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Elements of the stress cascade and the neurobiology of schizophrenia
2. Phenomenology
13
the data observed prior to a conclusion being reached. In addition to the 85:15 ratio of beads, ratios of 60:40 and 44:28:28 were also used. Data was also collected to measure possible factors which may explain the data gathering bias - including short term memory and a 'need for closure' style of thinking. Results: The data thus far suggests that on the easier version of the task (85:15) the three groups performed similarly, whereas on the harder versions the clinical groups behaved differently with a marked data gathering bias present in both the prodromal subjects and those with first episode psychosis. Conclusion: a data gathering bias may predate the onset of frank persecutory delusions and may also be present in non-schizophrenic psychoses.
EXTRALIMITAL TRIRADII AS A MARKER OF RISK FOR SCHIZOTYPY J. T. Chok,* T. R. K w a p i l
order of schizophrenia patients was characterized by disorganization and peculiar word usage. Cognitive slippage, or mild thought disorder, has also been found in the unaffected relatives of schizophrenia and bipolar patients (Shenton et al. 1989) and is qualitatively similar to that found in the respective proband groups. Here, we continue this line of inquiry and replicate previous findings using the TDI to assess the quantity and quality of disordered thinking in a new sample of 73 schizophrenia patients, 83 bipolar patients, 108 clinically unaffected first-degree relatives of schizophrenia patients, 52 unaffected first-degree relatives of bipolar patients, and 25 normal control subjects. We show that the TDI identifies distinctive types of thought disorder in the two patient groups and that the relatives of schizophrenia and bipolar patients produce thought disorder that is qualitatively similar to that found in the patient groups but at quantitatively lower levels. These results indicate that specific kinds of thought disorder are co-familial traits for schizophrenia and bipolar disorder.
Department of Psychology, UNC-Greensboro, Greensboro, NC, USA Dermatoglyphic anomalies have been investigated as potential markers of risk for schizophrenia and related disorders. The present study examined a previously unexamined dermatoglyphic anomaly, extralimital triradii, and ridge dissociation as markers of risk for schizotypy in young adults. These dermatoglyphic anomalies are hypothesized to indicate severe disruptions in the second trimester of prenatal development, a time period that appears to be etiologically relevant in the development of schizophrenia. Participants (n = 184) were classified as psychosis-prone (i.e., at risk for schizophrenia and related disorders) based upon their scores on the Revised Social Anhedonia Scale (Eckblad, Chapman, Chapman & Mishlove, 1982), the Perceptual Aberration Scale (Chapman, Chapman, & Raulin, 1978), the Magical Ideation Scale (Eckblad & Chapman, 1983), and the Physical Anhedonia Scale (Chapman, Chapman, & Raulin, 1976). It was hypothesized that participants in these groups would exhibit higher incidences of extralimital triradii and ridge dissociation than control participants. Overall, 11 participants in the study exhibited a severe anomaly, 9 of whom belonged to one of the psychosis-prone groups. These findings strongly encourage the future investigation of these severe anomalies in at-risk and psychotic populations.
THOUGHT DISORDER IN SCHIZOPHRENIA AND BIPOLAR DISORDER: SPECIFICITY AND FAMILIAL AGGREGATION M. J. C o l e m a n , * D. L. Levy, E S. H o l z m a n
Psychology Research Laboratory, Mailman Research Centel, McLean Hospital, Behnont, MA, USA Formal thought disorder has long been regarded as a distinguishing feature of schizophrenia. Kraepelin (1919) described the disordered thought processes of schizophrenia as "derailments". Bleuler (1950) wrote that the central feature of schizophrenic thought was "loosening of associations". Both Kraepelin (1919) and Bleuler (1950) observed that the biological family members of schizophrenia patients often displayed what appeared to be attenuated symptoms of schizophrenic illness, such as odd behavior and speech, blunted affect, impoverished social relations, and suspiciousness. In a study using the Thought Disorder Index (TDI) (Johnston & Holzman, 1979) to compare formal thought disorder in schizophrenia and mania patients, Solovay et al. (1987) found the thought disorder of mania patients to be characterized by excessively elaborated, often playful or whimsical, combinatory thinking, ~vhereas the thought dis-
ELEMENTS OF THE STRESS CASCADE AND THE NEUROBIOLOGY OF SCHIZOPHRENIA C. Corcoran,* D. Malaspina, R. Goetz, R. Gil, J. Gorman, B. M c E w e n
Dept of Psychiatry, NYSP1/Columbia, New York, NY,, USA A number of neural abnormalities identified in schizophrenia have also been found in animal models and human studies of stress exposure, including hippocampal volume reduction, impaired cognition and alterations in the HPA axis. Because exposure to early trauma is prevalent in schizophrenia, we examined if associations would exist in schizophrenia among these variables, and with positive and negative symptoms. 18 patients with DSM-IV schizophrenia or schizoaffective disorder were assessed for: 1) symptoms (PANSS) 2) cognition (WAIS, Wisconsin Card Sort, Wechsler Memory and Trails A/B) 3) brain volumes (whole brain, hippocampus and amygdala) 4) basal ItPA axis (sampling of salivary cortisol in am, post-lunch and at 10 pm) and 5) exposure to and perception of psychosocial stress (Early Trauma Inventory, SEPRATE life event assessment, Perceived Stress Scale). Results showed two constellations of intercorrelated variables. The first group typified certain abnormalities of schizophrenia. The second group of interconnected variables existed for the group with exposure to early trauma. Variables in the schizophrenia constellation included hippocampal volume reduction, elevated evening cortisols, poor WCST performance, and indices of general psychopathology, with correlations among factors ranging from .4 to .7 Early trauma in this sample was associated with more positive symptoms, fewer negative symptoms, dysthymia, and elevated morning cortisols, again with correlations ranging from .4 to .7. We found a pattern of intercorrelations in a family of variables that are known to characterize schizophrenia, including reduced hippocampal volumes, elevated evening cortisols, and impairment in Wisconsin Card Sort Test performance. Early u'anma can modify the expression of schizophrenia, with increased positive symptoms and dysthymia.
SCHIZOTYPAL TRAITS AND SPATIAL ABILITY IN CHILDREN E. Cyhlarova,* A. J. R i c h a r d s o n , G. S. Claridge
Dept of Experimental Psychology, Oxford University, O.~[ord, United Kingdom Impairments of cognitive function have been demonstrated in patients diagnosed with schizophrenia, schizotypal personality disorder, in individuals identified as at risk for schizophrenia, and in
International Congress on Schizophrenia Research 2003
13
the data observed prior to a conclusion being reached. In addition to the 85:15 ratio of beads, ratios of 60:40 and 44:28:28 were also used. Data was also collected to measure possible factors which may explain the data gathering bias - including short term memory and a 'need for closure' style of thinking. Results: The data thus far suggests that on the easier version of the task (85:15) the three groups performed similarly, whereas on the harder versions the clinical groups behaved differently with a marked data gathering bias present in both the prodromal subjects and those with first episode psychosis. Conclusion: a data gathering bias may predate the onset of frank persecutory delusions and may also be present in non-schizophrenic psychoses.
EXTRALIMITAL TRIRADII AS A MARKER OF RISK FOR SCHIZOTYPY J. T. Chok,* T. R. K w a p i l
order of schizophrenia patients was characterized by disorganization and peculiar word usage. Cognitive slippage, or mild thought disorder, has also been found in the unaffected relatives of schizophrenia and bipolar patients (Shenton et al. 1989) and is qualitatively similar to that found in the respective proband groups. Here, we continue this line of inquiry and replicate previous findings using the TDI to assess the quantity and quality of disordered thinking in a new sample of 73 schizophrenia patients, 83 bipolar patients, 108 clinically unaffected first-degree relatives of schizophrenia patients, 52 unaffected first-degree relatives of bipolar patients, and 25 normal control subjects. We show that the TDI identifies distinctive types of thought disorder in the two patient groups and that the relatives of schizophrenia and bipolar patients produce thought disorder that is qualitatively similar to that found in the patient groups but at quantitatively lower levels. These results indicate that specific kinds of thought disorder are co-familial traits for schizophrenia and bipolar disorder.
Department of Psychology, UNC-Greensboro, Greensboro, NC, USA Dermatoglyphic anomalies have been investigated as potential markers of risk for schizophrenia and related disorders. The present study examined a previously unexamined dermatoglyphic anomaly, extralimital triradii, and ridge dissociation as markers of risk for schizotypy in young adults. These dermatoglyphic anomalies are hypothesized to indicate severe disruptions in the second trimester of prenatal development, a time period that appears to be etiologically relevant in the development of schizophrenia. Participants (n = 184) were classified as psychosis-prone (i.e., at risk for schizophrenia and related disorders) based upon their scores on the Revised Social Anhedonia Scale (Eckblad, Chapman, Chapman & Mishlove, 1982), the Perceptual Aberration Scale (Chapman, Chapman, & Raulin, 1978), the Magical Ideation Scale (Eckblad & Chapman, 1983), and the Physical Anhedonia Scale (Chapman, Chapman, & Raulin, 1976). It was hypothesized that participants in these groups would exhibit higher incidences of extralimital triradii and ridge dissociation than control participants. Overall, 11 participants in the study exhibited a severe anomaly, 9 of whom belonged to one of the psychosis-prone groups. These findings strongly encourage the future investigation of these severe anomalies in at-risk and psychotic populations.
THOUGHT DISORDER IN SCHIZOPHRENIA AND BIPOLAR DISORDER: SPECIFICITY AND FAMILIAL AGGREGATION M. J. C o l e m a n , * D. L. Levy, E S. H o l z m a n
Psychology Research Laboratory, Mailman Research Centel, McLean Hospital, Behnont, MA, USA Formal thought disorder has long been regarded as a distinguishing feature of schizophrenia. Kraepelin (1919) described the disordered thought processes of schizophrenia as "derailments". Bleuler (1950) wrote that the central feature of schizophrenic thought was "loosening of associations". Both Kraepelin (1919) and Bleuler (1950) observed that the biological family members of schizophrenia patients often displayed what appeared to be attenuated symptoms of schizophrenic illness, such as odd behavior and speech, blunted affect, impoverished social relations, and suspiciousness. In a study using the Thought Disorder Index (TDI) (Johnston & Holzman, 1979) to compare formal thought disorder in schizophrenia and mania patients, Solovay et al. (1987) found the thought disorder of mania patients to be characterized by excessively elaborated, often playful or whimsical, combinatory thinking, ~vhereas the thought dis-
ELEMENTS OF THE STRESS CASCADE AND THE NEUROBIOLOGY OF SCHIZOPHRENIA C. Corcoran,* D. Malaspina, R. Goetz, R. Gil, J. Gorman, B. M c E w e n
Dept of Psychiatry, NYSP1/Columbia, New York, NY,, USA A number of neural abnormalities identified in schizophrenia have also been found in animal models and human studies of stress exposure, including hippocampal volume reduction, impaired cognition and alterations in the HPA axis. Because exposure to early trauma is prevalent in schizophrenia, we examined if associations would exist in schizophrenia among these variables, and with positive and negative symptoms. 18 patients with DSM-IV schizophrenia or schizoaffective disorder were assessed for: 1) symptoms (PANSS) 2) cognition (WAIS, Wisconsin Card Sort, Wechsler Memory and Trails A/B) 3) brain volumes (whole brain, hippocampus and amygdala) 4) basal ItPA axis (sampling of salivary cortisol in am, post-lunch and at 10 pm) and 5) exposure to and perception of psychosocial stress (Early Trauma Inventory, SEPRATE life event assessment, Perceived Stress Scale). Results showed two constellations of intercorrelated variables. The first group typified certain abnormalities of schizophrenia. The second group of interconnected variables existed for the group with exposure to early trauma. Variables in the schizophrenia constellation included hippocampal volume reduction, elevated evening cortisols, poor WCST performance, and indices of general psychopathology, with correlations among factors ranging from .4 to .7 Early trauma in this sample was associated with more positive symptoms, fewer negative symptoms, dysthymia, and elevated morning cortisols, again with correlations ranging from .4 to .7. We found a pattern of intercorrelations in a family of variables that are known to characterize schizophrenia, including reduced hippocampal volumes, elevated evening cortisols, and impairment in Wisconsin Card Sort Test performance. Early u'anma can modify the expression of schizophrenia, with increased positive symptoms and dysthymia.
SCHIZOTYPAL TRAITS AND SPATIAL ABILITY IN CHILDREN E. Cyhlarova,* A. J. R i c h a r d s o n , G. S. Claridge
Dept of Experimental Psychology, Oxford University, O.~[ord, United Kingdom Impairments of cognitive function have been demonstrated in patients diagnosed with schizophrenia, schizotypal personality disorder, in individuals identified as at risk for schizophrenia, and in
International Congress on Schizophrenia Research 2003