OBJECTIVE: The clinical hallmark of schizophrenia is psychosis. The objective of this overview is to link the neurobiology (brain), the phenomenological experience (mind), and pharmacological aspects of psychosis-in-schizophrenia into a unitary framework. METHOD: Current ideas regarding the neurobiology and phenomenology of psychosis and schizophrenia, the role of dopamine, and the mechanism of action of antipsychotic medication were integrated to develop this framework. RESULTS: A central role of dopamine is to mediate the “salience” of environmental events and internal representations. It is proposed that a dysregulated, hyperdopaminergic state, at a “brain” level of description and analysis, leads to an aberrant assignment of salience to the elements of one’s experience, at a “mind” level. Delusions are a cognitive effort by the patient to make sense of these aberrantly salient experiences, whereas hallucinations reflect a direct experience of the aberrant salience of internal representations. Antipsyc...

Psychosis as a state of aberrant salience: A framework linking biology, phenomenology, and pharmacology in schizophrenia.

Existing self-report measures of schizotypal personality assess only one to three of the nine traits of schizotypal personality disorder. This study describes the development of the Schizotypal Personality Questionnaire (SPQ), a self-report scale modeled on DSM-III-R criteria for schizotypal personality disorder and containing subscales for all nine schizotypal traits. Two samples of normal subjects (w •= 302 and n = 195) were used to test replicability of findings. The SPQ was found to have high sampling validity, high internal reliability (0.91), test-retest reliability (0.82), convergent validity (0.59 to 0.81), discriminant validity, and criterion validity (0.63, 0.68), findings which were replicated across samples. Fifty-five percent of subjects scoring in the top 10 percent of SPQ scores had a clinical diagnosis of schizotypal personality disorder. Thus, the SPQ may be useful in screening for schizotypal personality disorder in the general population and also in researching the correlates of individual schizotypal traits.

https://www.researchgate.net/file.PostFileLoader.html?id=54875122d685cc91708b46af&assetKey=AS%3A273649305620489%401442254486398

The SPQ: A Scale for the Assessment of Schizotypal Personality Based on DSM-III-R Criteria

A systematic review of all reported incidence and prevalence studies of population rates of subclinical psychotic experiences reveals a median prevalence rate of around 5% and a median incidence rate of around 3%. A meta-analysis of risk factors reveals associations with developmental stage, child and adult social adversity, psychoactive drug use, and also male sex and migrant status. The small difference between prevalence and incidence rates, together with data from follow-up studies, indicates that approximately 75-90% of developmental psychotic experiences are transitory and disappear over time. There is evidence, however, that transitory developmental expression of psychosis (psychosis proneness) may become abnormally persistent (persistence) and subsequently clinically relevant (impairment), depending on the degree of environmental risk the person is additionally exposed to. The psychosis proneness-persistence-impairment model considers genetic background factors impacting on a broadly distributed and transitory population expression of psychosis during development, poor prognosis of which, in terms of persistence and clinical need, is predicted by environmental exposure interacting with genetic risk.

/pdf/a-systematic-review-and-meta-analysis-of-the-psychosis-468eokeeyn.pdf

A systematic review and meta-analysis of the psychosis continuum: evidence for a psychosis proneness-persistence-impairment model of psychotic disorder

This article examines the evidence that certain deficits in information processing and attentional functioning are present across populations at risk for schizophrenic disorder, with active schizophrenic psychotic symptomatology, and in relative remission after a schizophrenic psychosis. In addition, the evidence that some deficits in processing information occur only in the actively psychotic period is inspected. Deficits in vigilance tasks with high-processing loads, in forced-choice span of apprehension for large arrays, and in serial recall for items that involve active rehearsal occur across risk populations, actively symptomatic schizophrenic patients, and relatively remitted schizophrenic patients. These deficits may reflect vulnerability factors for schizophrenic disorders. Reaction time crossover, dichotic listening, backward masking, and referential communication deficits might also be vulnerability indicators. These deficits may be related to a reduction in the processing capacity that is available for task-relevant cognitive operations in persons vulnerable to schizophrenic disorder, which could, in turn, be caused by several different underlying cognitive anomalies. Cognitive deficits that have been found only during actively psychotic periods or in chronic schizophrenic patients, such as poorer recognition of briefly presented, single, familiar letters or numbers, are characterized by low demands on processing capacity. These deficiencies may be caused by further reduction in available processing capacity or a temporary disruption of automatic as well as attention-demanding processes; they could also reflect a stable, more severe cognitive deficit in a subtype of schizophrenic disorder.

/pdf/information-processing-and-attentional-functioning-in-the-2vo4l021wd.pdf

Information Processing and Attentional Functioning in the Developmental Course of Schizophrenic Disorders

The quantity and quality of research into autism and related conditions have increased dramatically in recent years. Consequently we selectively review key accomplishments and highlight directions for future research. More consistent approaches to diagnosis and more rigorous assessment methods have significantly advanced research, although the boundaries of the 'broader phenotype' remain to be defined and the validity of Asperger's disorder as a discrete syndrome remains controversial. Recent epidemiological studies have shown that Autism Spectrum Disorders are common, but there continues to be debate about the causes of the increase in the frequency with which autism is diagnosed. Psychological research has helped to develop new developmental models for the disorder and there have also been significant advances in the molecular genetics of autism and understanding of the underlying neurobiological processes. Areas important for future research include the study of autism as it first develops, i.e., in infants and very young children, and of specific processes (psychological and neurobiological) which underlie the disorder. Significant challenges lie ahead in evaluating the growing number of treatments for autism and in integrating the results of research into treatment and educational settings.

Autism and Pervasive Developmental Disorders

The predictive validities of several indicators of psychosis proneness were evaluated in a 10-year longitudinal study (N = 508). As hypothesized, high scorers on the Perceptual Aberration Scale, Magical Ideation Scale, or both (n = 182), especially those who initially reported psychoticlike experiences of at least moderate deviance, exceeded control subjects (n = 153) on psychoses (revised 3rd edition of the Diagnostic and Statistical Manual of Mental Disorders), psychotic relatives, schizotypal symptoms, and psychoticlike experiences at follow up. Ss who initially scored high on the Magical Ideation Scale and above the mean on the Social Anhedonia Scale were especially deviant. The Physical Anhedonia Scale and the Impulsive Nonconformity Scale were not effective predictors of psychosis proneness.

Putatively psychosis-prone subjects 10 years later.

Magical ideation as an indicator of schizotypy.

http://psycnet.apa.org/journals/abn/95/3/214.pdf

Development and validation of a scale for hypomanic personality.

Former college students (n = 36) identified by high scores on the Hypomanic Personality Scale (HYP; Eckblad & Chapman, 1986) were compared with control participants (n = 31) at a 13-year follow-up assessment. As hypothesized, the HYP group reported more bipolar disorders and major depressive episodes than the control group. The HYP group also exceeded the control group on the severity of psychotic-like experiences, symptoms of borderline personality disorder, and rates of substance use disorders. HYP group members with elevated scores on the Impulsive-Nonconformity Scale (Chapman et al., 1984) experienced greater rates of bipolar mood disorders, poorer overall adjustment, and higher rates of arrest than the remaining HYP or control participants.

/pdf/a-longitudinal-study-of-high-scorers-on-the-hypomanic-3if146pokj.pdf

Mark Eckblad

Papers

Putatively psychosis-prone subjects 10 years later.

Magical ideation as an indicator of schizotypy.

Development and validation of a scale for hypomanic personality.

A Longitudinal Study of High Scorers on the Hypomanic Personality Scale

Hypomanic Personality Scale