Shyness, emotion processing, and objective quality of life among adults with schizophrenia: an ERP study

Purpose: Although individual differences in temperament have been shown to influence Quality of Life (QoL) among individuals with schizophrenia, there exists considerable heterogeneity in such outcomes suggesting moderating factors. Here we used event-related potential (ERP) methodology to examine whether the processing of facial emotions moderated the association between shyness and objective QoL among adults with schizophrenia.Methods: Forty stable outpatients with schizophrenia completed measures of shyness and QoL. Early visual ERP components (P100, N170) were recorded while participants viewed emotional faces.Results: We observed a significant interaction between shyness and P100 and N170 amplitudes in response to fearful faces in predicting Intrapsychic Foundations QoL. Patients with reduced P100 and N170 amplitudes to fearful compared to neutral faces displayed the lowest QoL, but only if they were also high in shyness. We also found a significant interaction between shyness and ERP latency at the P100 and N170 in response to happy faces. Patients who displayed longer P100 and N170 latencies to happy faces compared to neutral faces and with higher shyness levels scored lower on Intrapsychic Foundations and Interpersonal Relations QoL, respectively.Conclusion: These findings suggest that the neural processing of emotional faces and shyness interact to predict aspects of QoL among outpatients with schizophrenia.

Revisiting Shyness and Sociability in Schizophrenia: A Psychometric Examination of Measurement Invariance and Mean Level Differences

Although there is a long and rich empirical history of demonstrating differences on psychological self-report measures between people with schizophrenia and healthy controls, the question of whether both groups respond to psychological measures in the same way has gone largely unexplored. That is, is there measurement equivalence, or invariance, across the samples? To our knowledge, there have been no published studies on measurement equivalency in personality measures across groups diagnosed with and without schizophrenia. Here we examined the question of measurement invariance on two widely used questionnaires assessing temperament, the Cheek and Buss Shyness and Sociability Scales (CBSHY and CBSOC, respectively) between 147 stable adult outpatients with schizophrenia and 147 healthy age- and sex-matched controls. Results supported measurement invariance of the CBSHY and CBSOC across our clinical and non-clinical groups. These findings suggested that stable adult outpatients with schizophrenia and age- and sex-matched controls respond to the shyness and sociability items in the same way. We found that adults with schizophrenia reported higher levels of shyness and lower levels of sociability than healthy controls, consistent with prior studies. Findings are discussed concerning their relevance more broadly to self-report assessments of personality and psychological traits in clinical populations.

Personality and opponent processes: Shyness, sociability, and visual afterimages to emotion

The opponent process theory of emotion posits that emotional states evoke opposite emotion states as they wane, resulting in sequential approach and withdrawal motivations. However, whether opponent processes are associated with individual differences in personality remains an empirical question. Using visual afterimage responses to emotional faces as an index of opponent processes, we found that young adults (N = 101; Mage = 19.41 years, SD = 2.06 years) characterized by relatively high shyness and high sociability (i.e., conflicted shyness) were more likely to perceive a negative face emotion afterimage after adapting to happy faces and a positive face emotion afterimage after adapting to angry faces, compared with young adults classified by other combinations of high and low shyness and sociability. We speculate that conflicted shyness may result from strong opponent processes to both positive and negative emotions to real or anticipated social situations in some individuals, resulting in conflicting social motivations. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Shyness, hormones, and quality of life among adults with schizophrenia

OBJECTIVE

Although individual differences in personality are known to influence quality of life in individuals with schizophrenia, relatively few studies have attempted to identify putative links underlying this relation.

METHODS

Here, we examined associations among temperamental shyness, hormones (ie baseline salivary cortisol and testosterone), and quality of life (QoL) measured in 42 stable outpatient adults with schizophrenia.

RESULTS

We found that baseline cortisol, but not testosterone, moderated the relation between shyness and QoL (ß = 1.09, p = 0.004). Among individuals with relatively low baseline cortisol, higher shyness was associated with lower Intrapsychic Foundations QoL. Individuals with relatively higher baseline cortisol reported similar QoL scores irrespective of level of shyness.

CONCLUSION

These preliminary results suggest that relatively lower baseline cortisol may be helpful to understanding the relation between temperament and Intrapsychic Foundations QoL in schizophrenia. The present findings are consistent with previous studies implicating relatively lower baseline cortisol levels in nonclinical samples of people who are shy and the negative downstream effects resulting from HPA axis dysregulation, and extends these prior findings to people with schizophrenia who are also shy.

Does Integrated Neurocognitive Therapy (INT) reduce severe negative symptoms in schizophrenia outpatients?

Negative symptoms often inhibit the social integration of people suffering from schizophrenia. Reducing severe negative symptoms (SNS) in a clinically relevant way is a major unmet need. The aim of this study was to investigate whether Integrated Neurocognitive Therapy (INT), a group cognitive remediation therapy (CRT), reduces SNS in schizophrenia outpatients. INT was compared with Treatment As Usual (TAU) in a randomized-controlled trial (RCT). A total of 61 SNS outpatients participated in the study, 28 were allocated to the INT group and 33 to the TAU group. A test-battery was used at baseline, post-treatment at 15weeks, and 1-year-follow-up. Remission rates of SNS after therapy were significantly higher for INT compared to TAU. A trend favoring INT was obtained at follow-up. Furthermore, INT showed significantly higher functional outcome during follow-up compared to TAU. Regarding cognition, the strongest significant effect was found in attention post-treatment. No effects between groups on more complex neurocognition and social cognition were evident. SNS outpatients seem to accept INT group intervention as suggested by the high attendance rate.

There is an app for that! The current state of mobile applications (apps) for DSM-5 obsessive-compulsive disorder, posttraumatic stress disorder, anxiety and mood disorders

Mental health apps are viewed as a promising modality to extend the reach of mental health care beyond the clinic. They do so by providing a means of assessment, tracking, and treatment through a smartphone. Given that nearly 2/3 of the American population owns a smartphone, mental health apps offer the possibility of overcoming treatment barriers such as geographic location or financial barriers. Unfortunately, the excitement surrounding mental health apps may be premature as the current supporting literature regarding their efficacy is limited. The app marketplace is littered with apps claiming to treat or assess symptoms, but even those created by reputable organizations or those incorporating components of evidence-based treatments have not yet been validated in terms of their efficacy. This review aims to provide a comprehensive review of the current state of the mental health app literature by examining published reports of apps designed for DSM-5 anxiety and mood disorders, OCD, and PTSD. The breadth of apps reviewed includes those oriented around assessment, symptom tracking, and treatment as well as "multipurpose" apps, which incorporate several of these components. This review will also present some of the most popular mental health apps which may have clinical utility and could be prescribed to clients. While we discuss many potential benefits of mental health apps, we focus on a number of issues that the current state of the app literature presents. Overall there is a significant disconnect between app developers, the scientific community and health care, leaving the utility of existing apps questionable.

Three-component synthesis of spiro[indoline-3,4'-pyrano[3,2-b]pyran]- 2,8'-diones using a one-pot reaction

A one-pot, three-component reaction of an isatin and kojic acid with an active methylene compound such as ethyl cyanoacetate, methyl cyanoacetate and malononitrile in methanol using catalytic amount of DABCO to give 2'- amino-6'-(hydroxymethyl)-8'H-spiro[indoline-3,4'-pyrano[3,2-b]pyran]-2,8'-diones in good to excellent yields under reflux conditions, is described.