Author
Alex S. Cohen
Other affiliations: Harvard University, University of Maryland, College Park, University of Rochester Medical Center ...read more
Bio: Alex S. Cohen is an academic researcher from Louisiana State University. The author has contributed to research in topics: Schizotypy & Mental health. The author has an hindex of 51, co-authored 239 publications receiving 9242 citations. Previous affiliations of Alex S. Cohen include Harvard University & University of Maryland, College Park.
Topics: Schizotypy, Mental health, Schizophrenia, Anhedonia, Cognition
Papers published on a yearly basis
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TL;DR: Barriers to progress in improvement of mental health services can be overcome by generation of political will for the organisation of accessible and humane mental health care, a qualitative survey of international mental health experts and leaders suggests.
881 citations
TL;DR: It is recommended that policymakers should act on the available evidence to scale up effective and cost-effective treatments and preventive interventions for mental disorders and community-based rehabilitation models provide a low-cost, integrative framework for care of children and adults with chronic mental disabilities.
787 citations
TL;DR: Findings suggest that this construct is multidimensional with at least 2 factors (involving diminished expression and anhedonia-asociality) and the importance of employing assessments that provide adequate coverage of the broad domain of negative symptoms.
Abstract: This review examines the structural validity of negative symptoms focusing on 2 questions: (1) Do negative symptoms represent a domain separate from other symptoms in schizophrenia? and (2) Within negative symptoms, is there a structure that suggests multidimensionality? Results from exploratory and confirmatory factor analytic studies are examined to address these questions. Across studies and symptom instruments, negative symptoms appear to consistently emerge as a factor separate from other dimensions of the illness in schizophrenia. Whether 2-, 3-, or 5-factor models are identified, negative symptoms consistently load on a factor separate from positive symptoms, affective symptoms of depression or anxiety, and symptoms of disorganization. Focusing on negative symptoms themselves, factor analytic findings suggest that this construct is multidimensional with at least 2 factors (involving diminished expression and anhedonia-asociality). Although these factors were replicable, serious limitations were noted in this literature. Thus, 2- (or even 3- or 5-) factor models of negative symptoms should not be considered definitive, but rather all converge to support the general conclusion of the multidimensionality of negative symptoms. The later findings indicate the importance of employing assessments that provide adequate coverage of the broad domain of negative symptoms. Importantly, caution is noted in the interpretability of findings based on existing instruments, and implications for future assessment are discussed.
578 citations
TL;DR: Patients' ability to experience hedonic emotion is preserved, although they also show relatively strong, simultaneously occurring aversive emotion when processing laboratory stimuli considered by others to be pleasant or neutral.
Abstract: Our understanding of the emotion deficits in schizophrenia is limited. Findings from studies employing trait emotion instruments suggest that patients have attenuated levels of positive emotion (ie, anhedonia) and increased levels of negative emotion. Conversely, patients and controls have not statistically differed in their subjective reactions to positive or negative valenced stimuli in most laboratory studies to date. Further obfuscating this issue is the fact that many of these laboratory studies are underpowered and a handful of emotion induction studies have found evidence of anhedonia. We conducted a meta-analysis of 26 published studies employing laboratory emotion induction procedures in patients with schizophrenia and healthy controls.Patients did notdiffer from controls whenstrictlyrating their subjective hedonic reactions to the stimuli. However, they reported experiencing relatively strong aversion to both positive and neutral stimuli (Hedges D .72 and .64, respectively). These findings were notthe result of demonstrable sample or methodological differences across studies. Patients’ ability to experience hedonic emotion is preserved, although they also show relatively strong, simultaneously occurring aversive emotion whenprocessing laboratory stimuli considered by others to be pleasant or neutral.
498 citations
TL;DR: The evidence suggests a need to reexamine presumed wisdom about schizophrenia outcomes in low- and middle-income countries, and assessments of outcomes should take excess mortality and suicide into account.
Abstract: Introduction: That schizophrenia has a better course and outcome in developing countries has become an axiom in international psychiatry. This is based primarily on a series of cross-national studies by the World Health Organization (WHO). However, increasing evidence from other research indicates a far more complex picture. Methods: Literature review and tabulation of data from 23 longitudinal studies of schizophrenia outcomes in 11 low- and middle-income countries. Results: We reviewed the evidence about the following domains: clinical outcomes and patterns of course, disability and social outcomes (marital and occupational status, in particular), and untreated samples and duration of untreated psychosis. Outcomes varied across the studies and the evidence suggests a need to reexamine the conclusions of the WHO studies. Additionally, assessments of outcomes should take excess mortality and suicide into account. Conclusions: It is time to reexamine presumed wisdom about schizophrenia outcomes in low- and middle-income countries.
246 citations
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TL;DR: Prevalence and severity of health loss were weakly correlated and age-specific prevalence of YLDs increased with age in all regions and has decreased slightly from 1990 to 2010, but population growth and ageing have increased YLD numbers and crude rates over the past two decades.
7,021 citations
TL;DR: The Global Burden of Diseases, Injuries, and Risk Factors Study 2010 (GBD 2010) as discussed by the authors was used to estimate the burden of disease attributable to mental and substance use disorders in terms of disability-adjusted life years (DALYs), years of life lost to premature mortality (YLLs), and years lived with disability (YLDs).
4,753 citations
TL;DR: The Linguistic Inquiry and Word Count (LIWC) system as discussed by the authors is a text analysis system that counts words in psychologically meaningful categories to detect meaning in a wide variety of experimental settings, including to show attentional focus, emotionality, social relationships, thinking styles and individual differences.
Abstract: We are in the midst of a technological revolution whereby, for the first time, researchers can link daily word use to a broad array of real-world behaviors. This article reviews several computerized text analysis methods and describes how Linguistic Inquiry and Word Count (LIWC) was created and validated. LIWC is a transparent text analysis program that counts words in psychologically meaningful categories. Empirical results using LIWC demonstrate its ability to detect meaning in a wide variety of experimental settings, including to show attentional focus, emotionality, social relationships, thinking styles, and individual differences.
4,356 citations
TL;DR: Mental health affects progress towards the achievement of several Millennium Development Goals, such as promotion of gender equality and empowerment of women, reduction of child mortality, improvement of maternal health, and reversal of the spread of HIV/AIDS.
2,943 citations
TL;DR: A meta-analysis of studies that have attempted to longitudinally predict a specific STB-related outcome suggests the need for a shift in focus from risk factors to machine learning-based risk algorithms.
Abstract: Suicidal thoughts and behaviors (STBs) are major public health problems that have not declined appreciably in several decades. One of the first steps to improving the prevention and treatment of STBs is to establish risk factors (i.e., longitudinal predictors). To provide a summary of current knowledge about risk factors, we conducted a meta-analysis of studies that have attempted to longitudinally predict a specific STB-related outcome. This included 365 studies (3,428 total risk factor effect sizes) from the past 50 years. The present random-effects meta-analysis produced several unexpected findings: across odds ratio, hazard ratio, and diagnostic accuracy analyses, prediction was only slightly better than chance for all outcomes; no broad category or subcategory accurately predicted far above chance levels; predictive ability has not improved across 50 years of research; studies rarely examined the combined effect of multiple risk factors; risk factors have been homogenous over time, with 5 broad categories accounting for nearly 80% of all risk factor tests; and the average study was nearly 10 years long, but longer studies did not produce better prediction. The homogeneity of existing research means that the present meta-analysis could only speak to STB risk factor associations within very narrow methodological limits-limits that have not allowed for tests that approximate most STB theories. The present meta-analysis accordingly highlights several fundamental changes needed in future studies. In particular, these findings suggest the need for a shift in focus from risk factors to machine learning-based risk algorithms. (PsycINFO Database Record
2,013 citations