Psychotic symptoms in children and adolescents with 22q11.2 deletion syndrome: Neuropsychological and behavioral implications

Background. Schizophrenia is characterized by profound and disabling deficits in the ability to recognize emotion in facial expression and tone of voice. Although these deficits are well documented in established schizophrenia using recently validated tasks, their predictive utility in at-risk populations has not been formally evaluated. Method. The Penn Emotion Recognition and Discrimination tasks, and recently developed measures of auditory emotion recognition, were administered to 49 clinical high-risk subjects prospectively followed for 2 years for schizophrenia outcome, and 31 healthy controls, and a developmental cohort of 43 individuals aged 7–26 years. Deficit in emotion recognition in at-risk subjects was compared with deficit in established schizophrenia, and with normal neurocognitive growth curves from childhood to early adulthood. Results. Deficits in emotion recognition significantly distinguished at-risk patients who transitioned to schizophrenia. By contrast, more general neurocognitive measures, such as attention vigilance or processing speed, were non-predictive. The best classification model for schizophrenia onset included both face emotion processing and negative symptoms, with accuracy of 96%, and area under the receiver-operating characteristic curve of 0.99. In a parallel developmental study, emotion recognition abilities were found to reach maturity prior to traditional age of risk for schizophrenia, suggesting they may serve as objective markers of early developmental insult. Conclusions. Profound deficits in emotion recognition exist in at-risk patients prior to schizophrenia onset. They may serve as an index of early developmental insult, and represent an effective target for early identification and remediation. Future studies investigating emotion recognition deficits at both mechanistic and predictive levels are strongly encouraged.

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Emotion recognition deficits as predictors of transition in individuals at clinical high risk for schizophrenia: a neurodevelopmental perspective.

Computers have been important to applied psychology since their introduction, and the application of computerized methods has expanded in recent decades. The application of computerized methods has broadened in both scope and depth. This article explores the most recent uses of computer-based assessment methods and examines their validity. The comparability between computer-administered tests and their pencil-and-paper counterparts is discussed. Basic decision making in psychiatric screening, personality assessment, neuropsychology, and personnel psychology is also investigated. Studies on the accuracy of computerized narrative reports in personality assessment and psychiatric screening are then summarized. Research thus far appears to indicate that computer-generated reports should be viewed as valuable adjuncts to, rather than substitutes for, clinical judgment. Additional studies are needed to support broadened computer-based test usage.

Louis S. Linfield

Papers

Evaluation in an inpatient setting of DTREE, a computer-assisted diagnostic assessment procedure.