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Cheng G, Xu L, Li H, Cheng Y, Jiang T, Xu Q, Wang J. Causal links between personality disorders and schizophrenia: A Mendelian randomization study. Medicine (Baltimore) 2025; 104:e42532. [PMID: 40388757 PMCID: PMC12091683 DOI: 10.1097/md.0000000000042532] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2024] [Accepted: 05/04/2025] [Indexed: 05/21/2025] Open
Abstract
Although observational studies have suggested associations between personality disorders and schizophrenia, the causality of these relationships remains unclear. Determining whether personality disorders causally contribute to schizophrenia could inform early identification and preventive efforts. We performed two-sample Mendelian randomization (MR) analysis using large-scale Genome-wide Association Study data from populations of European ancestry. Because no single nucleotide polymorphism for personality disorders reached the conventional genome-wide significance threshold (P < 5 × 10-8), we sequentially relaxed the criteria (P < 5 × 10-7, P < 5 × 10-6, P < 5 × 10-5) until at least 10 instrumental variables were obtained. Ultimately, 11-95 single nucleotide polymorphism met the relaxed threshold (P < 5 × 10-5), all with F-statistics > 10, thus ensuring robust instrumental variables. The inverse variance weighted method served as our primary MR approach, supplemented by MR-Egger, weighted median, and MR Robust Adjusted Profile Score analyses, to minimize confounding, reverse causation, and weak instrument bias. Inverse variance weighted analysis revealed a significant causal association between genetically predicted personality disorders and schizophrenia (odds ratios = 1.190, 95% confidence intervals: 1.122-1.261, P = 5.51 × 10-9). Additionally, when examining a combined group of specific personality disorders, a similar causal effect was observed (odds ratios = 1.180, 95% confidence intervals: 1.033-1.345, P = .015). The sensitivity analyses showed no evidence of horizontal pleiotropy, thus supporting the robustness of these findings. Our study provides the first genetic evidence that personality disorders may have a causal influence on schizophrenia risk. These results highlight the importance of early screening and targeted interventions in individuals with personality disorders. Future research should expand to more diverse populations, employ dimensional diagnostic frameworks, and investigate the underlying biological and developmental pathways to refine the preventative and therapeutic strategies.
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Affiliation(s)
- Gangming Cheng
- Department of Geriatric Medicine Ward II, Wuhan Mental Health Center, Wuhan, Hubei Province, China
- Department of Geriatric Medicine Ward II, Wuhan Hospital for Psychotherapy, Wuhan, Hubei Province, China
- Research Center for Psychological and Health Sciences, China University of Geosciences, Wuhan, Hubei Province, China
| | - Lin Xu
- Department of General Psychiatry Ward IV, Wuhan Hospital for Psychotherapy, Wuhan, Hubei Province, China
| | - Hongjie Li
- Department of Geriatric Medicine Ward II, Wuhan Mental Health Center, Wuhan, Hubei Province, China
- Department of Geriatric Medicine Ward II, Wuhan Hospital for Psychotherapy, Wuhan, Hubei Province, China
| | - Yuan Cheng
- Department of Geriatric Medicine Ward II, Wuhan Mental Health Center, Wuhan, Hubei Province, China
- Department of Geriatric Medicine Ward II, Wuhan Hospital for Psychotherapy, Wuhan, Hubei Province, China
| | - Tao Jiang
- Department of Geriatric Medicine Ward II, Wuhan Mental Health Center, Wuhan, Hubei Province, China
- Department of Geriatric Medicine Ward II, Wuhan Hospital for Psychotherapy, Wuhan, Hubei Province, China
| | - Qiong Xu
- Department of Nutrition, Xinzhou District People’s Hospital, Wuhan, Hubei Province, China
| | - Jing Wang
- Department of Geriatric Medicine Ward II, Wuhan Mental Health Center, Wuhan, Hubei Province, China
- Department of Geriatric Medicine Ward II, Wuhan Hospital for Psychotherapy, Wuhan, Hubei Province, China
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Llapashtica E, Barbur JL, Haenschel C. Reduced Visual Function in Schizotypal Traits: An Exploratory Study. Schizophr Bull 2025; 51:S205-S213. [PMID: 40037828 PMCID: PMC11879504 DOI: 10.1093/schbul/sbae049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/06/2025]
Abstract
BACKGROUND AND HYPOTHESIS Visual impairments have been proposed as risk factors for psychotic symptoms and illnesses. Visual impairments can considerably impact people's daily lives, but little is known about the impact and diagnostic sensitivity of such abnormalities for schizotypal personality traits. This study aims to explore possible relationships between schizotypy and visual acuity (VA), contrast sensitivity, and parameters that describe eye movements and visual processing times. STUDY DESIGN Schizotypy was assessed in 37 participants with the Multidimensional Schizotypy Scale-Brief (MSS-B). For the visual function measures, we used the Acuity-Plus test and the new Eye Movement and Integrated Saccade Latency (EMAIL) test. The latter measures oculomotor performance during an eye movement task, including the visual processing time at the end of each saccade. STUDY RESULTS The disorganized dimension of the schizotypy scores predicted VA when measured with black optotypes. Additionally, we found that participants who had higher disorganized scores showed an increased response variability, as assessed through the goodness of fit measure from the EMAIL test. CONCLUSIONS These results from this exploratory study extend upon earlier findings from both general and patient samples, highlighting the clinical and subclinical importance of understanding how spatial vision can be affected in people with schizotypal disorganized behavior.
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Affiliation(s)
| | - John L Barbur
- The Henry Wellcome Laboratories for Vision Science, Centre for Applied Vision Research, School of Health and Psychological Sciences, City, University of London, London, UK
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Nieboer W, Ghiani A, de Vries R, Brenner E, Mann DL. Eye Tracking to Assess the Functional Consequences of Vision Impairment: A Systematic Review. Optom Vis Sci 2023; 100:861-875. [PMID: 38165789 DOI: 10.1097/opx.0000000000002088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2024] Open
Abstract
BACKGROUND Eye tracking is a promising method for objectively assessing functional visual capabilities, but its suitability remains unclear when assessing the vision of people with vision impairment. In particular, accurate eye tracking typically relies on a stable and reliable image of the pupil and cornea, which may be compromised by abnormalities associated with vision impairment (e.g., nystagmus, aniridia). OBJECTIVES This study aimed to establish the degree to which video-based eye tracking can be used to assess visual function in the presence of vision impairment. DATA SOURCES A systematic review was conducted using PubMed, EMBASE, and Web of Science databases, encompassing literature from inception to July 2022. STUDY ELIGIBILITY CRITERIA, PARTICIPANTS, AND INTERVENTIONS Studies included in the review used video-based eye tracking, included individuals with vision impairment, and used screen-based tasks unrelated to practiced skills such as reading or driving. STUDY APPRAISAL AND SYNTHESIS METHODS The included studies were assessed for quality using the Strengthening the Reporting of Observational Studies in Epidemiology assessment tool. Data extraction and synthesis were performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. RESULTS Our analysis revealed that five common tests of visual function were used: (i) fixation stability, (ii) smooth pursuit, (iii) saccades, (iv) free viewing, and (v) visual search. The studies reported considerable success when testing individuals with vision impairment, yielding usable data from 96.5% of participants. LIMITATIONS There was an overrepresentation of conditions affecting the optic nerve or macula and an underrepresentation of conditions affecting the anterior segment or peripheral retina. CONCLUSIONS AND IMPLICATIONS OF KEY FINDINGS The results offer promise for the use of eye tracking to assess the visual function of a considerable proportion of those with vision impairment. Based on the findings, we outline a framework for how eye tracking can be used to test visual function in the presence of vision impairment.
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Affiliation(s)
| | - Andrea Ghiani
- Department of Human Movement Sciences, Amsterdam Movement Sciences and Institute of Brain and Behaviour Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Ralph de Vries
- Medical Library, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - Eli Brenner
- Department of Human Movement Sciences, Amsterdam Movement Sciences and Institute of Brain and Behaviour Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | - David L Mann
- Department of Human Movement Sciences, Amsterdam Movement Sciences and Institute of Brain and Behaviour Amsterdam, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
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Cooper C, Meso AI. Cognitive-perceptual traits associated with autism and schizotypy influence use of physics during predictive visual tracking. Eur J Neurosci 2023; 58:4236-4254. [PMID: 37850610 DOI: 10.1111/ejn.16169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Revised: 09/11/2023] [Accepted: 09/27/2023] [Indexed: 10/19/2023]
Abstract
Schizophrenia and autism spectrum disorder (ASD) can disrupt cognition and consequently behaviour. Traits of ASD and the subclinical manifestation of schizophrenia called schizotypy have been studied in healthy populations with overlap found in trait profiles linking ASD social deficits to negative schizotypy and ASD attention to detail to positive schizotypy. Here, we probed the relationship between subtrait profiles, cognition and behaviour, using a predictive tracking task to measure individuals' eye movements under three gravity conditions. A total of 48 healthy participants tracked an on-screen projected ball under familiar gravity, inverted upward acceleration (against gravity) and horizontal gravity control conditions while eye movements were recorded and dynamic performance quantified. Participants completed ASD and schizotypy inventories generating highly correlated scores, r = 0.73. All tracked best under the gravity condition, producing anticipatory downward responses from stimulus onset which were delayed under upward inverted gravity. Tracking performance was not associated with overall ASD or schizotypy trait levels. Combining measures using principal components analysis (PCA), we decomposed the inventories into subtraits unveiling interesting patterns. Positive schizotypy was associated with ASD dimensions of rigidity, odd behaviour and face processing, which all linked to anticipatory tracking responses under inverted gravity. In contrast, negative schizotypy was associated with ASD dimensions of social interactions and rigidity and to early stimulus-driven tracking under gravity. There was also substantial nonspecific overlap between ASD and schizotypy dissociated from tracking. Our work links positive-odd traits with anticipatory tracking when physics rules are violated and negative-social traits with exploitation of physics laws of motion.
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Affiliation(s)
- Chloe Cooper
- Acute Inpatient Psychology, Dorset Healthcare University NHS Foundation Trust, Poole, UK
- Psychology and Interdisciplinary Neuroscience Group, Bournemouth University, Poole, UK
| | - Andrew Isaac Meso
- Psychology and Interdisciplinary Neuroscience Group, Bournemouth University, Poole, UK
- Neuroimaging Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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Durtette A, Schmid F, Barrière S, Obert A, Lang J, Raucher-Chéné D, Gierski F, Kaladjian A, Henry A. Facial emotion recognition processes according to schizotypal personality traits: An eye-tracking study. Int J Psychophysiol 2023; 190:60-68. [PMID: 37385101 DOI: 10.1016/j.ijpsycho.2023.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 05/04/2023] [Accepted: 06/11/2023] [Indexed: 07/01/2023]
Abstract
Facial emotion recognition has been shown to be impaired among patients with schizophrenia and, to a lesser extent, among individuals with high levels of schizotypal personality traits. However, aspects of gaze behavior during facial emotion recognition among the latter are still unclear. This study therefore investigated the relations between eye movements and facial emotion recognition among nonclinical individuals with schizotypal personality traits. A total of 83 nonclinical participants completed the Schizotypal Personality Questionnaire (SPQ) and performed a facial emotion recognition task. Their gaze behavior was recorded by an eye-tracker. Self-report questionnaires measuring anxiety, depressive symptoms, and alexithymia were administered. At the behavioral level, correlation analyses showed that higher SPQ scores were associated with lower surprise recognition accuracy scores. Eye-tracking data revealed that higher SPQ scores were associated with shorter dwell time on relevant facial features during sadness recognition. Regression analyses revealed that the total SPQ score was the only significant predictor of eye movements during sadness recognition, and depressive symptoms were the only significant predictor of surprise recognition accuracy. Furthermore, dwell time predicted response times for sadness recognition in that shorter dwell time on relevant facial features was associated with longer response times. Schizotypal traits may be associated with decreased attentional engagement in relevant facial features during sadness recognition and impede participants' response times. Slower processing and altered gaze patterns during the processing of sad faces could lead to difficulties in everyday social situations in which information must be rapidly processed to enable the successful interpretation of other people's behavior.
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Affiliation(s)
- Apolline Durtette
- Université de Reims Champagne Ardenne, Laboratoire Cognition, Santé et Société, B.P. 30, 57 Rue Pierre Taittinger, 51571 Reims Cedex, France.
| | - Franca Schmid
- Université de Reims Champagne Ardenne, Laboratoire Cognition, Santé et Société, B.P. 30, 57 Rue Pierre Taittinger, 51571 Reims Cedex, France.
| | - Sarah Barrière
- Pôle Universitaire de Psychiatrie, EPSM et CHU de Reims, 8 Rue Roger Aubry, 51100 Reims, France.
| | - Alexandre Obert
- Institut national universitaire Champollion, Université de Toulouse, Laboratoire Sciences de la cognition, Technologie, Ergonomie, Place de Verdun, 81000 Albi, France.
| | - Julie Lang
- Pôle Universitaire de Psychiatrie, EPSM et CHU de Reims, 8 Rue Roger Aubry, 51100 Reims, France.
| | - Delphine Raucher-Chéné
- Université de Reims Champagne Ardenne, Laboratoire Cognition, Santé et Société, B.P. 30, 57 Rue Pierre Taittinger, 51571 Reims Cedex, France; Douglas Mental Health University Institute, McGill University, 6875 Boulevard LaSalle, Montreal, Canada.
| | - Fabien Gierski
- Université de Reims Champagne Ardenne, Laboratoire Cognition, Santé et Société, B.P. 30, 57 Rue Pierre Taittinger, 51571 Reims Cedex, France; Pôle Universitaire de Psychiatrie, EPSM et CHU de Reims, 8 Rue Roger Aubry, 51100 Reims, France.
| | - Arthur Kaladjian
- Université de Reims Champagne Ardenne, Laboratoire Cognition, Santé et Société, B.P. 30, 57 Rue Pierre Taittinger, 51571 Reims Cedex, France; Pôle Universitaire de Psychiatrie, EPSM et CHU de Reims, 8 Rue Roger Aubry, 51100 Reims, France; Université de Reims Champagne Ardenne, Faculté de Médicine, 51 rue Cognacq-Jay, 51100, Reims, France.
| | - Audrey Henry
- Université de Reims Champagne Ardenne, Laboratoire Cognition, Santé et Société, B.P. 30, 57 Rue Pierre Taittinger, 51571 Reims Cedex, France; Pôle Universitaire de Psychiatrie, EPSM et CHU de Reims, 8 Rue Roger Aubry, 51100 Reims, France.
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Prospective memory performance and its improvement in individuals with high schizotypal traits: Evidence from eye-tracking studies. Clin Neurophysiol 2022; 143:133-142. [DOI: 10.1016/j.clinph.2022.09.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2022] [Revised: 08/28/2022] [Accepted: 09/10/2022] [Indexed: 11/19/2022]
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Smith ES, Crawford TJ. Positive and Negative Symptoms Are Associated with Distinct Effects on Predictive Saccades. Brain Sci 2022; 12:brainsci12040418. [PMID: 35447950 PMCID: PMC9025332 DOI: 10.3390/brainsci12040418] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Revised: 03/10/2022] [Accepted: 03/19/2022] [Indexed: 02/05/2023] Open
Abstract
The predictive saccade task is a motor learning paradigm requiring saccades to track a visual target moving in a predictable pattern. Previous research has explored extensively anti-saccade deficits observed across psychosis, but less is known about predictive saccade-related mechanisms. The dataset analysed came from the studies of Crawford et al, published in 1995, where neuroleptically medicated schizophrenia and bipolar affective disorder patients were compared with non-medicated patients and control participants using a predictive saccade paradigm. The participant groups consisted of medicated schizophrenia patients (n = 40), non-medicated schizophrenia patients (n = 18), medicated bipolar disorder patients (n = 14), non-medicated bipolar disorder patients (n = 18), and controls (n = 31). The current analyses explore relationships between predictive saccades and symptomatology, and the potential interaction of medication. Analyses revealed that the schizophrenia and bipolar disorder diagnostic categories are indistinguishable in patterns of predictive control across several saccadic parameters, supporting a dimensional hypothesis. Once collapsed into predominantly high-/low- negative/positive symptoms, regardless of diagnosis, differences were revealed, with significant hypometria and lower gain in those with more negative symptoms. This illustrates how the presentation of the deficits is homogeneous across diagnosis, but heterogeneous when surveyed by symptomatology; attesting that a diagnostic label is less informative than symptomatology when exploring predictive saccades.
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Affiliation(s)
- Eleanor S. Smith
- Department of Psychology, University of Cambridge, Cambridge CB2 3EB, UK;
| | - Trevor J. Crawford
- Centre for Ageing Research, Department of Psychology, Lancaster University, Lancaster LA1 4YF, UK
- Correspondence:
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Meso AI, De Vai RL, Mahabeer A, Hills PJ. Evidence of inverted gravity-driven variation in predictive sensorimotor function. Eur J Neurosci 2020; 52:4803-4823. [PMID: 32730682 DOI: 10.1111/ejn.14926] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 07/01/2020] [Accepted: 07/20/2020] [Indexed: 11/30/2022]
Abstract
We move our eyes to place the fovea into the part of a viewed scene currently of interest. Recent evidence suggests that each human has signature patterns of eye movements like handwriting which depend on their sensitivity, allocation of attention and experience. Use of implicit knowledge of how earth's gravity influences object motion has been shown to aid dynamic perception. We used a projected ball-tracking task with a plain background offering no context cues to probe the effect of acquired experience about physical laws of gravitation on performance differences of 44 participants under a simulated gravity and an atypical (upward) antigravity condition. Performance measured by the unsigned difference between instantaneous eye and stimulus positions (RMSE) was consistently worse in the antigravity condition. In the vertical RMSE, participants took about 200 ms longer to improve to the best performance for antigravity compared to gravity trials. The antigravity condition produced a divergence of individual performance which was correlated with levels of questionnaire-based quantified traits of schizotypy but not control traits. Grouping participants by high or low traits revealed a negative relationship between schizotypy trait level and both initiation and maintenance of tracking, a result consistent with trait-related impoverished sensory prediction. The findings confirm for the first time that where cues enabling exact estimation of acceleration are unavailable, knowledge of gravity contributes to dynamic prediction improving motion processing. With acceleration expectations violated, we demonstrate that antigravity tracking could act as a multivariate diagnostic window into predictive brain function.
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Affiliation(s)
- Andrew Isaac Meso
- Neuroimaging Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.,Institut de Neuroscience de la Timone, Team Invibe, CNRS & Aix-Marseille Université, Marseille, 13005, France.,Psychology & Interdisciplinary Neuroscience Group, Bournemouth University, Poole, UK
| | - Robert L De Vai
- Psychology & Interdisciplinary Neuroscience Group, Bournemouth University, Poole, UK
| | - Ashakee Mahabeer
- Psychology & Interdisciplinary Neuroscience Group, Bournemouth University, Poole, UK
| | - Peter J Hills
- Psychology & Interdisciplinary Neuroscience Group, Bournemouth University, Poole, UK
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