R (Osman et al., 2001) was also tested. Women with BPD performed similar to controls on all EF except decision making. Weaker Stroop interference control, however, was the only significant EF contributor to suicide risk, demonstrating near equivalent contributions to that of depression. EF and depression collectively explained 34% of the adjusted variance in total suicide risk. Contrary to expectations, IGT decision making and motor inhibition were not associated with overall suicide risk. Only Stroop interference control contributed significantly to lifetime suicide intent/attempt beyond depression or BPD severity. As prior suicide attempt remains the strongest predictor of future attempt (Soloff et al., 2003), the sensitivity of stroop performance to suicidal risk may be clinically important. Interference control may represent a “diathesis” for suicide that is independent of psychiatric diagnoses.Executive function and suicidal risk in women with Borderline Personality DisorderJeannette LeGris, Paul S. Links, Robert van Reekum, Rosemary Tannock, Maggie Toplak10.1016/j.psychres.2011.10.008Psychiatry Research 196, 1 (2012)2012-02-29Psychiatry Research2012-02-291961S0165-1781(12)X0005-2Personality and personality disorder101108http://www.psy-journal.com/article/PIIS0165178111006068/abstract?rss=yesAbstract: Based on the Baltimore Epidemiologic Catchment Area (ECA) follow-up survey, we examined relationships between dimensions of Diagnostic and Statistical Manual of Mental Disorders (DSM-IV) personality disorders and both subjective and objective memory functioning in a community population. Our study subjects consisted of 736 individuals from the ECA follow-up study of the original Baltimore ECA cohort, conducted between 1993 and 1996 and available for assessment in the Hopkins Epidemiology Study of Personality Disorders from 1997 to 1999. Subjects were assessed for DSM-IV personality disorders using a semi-structured instrument, the International Personality Disorder Examination, and were asked about a subjective appraisal of memory. Verbal memory function, including immediate recall, delayed recall, and recognition, were also evaluated. Multiple linear regression analyses were used to determine associations between personality dimensions of DSM-IV Axis II traits and subjective and objective memory functioning. Scores on schizoid and schizotypal personality dimensions were associated with subjective and objective memory dysfunction, both with and without adjustment for Axis I disorders. Borderline, antisocial, avoidant, and dependent personality disorder scores were associated with subjective memory impairment only, both with and without adjustment for Axis I disorders. This study suggests that subjective feelings of memory impairment and/or objective memory dysfunction are associated with specific personality disorder dimensions.Relationship between personality disorder dimensions and verbal memory functioning in a community populationSubin Park, Jin Pyo Hong, Hochang B. Lee, Jack Samuels, O. Joseph Bienvenu, Hye Yoon Chung, William W. Eaton, Paul T. Costa, Gerald Nestadt10.1016/j.psychres.2011.08.012Psychiatry Research 196, 1 (2012)2012-02-20Psychiatry Research2012-02-201961S0165-1781(12)X0005-2Personality and personality disorder109114http://www.psy-journal.com/article/PIIS0165178111006688/abstract?rss=yesAbstract: Schizotypy is a non-clinical manifestation of the same underlying biological factors that give rise to psychotic disorders (Claridge and Beech, 1995). Research on normative populations scoring high on schizotypy is valuable because it may help elucidate the predisposition to schizophrenia (Jahshan and Sergi, 2007) and because performance is not confounded by issues present in schizophrenia samples. In the current study, a Confirmatory Factor Analysis was conducted using several comprehensive measures of schizotypy. As expected and replicating prior research, a four-factor model of schizotypy emerged including a positive, a negative, a cognitive disorganization, and an impulsive nonconformity factor. We also evaluated how each factor related to distinct cognitive biases. In support of hypotheses, increased self-certainty, decreased theory of mind, and decreased source memory were associated with higher scores on the positive factor; decreased theory of mind was associated with higher scores on the negative factor; and increased self-certainty was associated with greater impulsive nonconformity. Unexpectedly, decreased self-certainty and increased theory of mind were associated with greater cognitive disorganization, and decreased source memory was associated with greater impulsive nonconformity. These findings offer new insights by highlighting cognitive biases that may be risk factors for psychosis.Associations between cognitive biases and domains of schizotypy in a non-clinical sampleStephanie Aldebot Sacks, Amy Gina Weisman de Mamani, Cristina Phoenix Garcia10.1016/j.psychres.2011.09.019Psychiatry Research 196, 1 (2012)2012-02-24Psychiatry Research2012-02-241961S0165-1781(12)X0005-2Personality and personality disorder115122http://www.psy-journal.com/article/PIIS0165178111006925/abstract?rss=yesAbstract: There remains debate about whether personality disorders (PDs) are better conceptualized as categorical, reflecting discontinuity from normal personality; or dimensional, existing on a continuum of severity with normal personality traits. Evidence suggests that most PDs are dimensional but there is a lack of consensus about the structure of Cluster A disorders. Taxometric methods are adaptable to investigating the taxonic status of psychiatric disorders. The current study investigated the latent structure of paranoid and schizoid PDs in an epidemiological sample (N=43,093) drawn from the National Epidemiological Survey on Alcohol and Related Conditions (NESARC) using taxometric analyses. The current study used taxometric methods to analyze three indicators of paranoid PD — mistrust, resentment, and functional disturbance — and three indicators of schizoid PD — emotional detachment, social withdrawal, and functional disturbance — derived factor analytically. Overall, taxometrics supported a dimensional rather than taxonic structure for paranoid and schizoid PDs through examination of taxometric graphs and comparative curve fit indices. Dimensional models of paranoid and schizoid PDs better predicted social functioning, role-emotional, and mental health scales in the survey than categorical models. Evidence from the current study supports recent efforts to represent paranoid and schizoid PDs as well as other PDs along broad personality dimensions.Taxometric analyses of paranoid and schizoid personality disordersAnthony Olufemi Ahmed, Bradley Andrew Green, Peter Francis Buckley, Megan Elizabeth McFarland10.1016/j.psychres.2011.10.010Psychiatry Research 196, 1 (2012)2012-02-29Psychiatry Research2012-02-291961S0165-1781(12)X0005-2Personality and personality disorder123132http://www.psy-journal.com/article/PIIS0165178111006044/abstract?rss=yesAbstract: Previous studies on survivors of childhood trauma documented associations between psychological dysregulation, impulsivity, and both behavioral and emotional manifestations of distress. Yet, the mechanism that links these variables remains unclear. The current study aims to examine the pattern of relations between a history of child abuse, impulsivity and dissociation. More specifically, it examines whether impulsivity serves as a moderator or mediator in the association between childhood trauma and dissociation. Eighty-one inpatients from the acute wards of two psychiatric hospitals participated in this study. Data were collected by clinician-administered questionnaires. A highly significant linear hierarchical regression analysis revealed that both psychiatric comorbidity and childhood trauma made unique contributions to the variance of dissociation. Yet, the significant association between childhood trauma and dissociation decreased when impulsivity was entered into the regression model. Our findings suggest that impulsivity mediates the association between childhood trauma and dissociative psychopathology and imply that the identification and treatment of impulsivity could be a potentially valuable clinical target in individuals with dissociative disorders.The role of impulsivity in the association between childhood trauma and dissociative psychopathology: Mediation versus moderationEli Somer, Karni Ginzburg, Lilach Kramer10.1016/j.psychres.2011.08.010Psychiatry Research 196, 1 (2012)2012-02-20Psychiatry Research2012-02-201961S0165-1781(12)X0005-2Personality and personality disorder133137http://www.psy-journal.com/article/PIIS0165178111007906/abstract?rss=yesAbstract: The present study was conducted on a large sample of Chinese medical students to test the moderating effect of resilience between negative life events and mental health problems, and investigate the factors that affect the mental health problems of the students. The Adolescent Self-Rating Life Events Check List, Eysenck Adult Personality Questionnaire-Revised, Social Support Rating Scale, Connor-Davidson Resilience Scale, and Symptom Check List were adopted for a survey with 1,998 Chinese medical students as respondents. Mental health problems had a positive correlation with negative life events and neuroticism. On the other hand, mental health problems had a negative correlation with social support, extraversion, and resilience. Regression analysis showed that resilience moderated negative life events and mental health problems. Promoting resilience may be helpful for the adjustment of college students.Negative life events and mental health of Chinese medical students: The effect of resilience, personality and social supportLi Peng, Jiajia Zhang, Min Li, Peipei Li, Yu Zhang, Xin Zuo, Yi Miao, Ying Xu10.1016/j.psychres.2011.12.006Psychiatry Research 196, 1 (2012)2012-03-14Psychiatry Research2012-03-141961S0165-1781(12)X0005-2Personality and personality disorder138141http://www.psy-journal.com/article/PIIS0165178111006470/abstract?rss=yesAbstract: Previous investigations have provided evidence that some polymorphisms in the 3′ untranslated region (3'-UTR) of GRIN2B are associated with susceptibility to obsessive-compulsive disorder (OCD). We evaluated the genetic contribution of the rs1805502, rs1805476 and rs890 polymorphisms in the 3'-UTR of GRIN2B in 206 OCD patients and 413 controls in a Chinese Han population, and found no significant differences in genotypic and allelic frequencies between OCD cases and the controls. Our results suggest the lack of an association between OCD and polymorphisms in the 3'-UTR of GRIN2B in a Chinese Han population.Lack of an association between obsessive-compulsive disorder and polymorphisms in the 3′ untranslated region of GRIN2B in a Chinese Han populationShiguo Liu, Yingying Yin, Yanhui Liu, Yuping Sun, Xinhua Zhang, Xu Ma10.1016/j.psychres.2011.09.003Psychiatry Research 196, 1 (2012)2012-03-30Psychiatry Research2012-03-301961S0165-1781(12)X0005-2Brief Reports142144http://www.psy-journal.com/article/PIIS0165178111006627/abstract?rss=yesAbstract: Previous studies have revealed psychosocial and cognitive impairments in patients during unipolar and bipolar depression, which persist even in subsyndromal and euthymic states. Currently, little is known about the nature and the extent of psychosocial and cognitive deficits during depression. The aim of the present study was to characterize psychosocial and cognitive profiles among unipolar (MDD) and bipolar (BD) patients during a major depressive episode and to compare the profiles of the patient groups. Depressed patients with MDD (n=13) and BD (n=11) were followed over a period of 12months. Clinical, psychosocial and neuropsychological assessments were conducted at baseline and at 6-week, 4-month, 8-month and 12-month follow-ups. In the case of severe mood disorders, psychosocial and neurocognitive functioning seem similar among MDD and BD patients during a depressive episode. All MDD and BD patients had global psychosocial dysfunction, characterized by occupational and relational impairments. Furthermore, the neurocognitive profile was heterogeneous with regard to the nature and extent of cognitive deficits but attentional processes were frequently compromised. After 1year of treatment, occupational and relational impairments, as well as neurocognitive dysfunction, persisted sufficiently to alter daily functioning.Psychosocial and neurocognitive functioning in unipolar and bipolar depression: A 12-month prospective studyJulie Godard, Philippe Baruch, Simon Grondin, Martin F. Lafleur10.1016/j.psychres.2011.09.013Psychiatry Research 196, 1 (2012)2012-02-28Psychiatry Research2012-02-281961S0165-1781(12)X0005-2Brief Reports145153http://www.psy-journal.com/article/PIIS016517811100607X/abstract?rss=yesAbstract: One hundred and thirty-nine university students completed measures of schizotypy and subjective well-being (SWB). Inverse associations were found between schizotypy and SWB scores. These results provide evidence that diminished SWB is characteristic along the schizophrenia continuum. Further research is required to determine the mechanisms by which schizotypal individuals experience reduced life satisfaction.Schizotypy and subjective well-being in university studentsGavin R. Abbott, Linda K. Byrne10.1016/j.psychres.2011.08.013Psychiatry Research 196, 1 (2012)2012-02-23Psychiatry Research2012-02-231961S0165-1781(12)X0005-2Brief Reports154156http://www.psy-journal.com/article/PIIS0165178111006172/abstract?rss=yesAbstract: This study examined the relationship between components of pathological narcissism and types of depressive tendencies among a sample of 117 psychiatric outpatients. Findings revealed that depressive themes concerning dependency were associated with narcissistic grandiosity. Depressive tendencies concerning self-criticism were positively associated with narcissistic vulnerability.Depressive tendencies and pathological narcissism among psychiatric outpatientsDavid Kealy, Michelle Tsai, John S. Ogrodniczuk10.1016/j.psychres.2011.08.023Psychiatry Research 196, 1 (2012)2012-02-22Psychiatry Research2012-02-221961S0165-1781(12)X0005-2Brief Reports157159http://www.psy-journal.com/article/PIIS0165178111007773/abstract?rss=yesThe central endocannabinoid system is an important neuroactive lipid signalling system with its CB1 receptor gene (CNR1) being linked to the modulation of the release of several monoamine neurotransmitters regulating the synaptic transmission of excitatory and inhibitory circuits. The level of expressed CB1 receptors in brain areas which are involved in the regulation of mood or cognition suggests an involvement of the brain endocannabinoid system in the pathophysiology of several psychiatric diseases. Animal models support this notion finding the endocannabinoid system to be a risk factor in the pathogenesis of depression, particularly suggesting an association between the CB1 receptor blockade and antidepressant and anti-stress effects. The first clinical studies found an association between the CNR1 gene and treatment response in depression and schizophrenia. Therefore, the hypothesis of this study was that the CNR1 gene would also be involved in early improvement in depression and schizophrenia which has not been evaluated so far.The CNR1 gene in depression and schizophrenia — Is there an association with early improvement and response?Rebecca Schennach, Peter Zill, Michael Obermeier, Daniela Hauer, Sandra Dehning, Anja Cerovecki, Markus Opgen-Rhein, Richard Musil, Ilja Spellmann, Judith Matz, Daniela Krause, Florian Seemüller, Norbert Müller, Hans-Jürgen Möller, Brigitta Bondy, Michael Riedel10.1016/j.psychres.2011.11.021Psychiatry Research 196, 1 (2012)2012-02-27Psychiatry Research2012-02-271961S0165-1781(12)X0005-2Letters to the Editor160160http://www.psy-journal.com/article/PIIS0165178111006123/abstract?rss=yesWe are pleased to see an additional validation of the Center for Epidemiologic Studies Depression Scale – Revised (CESD-R:()) in the article in Psychiatry Research by Van Dam and Earleywine (). We wish to make readers aware that an electronic version of the CESD-R is freely and publicly available at http://cesd-r.com. The web version includes symptom score interpretations that can be emailed to the subject, to his or her clinician, or to a research project site. The output includes a profile suggesting which of the nine symptom criteria are occurring most frequently, as well as recommendations to seek help if the pattern of responses suggests depression may be present. The output includes a ‘depression score’ based upon the original CESD-R continuous scale (analogous to the original CESD scale (), as well as a categorization of that score (e.g., “Possible major depressive episode”) based on an algorithm different from that of Van Dam and Earleywine, as documented on the web site (http://cesd-r.com/cesdr/). Notably, the most severe category in the web algorithm reflects a pattern of self-reported answers that fully meet the criteria for DSM IV-defined major depressive disorder.The CESD-R is available on the webWilliam W. Eaton, Michele Ybarra, Joseph Schwab10.1016/j.psychres.2011.08.018Psychiatry Research 196, 1 (2012)2012-02-20Psychiatry Research2012-02-201961S0165-1781(12)X0005-2Letters to the Editor161161http://www.psy-journal.com/article/PIIS0165178111002903/abstract?rss=yesWe have read with interest the article “Proposal of a socio–cognitive–behavioral structural equation model of internalized stigma in people with severe and persistent mental illness” (), which assessed the important and somewhat neglected issue of prediction of internalized stigma, and proposed a model integrating social, clinical and cognitive variables. Such articles are required as little is known about the processes and factors that affect the perception of self-stigma.Socio–cognitive–behavioral structural equation model of internalized stigma in people with severe and persistent mental illness should include personality dimensionsBranka Aukst Margetić, Miro Jakovljević, Branimir Margetić10.1016/j.psychres.2011.04.009Psychiatry Research 196, 1 (2012)2011-10-24Psychiatry Research2011-10-241961S0165-1781(12)X0005-2Letters to the Editor162163http://www.psy-journal.com/article/PIIS0165178111006809/abstract?rss=yesOur thanks to for their detailed reading and comments on our work (). No doubt, these will allow us to undertake new research designs that are more coherent and complete in the future.Response to Dr. Aukst Margetić et al.Manuel Muñoz, María Sanz, Eloísa Pérez-Santos, María de los Ángeles Quiroga10.1016/j.psychres.2011.09.028Psychiatry Research 196, 1 (2012)2012-02-10Psychiatry Research2012-02-101961S0165-1781(12)X0005-2Letters to the Editor164164