Cognitive-perceptual, interpersonal, and disorganized features of schizotypal personality

Suppression of Deactivation of Working Memory and Promotion of Activation of Sustained Attention in the Default Mode Network Are Affected by Schizotypy in a Large Sample of Nonclinical Subjects

INTRODUCTION

Schizotypy is a personality trait characterized by subclinical expression of the signs and symptoms of schizophrenia. Maladaptive schizotypy is given the clinical designation of schizotypal personality disorder. Previous studies have shown that functional disturbance of the default mode network (DMN) is associated with maladaptive schizotypy. Working memory impairment is a particularly common feature of maladaptive schizotypy and schizophrenia. As these characteristics can also be observed in the healthy population, our purpose was to identify the neural correlates of schizotypy during sustained attention tasks and working memory tasks in nonclinical subjects.

METHODS

We recruited 409 healthy individuals (251 men and 158 women; 20.7 ± 1.8 [SD] years of age) and determined their schizotypy scores using the Schizotypal Personality Questionnaire. We used a typical functional MRI (fMRI) task under 0-back and 2-back conditions. Corrections for multiple comparisons were performed via the threshold-free cluster enhancement method with a familywise error-corrected threshold of p < 0.0167 (0.05/3) at the whole-brain level, including the cerebellum.

RESULTS

Suppression of deactivation of the DMN (the medial prefrontal cortex (mPFC), the posterior cingulate cortex, the inferior parietal lobule, and the middle temporal gyrus) in the working memory (2-back > rest) task and promotion of activation during the sustained attention (0-back > rest) task were associated with schizotypy scores. Among the schizotypy subscores, cognitive-perceptual deficits were significantly related only to the left precuneus, the mPFC, and the superior temporal gyrus for the 2-back > 0-back contrast; to the left precuneus and the bilateral mPFC for the 2-back > rest contrast; and to the left superior temporal cortex and the right precuneus for the 0-back > rest contrast within the DMN.

CONCLUSION

Disturbance of the DMN is related to the degree of schizotypy, especially to the degree of cognitive‒perceptual deficits, even in nonclinical subjects.

Parent-Rated Schizotypy and Clinician-Rated Psychotic Experiences in Early Adolescence as Predictors of Schizophrenia Diagnosis by Middle Adulthood

BACKGROUND AND HYPOTHESIS

Subclinical psychotic symptoms (also known as psychotic experiences comprising positive features only, and schizotypy comprising positive, negative, and disorganized features) are important markers of schizophrenia liability. Different assessment methods detect different sources of meaningful variance and are vulnerable to different biases and sources of measurement error. Whereas interview-rated psychotic symptoms in childhood are known to predict adult schizophrenia diagnosis, the predictive value of parent-rated psychotic symptoms remains unknown. We tested whether clinician-rated psychotic symptoms and parent-rated positive, negative, and disorganized schizotypy in early adolescence are nonredundant predictors of schizophrenia diagnosis by age 38 years.

STUDY DESIGN

In a representative birth cohort (n = 1037) from Dunedin, New Zealand, psychotic symptoms were assessed by clinical interview at age 11 years, schizotypy was assessed by parent or caregiver ratings at ages 13- and 15 years, and lifetime schizophrenia diagnosis was assessed throughout adulthood until age 38 years. We tested for redundancy using bootstrapped multivariable logistic regression.

STUDY RESULTS

Clinician-rated psychotic symptoms at age 11 predicted adult schizophrenia diagnosis (OR = 2.68, 95% CI = 1.42, 5.06), as did parent-rated total schizotypy (OR = 1.83, 95% CI = 1.42, 2.36). In univariable models, clinician-rated psychotic experiences and parent-rated positive, negative, and disorganized schizotypy were significant predictors of schizophrenia diagnosis. In multivariable models where clinician- and parent-rated scores were entered, only parent-rated negative and disorganized schizotypy did not predict adult schizophrenia diagnosis.

CONCLUSIONS

Parent-rated schizotypy and clinician-rated subclinical psychotic symptoms are valid, nonredundant indicators of lifetime risk for schizophrenia.

Dynamic interactions among schizotypal traits, affective and prodromal symptoms, social functioning in a large sample of college students: A cross-lagged panel network analysis

OBJECTIVE

Previous studies suggested that schizotypal traits are closely related with affective symptoms and social dysfunction in general population. However, the dynamic interactions among these variables across time remain unclear. This study aimed to investigate this issue using cross-sectional and longitudinal network analysis.

METHODS

A total of 9136 college students completed self-report scales measuring schizotypal traits, anxiety, depression, prodromal risk, and social functioning at timepoint 1 (T1) and six months later. Classical contemporaneous network analysis was used to estimate the associations among all variables at T1, and the cross-lagged panel network analysis was performed to estimate the predictive effects at follow-up. In addition, prodromal high-risk and low-risk subgroups at T1 were identified using Prodromal Questionnaire (PQ-16) to investigate differences on network constructs and edge weights using Network Comparison Tests (NCT).

RESULTS

Contemporaneous network showed that negative dimension of schizotypal traits, anxiety, and depression interacted and were all negatively correlated with social functioning. Of all the nodes in the network, interpersonal features of schizotypal traits was the most centralized. The results of cross-lagged network analysis further verified the predictive effect of personality traits and emotions on social function. In addition, NCT revealed significant difference between prodromal high-risk and low-risk subgroups in network structure and strength of edges connecting schizotypal traits, affective symptoms with prodromal risk, but not in global strength.

CONCLUSIONS

Our findings suggest that schizotypal traits, affective symptoms, and prodromal risk relate to social functioning, both independently and through their dynamic interactions.

Facial Emotion Recognition and its Associations With Psychological Well-Being Across Four Schizotypal Dimensions: a Cross-Sectional Study

OBJECTIVE

The present study aimed to examine facial emotion recognition in a sample from the general population with elevated schizotypal traits, as defined by the four-factor model of schizotypy, and the association of facial emotion recognition and the schizotypal dimensions with psychological well-being.

METHOD

Two hundred and thirty-eight participants were allocated into four schizotypal groups and one control group. Following a cross-sectional study design, facial emotion recognition was assessed with a computerized task that included images from the Radboud Faces Database, schizotypal traits were measured with the Schizotypal Personality Questionnaire, and psychological well-being was evaluated with the Flourishing scale.

RESULTS

The results revealed distinct patterns of performance across the schizotypal groups and the application of a dimensional approach that included all participants as one group indicated specific associations between the four schizotypal dimensions and psychological well-being. Specifically, (a) negative schizotypes showed poor identification of sadness and fear potentially due to the activation of coping mechanisms, (b) disorganized schizotypes inaccurately recognized surprise, possibly reflecting the effects of disorganized thought on distinguishing this ambiguous emotion, and (c) psychological well-being was predicted by high cognitive-perceptual along with low negative and disorganized schizotypy as well as the accurate recognition of specific emotional states that are common in daily social interactions.

CONCLUSIONS

In conclusion, the study findings further advance the identification of emotion-processing difficulties in schizophrenia-vulnerable individuals and further highlight the need for highly personalized early intervention strategies.

Functional Connectome Hierarchy in Schizotypy and Its Associations With Expression of Schizophrenia-Related Genes

BACKGROUND AND HYPOTHESIS

Schizotypy has been conceptualized as a continuum of symptoms with marked genetic, neurobiological, and sensory-cognitive overlaps to schizophrenia. Hierarchical organization represents a general organizing principle for both the cortical connectome supporting sensation-to-cognition continuum and gene expression variability across the cortex. However, a mapping of connectome hierarchy to schizotypy remains to be established. Importantly, the underlying changes of the cortical connectome hierarchy that mechanistically link gene expressions to schizotypy are unclear.

STUDY DESIGN

The present study applied novel connectome gradient on resting-state fMRI data from 1013 healthy young adults to investigate schizotypy-associated sensorimotor-to-transmodal connectome hierarchy and assessed its similarity with the connectome hierarchy of schizophrenia. Furthermore, normative and differential postmortem gene expression data were utilized to examine transcriptional profiles linked to schizotypy-associated connectome hierarchy.

STUDY RESULTS

We found that schizotypy was associated with a compressed functional connectome hierarchy. Moreover, the pattern of schizotypy-related hierarchy exhibited a positive correlation with the connectome hierarchy observed in schizophrenia. This pattern was closely colocated with the expression of schizophrenia-related genes, with the correlated genes being enriched in transsynaptic, receptor signaling and calcium ion binding.

CONCLUSIONS

The compressed connectome hierarchy suggests diminished functional system differentiation, providing a novel and holistic system-level basis for various sensory-cognition deficits in schizotypy. Importantly, its linkage with schizophrenia-altered hierarchy and schizophrenia-related gene expression yields new insights into the neurobiological continuum of psychosis. It also provides mechanistic insight into how gene variation may drive alterations in functional hierarchy, mediating biological vulnerability of schizotypy to schizophrenia.

Childhood Trauma Across the Schizophrenia Spectrum: A Comparison of Schizotypal Personality Disorder and Schizophrenia

BACKGROUND

The etiology of schizophrenia involves both biological and environmental risk factors. Studying childhood trauma in disorders along the schizophrenia spectrum, including schizotypal personality disorder (SPD), can inform early risk and protective factors for psychosis. However, no study has directly compared childhood trauma between SPD and schizophrenia.

STUDY DESIGN

One hundred twenty-four participants (schizophrenia/schizoaffective disorder [SZ] n = 45, SPD n = 32, and healthy controls [HCs] n = 47) matched on age and gender were assessed for different types of childhood abuse and neglect as well as clinical symptoms. Kruskal-Wallis H-tests examined group differences in childhood trauma severity and logistic regression modeled childhood trauma types that were associated with an SZ vs SPD diagnosis.

STUDY RESULTS

SZ and SPD had greater severity than HC on total trauma score and all types of childhood trauma assessed (all P-values < .05). SZ and SPD only differed on childhood sexual abuse, which was greater in SZ (P = .039). Childhood sexual abuse (odds ratio [OR] = 1.14, 95% confidence interval [CI] = 1.02-1.27, P = .02) and emotional abuse (OR = 0.82, 95% CI = 0.71-0.95, P = .01) were independent predictors of an SZ vs SPD diagnosis. Sensitivity analysis indicated that a cutoff at mild sexual abuse was significant in predicting SZ vs SPD when compared with none/minimal sexual abuse. In SZ, greater sexual abuse was associated with positive schizotypal traits and in SPD, greater emotional abuse was associated with depressive symptoms.

CONCLUSIONS

Findings suggest that childhood sexual and emotional abuse may be important factors that influence illness trajectory across the severity of disorders on schizophrenia spectrum. These findings have implications for understanding disease mechanisms and early prevention.

Re-evaluation of the relationship between paranormal belief and perceived stress using statistical modelling

Recent research indicates that paranormal belief, in the absence of allied cognitive-perceptual and psychopathology-related factors, is not associated with negative wellbeing outcomes. However, investigators have historically reported relationships between specific facets of belief (e.g., superstition) and stress vulnerability. These typically derive from the Revised Paranormal Belief Scale (RPBS), which has questionable psychometric integrity. The main issue being that several RPBS items perform poorly. Noting this, the present paper re-examined the relationship between paranormal belief and stress using the Rasch purified version of the RPBS. This comprises two dimensions, called Traditional Paranormal Belief (TPB) and New Age Philosophy (NAP). These are operationalised in terms of function. Specifically, whether belief provides a sense of control at the social (TPB) or individual level (NAP). Accordingly, this study examined whether TPB and NAP were differentially predictive of levels of perceived stress. In this context, stress served as an indicator of well-being. A sample of 3084 participants (Mage = 50.31, SD = 15.20, range 18-91) completed the RPBS alongside the 10-item Perceived Stress Scale (PSS-10). Confirmatory factor analysis and structural equation modelling revealed that TPB was significantly predictive of higher Distress, and lower Coping. NAP was neither predictive of Distress nor Coping. These findings support the notion that TPB is attendant with external control, particularly the notion that unknown supernatural forces/powers influence existence.

Overshadowing and salience attribution in relation to cannabis use

Aberrant attentional salience has been implicated in the cannabis-psychosis association. Here, history and frequency of cannabis use were examined against changes in overshadowing (OS), a cue competition paradigm that involves salience processing. Additionally, we examined the association between OS and alternative measures of aberrant salience, as well as schizotypy, in a non-clinical adult sample. 280 participants completed an online geometry learning-based OS task, while a subset (N = 149) also completed the Salience Attribution Task (SAT) measure of aberrant salience. All completed the Schizotypal Personality Questionnaire (SPQ), Aberrant Salience Inventory (ASI), and the modified Cannabis Experience Questionnaire (CEQmv). Differences across OS and SAT performance stages and between cannabis use groups were assessed using mixed ANOVAs. Multiple regression and correlational analyses assessed the relationships between OS and SAT task metrics and SPQ and ASI subscale scores. Current cannabis users had significantly lower OS scores during the testing phase relative to those who do not use cannabis, at medium effect sizes. Schizotypy or ASI scores did not mediate this relationship. In the SAT, current cannabis users presented significantly higher implicit aberrant salience relative to non-users. Scores in the first training phase of the OS task significantly predicted higher explicit aberrant and adaptive salience scores in the SAT. These data indicate an association between regular cannabis use and abnormalities in cue competition effects in a healthy adult sample. Comparisons of OS and SAT cast new light on putative overlapping mechanisms underlying performance across different measures of salience.

Omega-3 Supplementation Reduces Schizotypal Personality in Children: A Randomized Controlled Trial

BACKGROUND AND HYPOTHESIS

Based on a childhood intervention from ages 3 to 5 years that included additional fish consumption and which resulted in reduced schizotypal personality at age 23, we had previously hypothesized that omega-3 could reduce schizotypy. The current study tests the hypothesis that omega-3 supplementation reduces schizotypy in children.

STUDY DESIGN

In this intention-to-treat, randomized, single-blind, stratified, factorial trial, a community sample of 290 children aged 11-12 years were randomized into Omega-3 Only, Cognitive Behavioral Therapy (CBT) Only, Omega-3 + CBT, and Control groups. Schizotypy was assessed using the SPQ-C (Schizotypal Personality Questionnaire for Children) at 0 months (baseline), 3 months (end of treatment), 6 months (3 months post-treatment), and 12 months (9 months post-treatment).

STUDY RESULTS

A significant group × time interaction (P = .013) indicated that, compared with Controls, total schizotypy scores were reduced in both Omega-3 Only and Omega-3 + CBT groups immediately post-treatment (d = 0.56 and 0.47, respectively), and also 3 months after supplementation terminated (d = 0.49, d = 0.70). Stronger findings were observed for the interpersonal schizotypy factor, with both omega-3 groups showing reductions 9 months post-treatment compared with the CBT Only group. Schizotypy reductions were significantly stronger for those with higher dietary intake of omega-3 at intake. Sensitivity analyses confirmed findings.

CONCLUSIONS

Results are unique in the field and suggest that omega-3 can help reduce schizotypal personality in community-residing children. From an epidemiological standpoint, if replicated and extended, these findings could have implications for early prevention of more significant schizotypal features developing later in adolescence.

CLINICAL TRIAL REGISTRATION

"Healthy Brains & Behavior: Understanding and Treating Youth Aggression (HBB)." ClinicalTrials.gov Identifier: NCT00842439, https://clinicaltrials.gov/ct2/show/NCT00842439.

Positive and negative schizotypy personality traits are lower in individuals on ketogenic diet in a non-clinical sample

Schizotypal personality comprises traits such as odd beliefs, perceptual abnormalities, and social difficulties; these traits are distributed throughout the general population. While not meeting the clinical threshold for schizophrenia or schizotypal personality disorder, schizotypal personality traits still provide insights for understanding early clinical risk factors. Ketogenic diet reportedly reduces psychotic symptoms in preclinical and clinical studies. Therefore, we investigated whether ketogenic diet is associated with lower schizotypal traits in the general population. Participants following a ketogenic or other diet were recruited using opportunity sampling. Individuals completed a survey investigating general demographic, socioeconomic, health, diet and lifestyle questions, followed by the Schizotypal Personality Questionnaire - Brief Revised version (SPQ-BR). We found that individuals following a ketogenic diet (n = 118) had lower ideas of reference, magical thinking, suspiciousness, unusual perceptions, constricted affect, social anxiety scores, cognitive (positive) perceptual scores, interpersonal (negative) scores and total SPQ-BR compared to individuals on the other diets (n = 139). Magical thinking, constricted affect, social anxiety, cognitive perceptual, interpersonal scores and total SPQ-BR scores remained significant when we controlled for body mass index (BMI) and age. Disorganised features were not influenced by ketogenic diet. The longer individuals adhered to a ketogenic diet the lower their positive and negative schizotypy traits. These findings highlight that ketogenic diet is associated with lower non-clinical schizotypal personality traits. Our results suggest that ketogenic diet might have potential prophylactic properties for individuals at-risk for psychosis.

The association between discourse production and schizotypal personality traits

Discourse abnormalities are a prominent feature in schizophrenia spectrum disorders, including poor lexical diversity, and have been found to differentiate patients from healthy subjects. However, discourse processing in individuals with high schizotypal personality traits is less understood and is often overshadowed by research on clinical psychotic symptoms. In the present study, we examined schizotypal traits at a non-clinical threshold and their association with lexical diversity and discourse coherence using two automated Natural Language Processing (NLP) tools - Type-Token-Ratio (TTR) measures from the Tool for the Automatic Analysis of Lexical Diversity (TAALED) and discourse coherence using sentence-level average cosign similarity with FastText to assess sentence similarity. 276 college students completed the full assessment including the Schizotypal Personality Questionnaire- Brief Revised (SPQ-BR) and recorded a speech sample describing a detailed painting. Results revealed that high schizotypal traits, specifically positive traits, were associated with lower lexical diversity and higher sentence similarity. Our findings suggest that even when clinically significant symptoms are not present, discourse abnormalities are present in healthy populations with high ST. The stronger association with positive traits suggests that theories of perseveration and top-down processing may warrant further investigation in schizophrenia-spectrum disorders.

Variations in positive well-being as a function of the interaction between paranormal belief and schizotypy

This study examined variations in positive well-being as a function of paranormal belief and schizotypy. A sample of 2,362 United Kingdom-based respondents completed self-report measures assessing paranormal belief, schizotypy, positive well-being (meaning in life, satisfaction with life, and self-esteem), paranormal experience, and belief in conspiracies. The paranormal belief was most strongly related to the cognitive-perceptual factor of schizotypy. Both paranormal belief and the cognitive-perceptual factor were associated with reporting paranormal experiences and endorsement of conspiracist beliefs. Despite commonality, paranormal belief and schizotypy were differentially related to well-being. Paranormal belief correlated positively with meaning in life (presence and search) and satisfaction with life. Schizotypy correlated negatively with presence, satisfaction with life, and self-esteem and positively with search. Latent profile analysis identified four subgroups: Profile 1, low belief and schizotypy (49% of the sample); Profile 2, low belief and cognitive-perceptual, moderate interpersonal and disorganised (13.6%); Profile 3, high belief, moderate cognitive-perceptual and interpersonal, low disorganised (24.3%); and Profile 4, high belief and schizotypy (13.1%). Multivariate analysis of variance (MANOVA) found that low belief with mixed schizotypy was associated with lower presence, and low belief and schizotypy (vs. high) were related to higher presence. Paranormal belief and schizotypy were associated with greater search, higher scores on paranormal experiential factors, and endorsement of generic conspiracist beliefs. Finally, lower belief and schizotypy were concomitant with higher satisfaction with life and self-esteem. Overall, paranormal belief was related to positive well-being, whereas schizotypy was associated with lower positive wellbeing.

The Future-oriented Repetitive Thought (FoRT) scale: Validation in Chinese samples and application in the schizophrenia spectrum

BACKGROUND

Repetitive thoughts are usually associated with psychopathology. The Future-oriented Repetitive Thought (FoRT) Scale is a measure designed to capture frequency of repetitive thought about positive and negative future events. However, the validity of the scale in Chinese population and its application in the schizophrenia spectrum have not been examined.

METHODS

The current study aimed to examine the psychometric properties of the Chinese version of the FoRT scale and to apply it to the schizophrenia spectrum. In Study 1, three samples (total N = 1875) of university students were recruited for exploratory factor analysis, confirmatory factor analysis, and validity test, respectively. In Study 2, we identified subsamples with high schizotypal traits (N = 89) and low schizotypal traits (N = 89), and recruited 36 inpatients with schizophrenia and 41 matched healthy controls.

RESULTS

The three-factor (pessimistic repetitive future thinking, repetitive thinking about future goals, and positive indulging about the future) structure of the FoRT scale with one item deleted, fitted the Chinese samples. And the scale could distinguish patients with schizophrenia and individuals with high schizotypal traits from controls.

CONCLUSION

These findings support that the Chinese version of the FoRT scale is a valid tool and provide evidence for the potential applications in the schizophrenia spectrum.

Emotional anticipation for dynamic emotional faces is not modulated by schizotypal traits: A Representational Momentum study

Schizotypy, a personality structure that resembles schizophrenia symptoms, is often associated with abnormal facial emotion perception. Based on the prevailing sense of threat in psychotic experiences, and the immediate perceptual history of seeing others' facial expressions, individuals with high schizotypal traits may exhibit a heightened tendency to anticipate anger. To test this, we used insights from Representational Momentum (RM), a perceptual phenomenon in which the endpoint of a dynamic event is systematically displaced forward, into the immediate future. Angry-to-ambiguous and happy-to-ambiguous avatar faces were presented, each followed by a probe with the same (ambiguous) expression as the endpoint, or one slightly changed to express greater happiness/anger. Participants judged if the probe was "equal" to the endpoint and rated how confident they were. The sample was divided into high (N = 46) and low (N = 49) schizotypal traits using the Schizotypal Personality Questionnaire (SPQ). First, a forward bias was found in happy-to-ambiguous faces, suggesting emotional anticipation solely for dynamic faces changing towards a potential threat (anger). This may reflect an adaptative mechanism, as it is safer to anticipate any hostility from a conspecific than the opposite. Second, contrary to our hypothesis, high schizotypal traits did not heighten RM for happy-to-ambiguous faces, nor did they lead to overconfidence in biased judgements. This may suggest a typical pattern of emotional anticipation in non-clinical schizotypy, but caution is needed due to the use of self-report questionnaires, university students, and a modest sample size. Future studies should also investigate if the same holds for clinical manifestations of schizophrenia.

The Moderation Effect of Approach Motivation Between Schizotypy and Creative Ideational Behavior

Introduction

The schizotypy-creativity link has been studied from different perspectives over the past few decades, yet the results of this relationship are inconsistent in the literature. Previous studies have suggested that two basic motivational systems-Behavioral Inhibition System (BIS, avoidance motivation) and Behavioral Activation System (BAS, approach motivation)-underlie the relationship between schizotypy and creativity. Few empirical studies, however, have examined how the relationship interacts with other variables. This study fills these gaps and explores the role of the approach and avoidance motivation assessed by trait behavioral activation and inhibition in the link between schizotypy as a dimensional personality trait and creative ideational behavior as a measure of creativity.

Method

Undergraduate students (N = 388) completed questionnaires including the Schizotypal Personality Questionnaire (SPQ) measuring 3 dimensions of schizotypy, Runco Ideational Behavior Scale (RIBS) measuring creative ideational behavior, and BIS/BAS Scales measuring trait behavioral motivation. Bivariate Pearson correlation was computed, and hierarchical linear regression was performed to explore the effects of schizotypy, BIS/BAS, and their interaction on creative ideational behavior. The conditional effect of schizotypy based on different levels of the moderator was further tested.

Results

The total score, positive dimension and disorganized dimension of SPQ were all positively correlated with RIBS, BAS, and BIS. Negative dimension of SPQ was not significantly correlated with the RIBS score but was positively correlated with BIS. Additionally, after controlling gender and age, BAS significantly moderated the relationship between the positive and disorganized dimensions of schizotypy and creative ideational behavior measured by RIBS. However, BIS was not a significant moderator.

Discussion

The findings of this study regarding the relationships between different dimensions of schizotypy, two motivational systems, and creative ideational behavior were mostly consistent with previous findings. The significant moderated effect of BAS on the relationship between two dimensions of schizotypy and creative ideational behavior made significant contributions to the understanding of the relationship between schizotypy and creativity.

Relationship between theta/beta ratio and mind wandering in schizotypy

Negative association was found between the frontal theta/beta ratio and mind wandering in participants with high schizotypal traits, while no such association was found in participants with low schizotypal traits. These findings provide insights into the neural mechanism of mind wandering in individuals with high schizotypal traits.

Atypical semantic cognition in schizotypal personality disorder and borderline personality disorder

Increased schizotypal traits have previously been associated with atypical semantic cognition in community samples. However, no study has yet examined whether adults diagnosed with schizotypal personality disorder (SPD) display atypical semantic fluency and memory. We hypothesized that 24 adults diagnosed with SPD would name more idiosyncratic words on the semantic fluency task and show decreased semantic recall for animal and fruit category words compared with 29 participants with borderline personality disorder (BPD) and a community sample of 96 age-matched controls. We examined whether atypical semantic cognition was specifically associated with disorganized and eccentric speech and thinking, or more broadly with pathological personality traits and personality functioning. Our main hypothesis was confirmed, as the SPD participants named more idiosyncratic words and recalled fewer semantically related words compared with controls. Surprisingly, participants with BPD likewise named more atypical words compared with controls. More idiosyncratic semantic fluency was associated with more eccentric speech and thinking. Increased idiosyncratic semantic fluency and reduced semantic recall were both coupled to increased detachment and lowered personality functioning, while reduced semantic recall further was related to increased interpersonal problems. Our findings suggest that persons with SPD, and to a lesser degree BPD, show atypical semantic cognition, which is associated with eccentric speech and thinking, and more broadly with impaired personality function, social withdrawal, and emotional flatness. The idiosyncratic semantic cognition may worsen difficulties with social reciprocity seen in SPD and BPD.

Schizotypy and perceptual span in a non-clinical sample: a virtual reality study

INTRODUCTION

Individuals with high schizotypy or schizophrenia exhibit difficulties in distributing their attention across space, leading to a reduction in their "perceptual span" - the extent of visual space that can be attended to at once. In this study, we aim to explore the correlation between schizotypy and perceptual span in a non-clinical sample to investigate whether perceptual span correlates with schizotypy across its range.

METHODS

Schizotypy was assessed in fifty-five participants using the Schizotypy Personality Questionnaire (SPQ; Raine, 1991). Participants were required to attend to two dynamic targets displayed in a head-mounted virtual reality display. Perceptual span was estimated as the lateral angle of separation between the two targets beyond which performance in the task dropped to threshold.

RESULTS

Participants with higher schizotypy scores performed significantly worse on the task. Of all the factors associated with schizotypy, the shared variance between Disorganisation and Cognitive/Perceptual Factors was most predictive of task performance.

CONCLUSION

The results support the hypothesis that schizotypy predicts perceptual span in non-clinical samples. Furthermore, the demonstration of a reduced perceptual span in individuals with higher trait schizotypy shows that variations in an individual's capacity to divide attention across space can be accurately captured using a virtual reality head-mounted display.

Quantifying the effects of practicing a semantic task according to subclinical schizotypy

The learning ability of individuals within the schizophrenia spectrum is crucial for their psychosocial rehabilitation. When selecting a treatment, it is thus essential to consider the impact of medications on practice effects, an important type of learning ability. To achieve this end goal, a pre-treatment test has to be developed and tested in healthy participants first. This is the aim of the current work, which takes advantage of the schizotypal traits present in these participants to preliminary assess the test's validity for use among patients. In this study, 47 healthy participants completed the Schizotypal Personality Questionnaire (SPQ) and performed a semantic categorization task twice, with a 1.5-hour gap between sessions. Practice was found to reduce reaction times (RTs) in both low- and high-SPQ scorers. Additionally, practice decreased the amplitudes of the N400 event-related brain potentials elicited by semantically matching words in low SPQ scorers only, which shows the sensitivity of the task to schizotypy. Across the two sessions, both RTs and N400 amplitudes had good test-retest reliability. This task could thus be a valuable tool. Ongoing studies are currently evaluating the impact of fully deceptive placebos and of real antipsychotic medications on these practice effects. This round of research should subsequently assist psychiatrists in making informed decisions about selecting the most suitable medication for the psychosocial rehabilitation of a patient.

The role of the differential outcomes procedure and schizotypy in the recognition of dynamic facial expressions of emotions

Emotional facial expression recognition is a key ability for adequate social functioning. The current study aims to test if the differential outcomes procedure (DOP) may improve the recognition of dynamic facial expressions of emotions and to further explore whether schizotypal personality traits may have any effect on performance. 183 undergraduate students completed a task where a face morphed from a neutral expression to one of the six basic emotions at full intensity over 10 s. Participants had to press spacebar as soon as they identified the emotion and choose which had appeared. In the first block, participants received no outcomes. In the second block, a group received specific outcomes associated to each emotion (DOP group), while another group received non-differential outcomes after correctly responding (NOP group). Employing generalized linear models (GLMs) and Bayesian inference we estimated different parameters to answer our research goals. Schizotypal personality traits did not seem to affect dynamic emotional facial expression recognition. Participants of the DOP group were less likely to respond incorrectly to faces showing Fear and Surprise at fewer intensity levels. This may suggest that the DOP could lead to better identification of the main features that differentiate each facial expression of emotion.

Network Structure of Childhood Trauma, Bodily Disturbances, and Schizotypy in Schizophrenia and Nonclinical Controls

Background and Hypothesis

Exposure to childhood trauma has been linked to the development of psychosis and bodily self-disturbances, 2 hallmarks of schizophrenia (SZ). Prior work demonstrated that bodily disturbances serve as a bridge between childhood trauma and SZ symptomatology, but the diagnostic specificity of these connections remains unknown. This study uses network analysis to bridge this gap by comparing the interplays between childhood trauma, bodily self-disturbances, and schizotypy in clinical and general populations.

Study Design

Networks were constructed to examine the relationships between schizotypy (Schizotypal Personality Questionnaire; SPQ), bodily self-disturbances (Perceptual Aberration Scale; PAS), and childhood trauma (Childhood Trauma Questionnaire, CTQ) in 152 people with SZ and 162 healthy comparison participants (HC). The Fused Graphical Lasso was used to jointly estimate the networks in the 2 groups and the structure and strength of the networks were compared. Node centrality and shortest paths between CTQ, PAS, and schizotypy were examined.

Study Results

When comparing SZ and HC, the network of bodily self-disturbances, childhood trauma, and schizotypy were similarly structured, but the network was significantly stronger in SZ than HC. In both groups, bodily self-disturbances were on one of the shortest paths between childhood trauma to schizotypal experiences.

Conclusions

Our findings revealed reliable associations between childhood trauma, bodily self-disturbance, and schizotypy, with bodily disturbances acting as a bridge from childhood trauma to schizotypy. The elevated strength of the SZ network indicates a more highly interconnected, and therefore reactive network in which exposure to childhood trauma can more easily activate bodily disturbances and schizotypy.

Childhood Schizotypy and Adolescent Mental Disorder

BACKGROUND AND HYPOTHESIS

Schizotypy provides a framework for understanding the developmental nature of psychotic disorders and a means of identifying "at-risk" individuals early in the lifespan. However, there is a lack of prospective longitudinal research examining the relationship between schizotypy in childhood and later psychotic and other mental disorders. We hypothesized that distinct profiles of schizotypy in childhood would be differentially associated with psychotic and other mental disorders emerging later in adolescence.

STUDY DESIGN

In a large population cohort of Australian young people (n = 26 837), we prospectively examined the relationship between person-centered profiles of schizotypy identified in middle childhood (age ~11 years) and adolescent diagnoses (age ~13-18 years) across 7 types of mental disorders using multinomial logistic regression.

RESULTS

Membership in any of 3 childhood schizotypy profiles (true schizotypy, affective schizotypy, or introverted schizotypy) was associated with an increased likelihood of being diagnosed with any type of mental disorder in adolescence; effects were strongest for the true schizotypy group (aOR = 3.07, 95% CI = 2.64, 3.57), followed by the introverted (aOR = 1.94, 95% CI = 1.75, 2.15) and affective (aOR = 1.29, 95% CI = 1.13, 1.47) schizotypy groups. Six of the 7 types of mental disorders measured (including psychotic disorders) were associated with at least 1 schizotypy group.

CONCLUSIONS

Schizotypy in middle childhood is an important correlate of mental disorders in adolescence; however, it does not appear to be specifically associated with psychotic disorders in this age group.

Measurement invariance of brief forms of the Schizotypal Personality Questionnaire across convenience versus random samples

Schizotypy, a multifaceted personality construct that represents liability for schizophrenia, is generally measured with self-report questionnaires that have been developed and validated in samples of undergraduate students. Given that understanding schizotypy in non-clinical samples is essential for furthering our understanding of schizophrenia-spectrum psychopathologies, it is critical to test whether non-clinically identified undergraduate and other convenience samples respond to schizotypy scales in the same way as random samples of the general population. Here, 651 undergraduates, 350 MTurk workers, and two randomly selected high school samples (n = 177, n = 551) completed brief versions of the Schizotypal Personality Questionnaire (SPQ-BR or SPQ-BRU). Multigroup confirmatory factor analysis was used to test whether measurement invariance was present across samples. Tests were made for all samples together and for each pair of samples. Results showed that a first-order nine-factor model fit the data well, and this factor structure displayed configural and metric invariance across the four samples. This suggests that schizotypy has the same factor structure, and the SPQ-BR/BRU is measuring the same construct across the different groups. However, when all groups were compared, results indicated a lack of scalar invariance across these samples, suggesting mean comparisons may be inappropriate across different sample types. However, when randomly selected high school students were compared with undergraduate students, scalar invariance was present. This suggests that factors such as culture and form type may be driving invariance, rather than sampling method (convenience vs general population).

Parental mental disorders and offspring schizotypy in middle childhood: an intergenerational record linkage study

PURPOSE

To investigate relationships between distinct schizotypy risk profiles in childhood and the full spectrum of parental mental disorders.

METHODS

Participants were 22,137 children drawn from the New South Wales Child Development Study, for whom profiles of risk for schizophrenia-spectrum disorders in middle childhood (age ~ 11 years) were derived in a previous study. A series of multinomial logistic regression analyses examined the likelihood of child membership in one of three schizotypy profiles (true schizotypy, introverted schizotypy, and affective schizotypy) relative to the children showing no risk, according to maternal and paternal diagnoses of seven types of mental disorders.

RESULTS

All types of parental mental disorders were associated with membership in all childhood schizotypy profiles. Children in the true schizotypy group were more than twice as likely as children in the no risk group to have a parent with any type of mental disorder (unadjusted odds ratio [OR] = 2.27, 95% confidence intervals [CI] = 2.01-2.56); those in the affective (OR = 1.54, 95% CI = 1.42-1.67) and introverted schizotypy profiles (OR = 1.39, 95% CI = 1.29-1.51) were also more likely to have been exposed to any parental mental disorder, relative to children showing no risk.

CONCLUSION

Childhood schizotypy risk profiles appear not to be related specifically to familial liability for schizophrenia-spectrum disorders; this is consistent with a model where liability for psychopathology is largely general rather than specific to particular diagnostic categories.

Psychotherapy for patients with schizotypal personality disorder: A scoping review

BACKGROUND

Treatment of schizotypal personality disorder is complex. Currently, there are no clear evidence-based recommendations for use of psychotherapy for individuals suffering from this mental illness, and studies are sparse. Our aim in this review is to map and describe the existing research and to answer the research question: What do we know about the use of psychotherapy for people with schizotypal personality disorder?

METHODS

We conducted a scoping review using systematic searches in the Embase, MEDLINE and PsycINFO databases. Two reviewers screened possible studies and extracted data on subject samples, type of psychotherapy, outcomes and suggested mechanisms of change. The review is based on the PRISMA checklist for scoping reviews.

RESULTS

Twenty-three papers were included, and we found a wide variety of study types, psychotherapeutic orientations and outcomes. Few studies emerged that focused solely on schizotypal personality disorder.

CONCLUSION

Psychotherapy as a treatment for schizotypal personality disorder is understudied compared with diagnoses such as schizophrenia and borderline personality disorder. Our results included two randomized controlled studies, as well as mainly smaller studies with different approaches to diagnostic criteria, psychotherapeutic orientation and outcome measures. The findings are too sparse and too diverse to make any evidence-based recommendations. We found some indications that psychotherapy may support and assist individuals with schizotypal personality disorder.

Comparing two measures of schizotypy and their relationship with psychological distress in British university students

AIMS

Schizotypy reflects the vulnerability to schizophrenia in the general population. Different questionnaires have been developed to measure aspects of schizotypy. Higher schizotypy scores have also been linked with depression, anxiety, and stress sensitivity. Here we examine the associations of schizotypy with symptoms of depression and anxiety in a sample of university students, using two different measures (N = 271).

METHODS

A series of confirmatory factor analyses was used to examine two distinct and frequently employed measures of schizotypy: the Community Assessment of Psychic Experiences (CAPE), and the Schizotypy Personality Questionnaire (SPQ). We assessed their relationship with each other and their predictive validity for anxiety, depression, and stress sensitivity.

RESULTS

Our results indicated the brief 7-factor SPQ (SPQ-BR) factor solution for the SPQ and the 15-item and 3 factor solution for the CAPE (i.e., CAPE-P15) as best fitting models. Particularly the CAPE dimension of persecutory ideation was a strong predictor of anxiety, depression, and stress sensitivity, whereas the SPQ dimensions of no close friends and social anxiety predicted psychological distress and stress in our student sample.

CONCLUSIONS

Our findings extend earlier work in general and patient samples and point to the importance of understanding the contribution of particularly positive schizotypy symptoms and different interpersonal aspects to psychological distress.

Impaired neural response to reward feedback in children with high schizotypal traits: Evidences from an ERP study

Reward processing deficit is a core feature of schizophrenia, however, it remains unclear whether reward processing is impaired in individuals with high schizotypy. In this study, 27 high schizotypal trait and 25 control group children were screened by the Chinese version of the Schizotypal Personality Questionnaire for Children (SPQC). We recorded their brain activity (event-related potentials, ERPs) while they completed a simple gambling task. In the early semi-automatic processing stage, small losses s evoked a more negative feedback-related negativity (FRN) in the high schizotypy group than that in control group, and the large wins evoked a less positive reward positivity (RewP) in the high schizotypy group than that in the control group. In the later cognitive appraisal stage, the Feedback-P3 (Fb-P3) amplitude was smaller in the schizotypy group than in control group. These results provided evidence that the abnormalities of outcome evaluation exist in the schizotypy children. Pending replications and longitudinal studies, the FRN, RewP and the P3 might represent a psychophysiological marker of risk for schizophrenia.

Examining Schizotypal Personality Scales Within and Across Interpersonal Circumplex Surfaces

Differing perspectives on the operationalization of schizotypal personality pathology (STPP) have led to numerous multidimensional assessment measures. The current study applied the interpersonal construct validation approach to self-report data from 856 undergraduate students to formally examine the interpersonal content, similarities, and differences in the subscales of four measures of STPP within and across two interpersonal circumplex surfaces using a bootstrapping methodology for computing confidence intervals around circumplex structural summary method parameters. Results suggested that negative-like expressions of STPP are prototypically and distinctively interpersonal constructs associated with cold and socially avoidant interpersonal problems and hypersensitivity to others' warmth and affection. Positive-like expressions of STPP as assessed by two out of four measures were prototypically and distinctively interpersonal constructs associated with vindictiveness. Across four measures, there was notable overlap in interpersonal correlates among related subscales, suggesting convergent validity. However, subscales containing social anxiety content were associated with more submissive (i.e., socially avoidant) interpersonal problems than subscales without social anxiety content.

Resting-State Functional Connectivity Explained Psychotic-like Experiences in the General Population and Partially Generalized to Patients and Relatives

Background

Psychotic-like experiences (PLEs) are considered the subclinical portion of the psychosis continuum. Research suggests that there are resting-state functional connectivity (rsFC) substrates of PLEs, yet it is unclear if the same substrates underlie more severe psychosis. Here, to our knowledge, we report the first study to build a cross-validated rsFC model of PLEs in a large community sample and directly test its ability to explain psychosis in an independent sample of patients with psychosis and their relatives.

Methods

Resting-state FC of 855 healthy young adults from the WU-Minn Human Connectome Project (HCP) was used to predict PLEs with elastic net. An rsFC composite score based on the resulting model was correlated with psychotic traits and symptoms in 118 patients with psychosis, 71 nonpsychotic first-degree relatives, and 45 healthy control subjects from the psychosis HCP.

Results

In the HCP, the cross-validated model explained 3.3% of variance in PLEs. Predictive connections spread primarily across the default, frontoparietal, cingulo-opercular, and dorsal attention networks. The model partially generalized to a younger, but not older, subsample in the psychosis HCP, explaining two measures of positive/disorganized psychotic traits (the Structured Interview for Schizotypy: β = 0.25, pone-tailed = .027; the Schizotypy Personality Questionnaire positive factor: β = 0.14, pone-tailed = .041). However, it did not differentiate patients from relatives and control subjects or explain psychotic symptoms in patients.

Conclusions

Some rsFC substrates of PLEs are shared across the psychosis continuum. However, explanatory power was modest, and generalization was partial. It is equally important to understand shared versus distinct rsFC variances across the psychosis continuum.

Developing and validating the Japanese version of the Referential Thinking Scale: A cross-sectional study

It has been shown that ideas of reference in the context of paranoia (IoR-P) and schizophrenia spectrum disorders (IoR-S) are caused by different psychological constructs. Although it is well known that both IoR-P and IoR-S are frequently evoked during the same period of life, how they interact with each other is unknown. The purpose of the present study was to develop the Japanese version of the Referential Thinking Scale (J-REF) to assess IoR-S, examine its validity and reliability, and explore the predictors of IoR-P and IoR-S. In this study, several subgroups of Japanese individuals in their 20s were included in the analysis. The J-REF had high internal consistency, high test-retest reliability, good convergent, and discriminant validity. Two hierarchical regression analyses showed that public self-consciousness predicted the manifestation of IoR-P, while the dimensions of schizotypy predicted that of IoR-S. Moreover, social anxiety and negative moods could cause IoR-P and IoR-S. This study directly showed the existence of two different types of ideas of reference in terms of their predictors. It is also significant in that it first examined referential thinking using the REF scale in the context of Asia and showed that there may not be much difference in the frequency of ideas of reference from other cultures. Future research directions are also discussed.

Schizotypal traits in a large sample of high-school and university students from Tunisia: correlates and measurement invariance of the arabic schizotypal personality questionnaire across age and sex

BACKGROUND

The main goal of the present study was to examine the characteristics of schizotypal traits and their correlations with genetic (i.e., family history of mental illness), demographic (i.e., age, sex), environmental (e.g., income, urbanicity, tobacco/alcohol/cannabis use), and psychological (i.e., personal history of mental illness other than psychosis) factors in Tunisian high-school and university students. Our secondary goal was to contribute the literature by examining the factor structure and factorial invariance of the Arabic Schizotypal Personality Questionnaire (SPQ) across sex and age (adolescents [12-18 years] vs. young adults [18-35 years]) groups.

METHOD

This was a cross-sectional study involving 3166 students: 1160 (36.6%) high-school students (53.0% females, aged 14.9 ± 1.8); and 2006 (63.4%) university students (63.9% females, aged 21.8 ± 2.3). All students were asked to complete a paper-and-pencil self-administered questionnaire containing sociodemographic characteristics as well as the Arabic version of the SPQ.

RESULTS

The total sample yielded total SPQ scores of 24.1 ± 16.6 out of 74. The SPQ yielded good composite reliability as attested by McDonald's omega values ranging from .68 to .80 for all nine subscales. Confirmatory Factor Analysis indicated that fit of the 9-factor model of SPQ scores was acceptable. This model is invariant (at the configural, metric and structural levels) across sex and age. Except for "Odd or eccentric behavior", all schizotypy features were significantly higher among female students compared to males. Multivariable analyses showed that female sex, being a university student, lowest family incomes, tobacco use, and having a personal history of psychiatric illness were significantly associated with higher positive, negative and disorganized schizotypy subscales scores.

CONCLUSION

Future research still needs to confirm our findings and investigate the contribution of the identified factors in the development of clinical psychosis. We can also conclude that the Arabic SPQ is appropriate for measuring and comparing schizotypy across age and sex in clinical and research settings. These findings are highly relevant and essential for ensuring the clinical utility and applicability of the SPQ in cross-cultural research.

Multidimensional schizotypy and embodied emotions

Background

Disembodiment and socio-emotional deficits are core features of the schizophrenia spectrum from the prodromal stages to chronic illness. A recent study documented anomalous emotional embodiment in individuals with schizophrenia. Although bodily self disturbances have been shown to precede and predict psychosis onset in at-risk populations, the etiology of anomalous emotional embodiment remains largely unexplored. The present study investigated bodily maps of emotions in relation to schizotypy to extend our understanding of embodied emotions in the schizophrenia spectrum.

Methods

A total of 419 participants (312 female; 19.50 ± 1.22 years) completed a topographical body mapping task where they reported patterns of embodiment experienced in the context of eleven different emotions and a neutral state (EmBODY). Embodied emotions were investigated in relation to multidimensional schizotypy.

Results

Individuals with elevated negative schizotypy experienced embodied emotions with higher intensity (r = 0.16, p = 0.003) but lower clarity (i.e., endorsing activation and deactivation in the same bodily location; β = -0.28, 95% CI [-0.54, -0.03], Z = 2.25, p=0.02) and endorsed more incongruent bodily sensations of emotions (i.e., reporting bodily activation in the context of a low-arousal emotion, r = 0.12, p = 0.05; reporting bodily deactivation in the context of high-arousal emotions, r = 0.13, p = 0.02). In line with the anomalous emotional embodiment documented in individuals with schizophrenia, some of these differences were particularly notable for low-arousal emotions.

Discussion

These results reveal negative schizotypy as a significant correlate of differences in emotional embodiment. More work is needed to link these differences to the anomalous bodily sensations of emotions documented in schizophrenia and assess their functional impact.

Mental rotation and schizotypal personality traits: A Bayesian approach

People diagnosed with schizophrenia exhibit mental rotation differences, suggesting that clinical levels of positive symptoms, such as psychotic hallucinations, are related to disruptions in their monitoring and manipulation of mental representations. According to the psychosis continuum, findings in people with a high level of schizotypal personality traits are expected to be qualitatively similar, but research concerning this topic is scarce. A spared mental imagery manipulation in this population only could suggest that this ability might be a possible protective factor, or that the emergence of clinical-level positive symptoms could be paired with disruptions in this capacity. To explore this issue, 205 undergraduate students (122 women) completed a novel mental rotation task identifying the stimulus that was a 90, 180, or 270° rotation of a black circle with colored portions and were assessed with the Schizotypal Personality Questionnaire. Men performed better in most conditions. No relationship was detected between schizotypal personality traits and accuracy in the task. These results do not support that mental imagery manipulation disruptions may be related to schizotypal personality traits in non-clinical populations. Thus, they might instead be associated with the onset of psychosis disorders as mental representation handling is hindered. However, additional research is required including the general population, as well as those with higher levels of psychotic symptoms and psychosis disorders. Future research could also focus on working memory processes related to mental representation manipulations of different sensory modalities such as auditory mental representations and their relationship with schizotypal personality traits and clinical populations.

Trait schizotypy and the psychosis prodrome: Current standard assessment of extended psychosis spectrum phenotypes

Schizotypy has become an increasingly important construct for elaborating psychotic disorders that vary along the schizophrenic spectrum. However, different schizotypy inventories vary in conceptual approach and measurement. In addition, commonly used schizotypy scales have been seen as qualitatively different from screening instruments for prodromal schizophrenia like the Prodromal Questionnaire-16 (PQ-16). Our study investigated the psychometric properties of three schizotypy questionnaires (the Schizotypal Personality Questionnaire-Brief, Oxford-Liverpool Inventory of Feelings and Experiences, and the Multidimensional Schizotypy Scale) as well as the PQ-16 in a cohort of 383 non-clinical subjects. We initially evaluated their factor structure using Principal Component Analysis (PCA) and used Confirmatory Factor Analysis (CFA) to test a newly proposed composition of factors. PCA results support a three-factor structure of schizotypy that accounts for 71 % of the total variance, but also shows cross-loadings of some schizotypy subscales. CFA of the newly composed schizotypy factors (together with an added neuroticism factor) shows good fit. Analyses including the PQ-16 indicate considerable overlap with measures of trait schizotypy, suggesting that the PQ-16 might not be quantitatively or qualitatively different from schizotypy measurements. Taken together, results indicate that there is good support for a three-factor structure of schizotypy but also that different schizotypy measurements grasp facets of schizotypy differently. This points towards the need for an integrative approach for assessing the construct of schizotypy.

Race and self-reported paranoia: Increased item endorsement on subscales of the SPQ

There is a dearth of research examining how individual-level and systemic racism may lead to elevated diagnostic and symptom rates of paranoia in Black Americans. The present study employed item response theory methods to investigate item- and subscale-level functioning in the Schizotypal Personality Questionnaire (SPQ) in 388 Black and 450 White participants across the schizophrenia-spectrum (i.e., non-psychiatric controls, individuals with schizophrenia, schizoaffective disorder, or schizotypal personality disorder). It was predicted that (1) Black participants would score significantly higher than Whites on the Suspiciousness and Paranoid Ideation subscale of the SPQ, while controlling for total SPQ severity and relevant demographics and (2) Black participants would endorse these subscale items at a lower latent severity level (i.e., total SPQ score) compared to Whites. Generalized linear modeling showed that Black participants endorsed higher scores on subscales sampling paranoia (e.g., Suspiciousness and Paranoid Ideation), while White participants endorsed higher rates within disorganized/positive symptomatology subscales (e.g., Odd or Eccentric Behavior). IRT analyses showed that Black individuals also endorse items within the Suspiciousness and Paranoid Ideation subscale at lower latent severity levels, leading to inflated subscale scores when compared to their White counterparts. Results indicate prominent race effects on self-reported paranoia as assessed by the SPQ. This study provides foundational data to parse what could be normative endorsements of paranoia versus indicators of clinical risk in Black Americans. Implications and recommendations for paranoia research and assessment are discussed.

Activation of the left medial temporal gyrus and adjacent brain areas during affective theory of mind processing correlates with trait schizotypy in a nonclinical population

Schizophrenia, a severe psychiatric disorder, is associated with abnormal brain activation during theory of mind (ToM) processing. Researchers recently suggested that there is a continuum running from subclinical schizotypal personality traits to fully expressed schizophrenia symptoms. Nevertheless, it remains unclear whether schizotypal personality traits in a nonclinical population are associated with atypical brain activation during ToM tasks. Our aim was to investigate correlations between fMRI brain activation during affective ToM (ToMA) and cognitive ToM (ToMC) tasks and scores on the Schizotypal Personality Questionnaire (SPQ) and the Basic Empathy Scale in 39 healthy individuals. The total SPQ score positively correlated with brain activation during ToMA processing in clusters extending from the left medial temporal gyrus (MTG), lingual gyrus and fusiform gyrus to the parahippocampal gyrus (Brodmann area: 19). During ToMA processing, the right inferior occipital gyrus, right MTG, precuneus and posterior cingulate cortex negatively correlated with the emotional disconnection subscore and the total score of self-reported empathy. These posterior brain regions are known to be involved in memory and language, as well as in creative reasoning, in nonclinical individuals. Our findings highlight changes in brain processing associated with trait schizotypy in nonclinical individuals during ToMA but not ToMC processing.

Facial emotion recognition and schizotypal traits: A systematic review of behavioural studies

AIM

Previous research has indicated that individuals expressing high schizotypal traits and patients with Schizotypal Personality Disorder (SPD), show deficits in facial emotion recognition, compared to low schizotypal or control groups. On the other hand, non-significant findings also exist and the association of facial emotion recognition deficits with the different schizotypal dimensions is not well defined, thus limiting any conclusive outcomes. Therefore, the aim of this systematic review was to further clarify this relationship.

METHODS

PsychInfo, Web of Science, Scopus and PubMed were systematically searched, and 23 papers with a cross-sectional design were selected. Nineteen studies examined individuals with high schizotypal traits and four studies evaluated SPD individuals with behavioural facial emotion recognition paradigms and self-report measures or clinical interviews for schizotypal traits. All selected studies were published between 1994 and August 2020.

RESULTS

According to the evidence of studies, high schizotypal individuals and SPD patients have poorer performance in facial emotion recognition tasks. Negative schizotypy was related to lower accuracy for positive and negative emotions and faster emotion labeling while positive schizotypy was associated with worse accuracy for positive, negative and neutral emotions and more biases. Disorganized schizotypy was associated with poorer accuracy for negative emotions and suspiciousness with higher accuracy for disgust faces but lower total accuracy.

CONCLUSIONS

These findings are consistent with the vulnerability for schizophrenia spectrum disorders and support the idea that emotion recognition deficits are trait markers for these conditions. Thus, the effectiveness of early-intervention programmes could increase by also targeting this class of deficits.

Polygenic risk for schizophrenia as a moderator of associations between childhood trauma and schizotypy

Recent evidence shows that genetic and environmental risk factors for psychotic disorders are associated with higher levels of schizotypy (or psychosis proneness) in the general population. However, little is known about how these risk factors interact. We specifically examined whether genetic loading for schizophrenia moderates the association between childhood trauma severity and schizotypy. Schizotypy was measured using the Schizotypal Personality Questionnaire (SPQ), and childhood trauma severity was measured with the Childhood Trauma Questionnaire (CTQ) among a total of 168 participants (comprising 51 healthy individuals, 56 diagnosed with schizophrenia, and 61 with bipolar disorder). Polygenic risk scores (PRS) for schizophrenia were calculated for all participants and examined as a potential moderator of associations between total scores on the CTQ and schizotypy total scores and dimensions (i.e., cognitive-perceptual, interpersonal, disorganised). Multiple linear regression models revealed associations between childhood trauma and all dimensions of schizotypy, but no associations between PRS and schizotypy. A significant interaction between PRS and childhood trauma was evident for the interpersonal and disorganised dimensions of schizotypy, as well as the total score, reflecting positive associations between childhood trauma severity and these two schizotypal dimensions, only for individuals with low or average PRS for schizophrenia. This suggests that trauma may be able to increase risk for psychosis independently of any genetic vulnerability. The present findings are consistent with the idea of several risk pathways for the development of psychotic disorders.

Nutrition, Sleep, and Exercise as Healthy Behaviors in Schizotypy: A Scoping Review

This scoping review identifies the role of nutrition, sleep, and exercise as healthy behaviors in non-clinical individuals with schizotypy throughout the lifespan.

METHODS

We systematically reviewed the existing literature on these topics through databases including: PsycINFO, Scopus, APA PsycNet, ScienceDirect, Wiley Online Library, and SpringerLink.

RESULTS

Of the 59 studies found, a total of 29 studies met the inclusion criteria on the review topic. Included studies reflect varying study designs (cross-sectional, multiple time-point, intervention, randomized-placebo controlled trials), assessment of schizotypy and associated healthy behaviors, focus on various samples and lifespan (e.g., undergraduates, adolescents, at-risk individuals), and stem from different countries.

CONCLUSION

While a moderate number of studies address the role of nutrition, sleep, and physical exercise in relation to schizotypy, studies intersecting these topics are limited. Of the limited studies that do exist, the majority are correlational with the beginnings of causal support from intervention studies. As such, more research is needed on the topics of nutrition, sleep, and exercise in relation to schizotypy. Specifically, future research should focus on providing a more holistic understanding of schizotypal traits and its subtypes, and which specific or combination of behaviors may reduce levels of schizotypy.

Personality and Affective Correlates of Openness to Experience from Big Five and HEXACO Personality Models: The Dual Nature of Big Five Openness

Openness to Experience is considered to be one of the broadest personality traits. Different operationalizations of Openness to Experience within and between personality models incorporate various features of this trait. Differences in Openness facets across inventories may lead to differences in relation to certain outcomes. Hence, the current study looked to explore the personality and affective correlates of Openness domains and facets from the Big Five and HEXACO model. The sample consisted of 540 participants who completed measures assessing Openness to Experience domains and facets from Big Five and HEXACO, schizotypy, Disintegration, need for cognition, subjective well-being, and mania. Results revealed that schizotypy and Disintegration had mostly non-significant correlations with Openness domains from both models. However, multiple facets of Openness had significant both positive and negative correlations with these constructs. In contrast to HEXACO, Openness from the Big Five model could be presented with two distinct subdomains. The Pure Openness subdomain is related to higher mania, while Pure Intellect is associated with lower schizotypy, higher well-being, and higher need for cognition. Our results suggest that measuring Openness at lower structural levels provides us with more nuanced patterns of relationships among constructs.

Ambiguous handedness and visuospatial pseudoneglect in schizotypy in physical and computer-generated virtual environments

Virtual reality (VR) technology has increased clinical attention in the health care of schizophrenia spectrum disorders in both diagnoses of the symptoms and assessment of schizotypal traits. However, the exact nature of VR-induced positive treatment effect in schizotypy is still unknown. In this study, VR technology was used as a non-invasive neurocognitive trigger to test the asymmetric visuospatial representational instability found in individuals with high schizotypy. The study aimed to reveal the brain functional hemispheric laterality in physical and virtual realities in individuals with schizotypal traits. Fifty-one healthy, right-handed participants (24 males and 27 females) were enrolled through public advertisements. Hemispheric functional asymmetry was measured by the Line Bisection Task (LBT). The results revealed that (a) LBT bias in the physical reality showed a handedness-related leftward pseudoneglect, however, similar handedness-related pseudoneglect in VR has not been found. (b) Comparing LBT bias in physically real and VR environments showed rightward drift in VR environments independently to the degree of handedness. (c) The schizotypy has no association with handedness, however, the cognitive schizotypy is related to the LBT bias. Higher cognitive schizotypy in VR associated with left hemispatial pseudoneglect. In conclusion, schizotypy is associated with ambiguous behavioral and cognitive functional laterality. In individuals with high cognitive schizotypy, the VR environment enhanced the representational articulation of the left hemispace. This effect may be originated from the enhancement of the right hemisphere overactivation and is followed by a lower mental control of the overt behavior.

The positive dimension of schizotypy is associated with a reduced attenuation and precision of self-generated touch

The brain predicts the sensory consequences of our movements and uses these predictions to attenuate the perception of self-generated sensations. Accordingly, self-generated touch feels weaker than an externally generated touch of identical intensity. In schizophrenia, this somatosensory attenuation is substantially reduced, suggesting that patients with positive symptoms fail to accurately predict and process self-generated touch. If an impaired prediction underlies the positive symptoms of schizophrenia, then a similar impairment should exist in healthy nonclinical individuals with high positive schizotypal traits. One hundred healthy participants (53 female), assessed for schizotypal traits, underwent a well-established psychophysics force discrimination task to quantify how they perceived self-generated and externally generated touch. The perceived intensity of tactile stimuli delivered to their left index finger (magnitude) and the ability to discriminate the stimuli (precision) was measured. We observed that higher positive schizotypal traits were associated with reduced somatosensory attenuation and poorer somatosensory precision of self-generated touch, both when treating schizotypy as a continuous or categorical variable. These effects were specific to positive schizotypy and were not observed for the negative or disorganized dimensions of schizotypy. The results suggest that positive schizotypal traits are associated with a reduced ability to predict and process self-generated touch. Given that the positive dimension of schizotypy represents the analogue of positive psychotic symptoms of schizophrenia, deficits in processing self-generated tactile information could indicate increased liability to schizophrenia.

Frontotemporal thalamic connectivity in schizophrenia and schizotypal personality disorder

Schizotypal personality disorder (SPD) resembles schizophrenia, but with attenuated brain abnormalities and the absence of psychosis. The thalamus is integral for processing and transmitting information across cortical regions and widely implicated in the neurobiology of schizophrenia. Comparing thalamic connectivity in SPD and schizophrenia could reveal an intermediate schizophrenia-spectrum phenotype to elucidate neurobiological risk and protective factors in psychosis. We used rsfMRI to investigate functional connectivity between the mediodorsal nucleus (MDN) and pulvinar, and their connectivity with frontal and temporal cortical regions, respectively in 43 healthy controls (HCs), and individuals in the schizophrenia-spectrum including 45 psychotropic drug-free individuals with SPD, and 20 individuals with schizophrenia-related disorders [(schizophrenia (n = 10), schizoaffective disorder (n = 8), schizophreniform disorder (n = 1) and psychosis NOS (n = 1)]. Individuals with SPD had greater functional connectivity between the MDN and pulvinar compared to individuals with schizophrenia. Thalamo-frontal (i.e., between the MDN and rostral middle frontal cortex) connectivity was comparable in SPD and HCs; in SPD greater connectivity was associated with less symptom severity. Individuals with schizophrenia had less thalamo-frontal connectivity and thalamo-temporal (i.e., pulvinar to the transverse temporal cortex) connectivity compared with HCs. Thalamo-frontal functional connectivity may be comparable in SPD and HCs, but abnormal in schizophrenia, and that this may be protective against psychosis in SPD.

The Relationship Among Mentalization, Mindfulness, Working Memory, and Schizotypal Personality Traits in the General Population

Individuals with high schizotypal traits are less able to observe, describe, and monitor inner feelings, thoughts, and experiences, commonly referred to as mindfulness and mentalization. High schizotypy is also associated with impaired working memory (WM). However, the relationship among mindfulness, mentalization, WM, and schizotypal traits is unknown. Three hundred individuals from the community (mean age: 38.0 years, SD = 10.5; 49.3% women) completed questionnaires examining schizotypal traits, mindfulness, and mentalization and performed working memory tasks. Results revealed that mentalization was a general predictor of schizotypal traits, including unusual experiences, cognitive disorganization, introverted anhedonia, and impulsive nonconformity, when the effect of mindfulness and working memory was controlled. We also found a positive correlation between mindfulness and mentalization. Low mindfulness and mentalization performances were associated with high schizotypy. However, poor working memory was only weakly linked to cognitive disorganization and introverted anhedonia. These findings suggest that weak mentalization is a core feature of schizotypy independent of mindfulness and working memory.

Altered brain structural and functional connectivity in schizotypy

BACKGROUND

Schizotypy refers to schizophrenia-like traits below the clinical threshold in the general population. The pathological development of schizophrenia has been postulated to evolve from the initial coexistence of 'brain disconnection' and 'brain connectivity compensation' to 'brain connectivity decompensation'.

METHODS

In this study, we examined the brain connectivity changes associated with schizotypy by combining brain white matter structural connectivity, static and dynamic functional connectivity analysis of diffusion tensor imaging data and resting-state functional magnetic resonance imaging data. A total of 87 participants with a high level of schizotypal traits and 122 control participants completed the experiment. Group differences in whole-brain white matter structural connectivity probability, static mean functional connectivity strength, dynamic functional connectivity variability and stability among 264 brain sub-regions of interests were investigated.

RESULTS

We found that individuals with high schizotypy exhibited increased structural connectivity probability within the task control network and within the default mode network; increased variability and decreased stability of functional connectivity within the default mode network and between the auditory network and the subcortical network; and decreased static mean functional connectivity strength mainly associated with the sensorimotor network, the default mode network and the task control network.

CONCLUSIONS

These findings highlight the specific changes in brain connectivity associated with schizotypy and indicate that both decompensatory and compensatory changes in structural connectivity within the default mode network and the task control network in the context of whole-brain functional disconnection may be an important neurobiological correlate in individuals with high schizotypy.

Developmental profiles of schizotypy in the general population: A record linkage study of Australian children aged 11-12 years

Objectives

The detection of young people at high risk for psychotic disorders has been somewhat narrowly focused on overt symptom‐based markers that reflect mild reality distortion (e.g., psychotic‐like experiences), or prodromal syndromes that are proximal to psychosis onset. The concept of schizotypy represents a broader framework for investigating risk for schizophrenia (and other disorders) in childhood, before the onset of prodromal or overt symptoms. We sought to detect profiles of risk for psychosis (schizotypy) in a general population sample of 22,137 Australian children aged 11–12 years, and to determine early life risk factors associated with these profiles from data available in linked records (registers).

Methods

Fifty‐nine self‐reported items were used as indicators of schizotypy across six broad domains; z‐scores for each domain were subjected to latent profile analyses (LPA). A series of multinomial logistic regressions was used to examine the association between resulting profile (class) membership and several childhood and parental risk factors, and the proportion of children with mental disorders among each schizotypy profile was examined.

Results

The LPA revealed three person‐centred profiles referred to as True Schizotypy (n = 1,323; 6.0%), Introverted Schizotypy (n = 4,473; 20.2%), and Affective Schizotypy (n = 4,261; 19.2%), as well as a group of children showing no risk (n = 12,080; 54.6%). Prior exposure to perinatal and familial adversities including childhood maltreatment, as well as poor early childhood development and academic functioning, was variously associated with all risk groups. There was a higher proportion of childhood mental disorder diagnoses among children in the True Schizotypy group, relative to other profiles.

Conclusion

Subtle differences in the pattern of exposures and antecedents among schizophrenia liability profiles in childhood may reflect distinct pathogenic pathways to psychotic or other mental illness.

Practitioner points

Children aged 11–12 years report characteristics of schizotypy which can be classified into three distinct profiles that may represent different pathological processes towards later mental ill‐health.

Early life exposure to perinatal and familial adversities including childhood maltreatment, early childhood developmental vulnerability, and poor academic functioning predict membership in all three childhood schizotypy profiles.

Latent liability for schizophrenia (and potentially other mental disorders) may be represented by different profiles of functioning observable in childhood.

Interoceptive functioning in schizophrenia and schizotypy

Though bodily self-disturbances are well documented in schizophrenia, interoceptive functioning (i.e., the perception of the internal state of the body) remains poorly understood in this population. In fact, only two studies to date have empirically measured interoceptive ability in schizophrenia. Both studies documented a deficit in interoceptive accuracy (i.e., the objective performance on a heartbeat detection task), and one noted differences in interoceptive sensibility (i.e., the subjective experience of interoception) in this population. To our knowledge, interoceptive awareness (i.e., the metacognitive awareness of one's interoceptive ability) has never been measured in schizophrenia and the link between interoceptive functioning and schizotypy remains unexplored. The present study addresses this gap by investigating the three dimensions of interoception in individuals with schizophrenia and matched controls (Experiment 1, N = 58) and in relation to schizotypal traits (Experiment 2, N = 109). Consistent with the literature, Experiment 1 documented a deficit in interoceptive accuracy and differences in interoceptive sensibility in individuals with schizophrenia. For the first time, our study revealed intact interoceptive awareness in individuals with schizophrenia. Against our expectations, we found no link between schizotypy and interoceptive functioning in Experiment 2. Our novel findings bear important clinical implications as insight into one's interoceptive limitations (i.e., intact interoceptive awareness) might promote treatment seeking behavior in schizophrenia. The lack of association between interoceptive ability and schizotypy in non-help-seeking youths suggests that changes in interoception may only arise with the onset of psychosis.