Emotion recognition in schizophrenic and depressed inpatients

The performance of schizophrenic inpatients (N = 14), depressed inpatients (N = 15), and normal hospital employees (N = 15), all females, was compared on Izard's (1971) test of emotion recognition. Subjects were required to match photographs of facial expressions of emotion with the correct label for the emotion. The average numbers of errors of four types were examined: Positive or neutral emotions mislabelled as other positive or neutral emotions; positive or neutral emotions mislabelled as negative; negative emotions mislabelled as positive or neutral; and negative emotions mislabelled as other negative emotions. The principal findings were (1) the schizophrenics were less accurate than normals, but they were not less accurate than the depressives, nor were they less accurate on negative than positive or neutral emotions; (2) the depressives did not display any form of negative bias in emotion recognition; and (3) both groups of inpatients were less accurate than normals when they labelled an emotion as positive or neutral, but not when they labelled it as negative. Implications of the results for the etiology and maintenance of schizophrenia and depression were noted.     

Conformity and psychopathology: a comparative study of conformity behaviors in manic-depressive, paranoid schizophrenic and normal populations.

Several theorists have speculated that schizophrenia constitutes a disorder in which there is minimal motivation to conform to social pressures, while manic-depressive psychoses represent disorders in which there is maximal motivation to conform to social pressures. However, there have been few experimental tests of these speculations, and those that have been conducted generally have yielded conflicting results because of methodological inconsistencies and limitations. The present investigation examined conformity behavior of male and female manic-depressives (MD), paranoid schizophrenics (PS), and normals (N) on two conformity tasks: attitude change and perceptual judgment. It was hypothesized that manic depressives would conform more than normals, who would conform more than paranoid schizophrenics (MD less than N less than PS). Results indicated that manic-depressives and normals conformed significantly more than paranoid schizophrenics, but did not differ from each other on either of the conformity tasks. Thus, the hypothesis was supported only partially. The results do not support the view that manic-depressive psychoses constitute disorders in which there is maximal motivation to conform to social pressures; however, the results do support the view that schizophrenia represents a disorder in which there is minimum motivation to conform. The results are discussed in terms of their implication for the uses of interpersonal psychotherapy forms.     

Duration criteria and long-term outcome in affective disorder and schizophrenia

This paper attempts to see whether the shorter duration criteria for affective disorders may naturally result in selecting patients who would show a better long-term outcome than that of schizophrenic patients. Follow-up of 298 patients with mania or depression revealed that those with 6 months or more of symptoms still had a better outcome than the outcome of schizophrenics. Furthermore, their outcome was similar to that of manics and depressives with less than 6 months of symptoms. Therefore, factors other than the shorter duration criterion for affective disorders should be sought to explain their better outcome than that of schizophrenics.     

Word association: Multple measures and multiple meanings

Investigated the interrelationships between reaction time and three major verbal word association variables (response commonality, idiosyncratic responses, and degree of logical relatedness) in schizophrenics (N = 42) and nonschizophrenic psychiatric controls (N = 30). This study investigated the degree to which these four measures assess similar or different components of associative thought disorder in the same Ss, using both verbal associative measures and a nonverbal performance measure. Results indicated that reaction time was largely independent of all verbal measures in schizophrenics. These data were discussed in regard to the meaning and interpretation of word association test data as a function of choice of dependent variables for measuring associative thought disturbance.     

Field dependence and extraversion neuroticism on an inpatient psychiatric service.

Compared relationship between field dependence (FD) and the scales of Neuroticism (N) and Extraversion (E) using paraprofessionals (N = 22), professionals (N = 42) and psychiatric inpatients (N = 35) to elucidate the high FD found among the psychiatric inpatients. Recent evidence contradicts Witkins' (1965) early view that as a group, psychiatric inpatients would show psychopathology at the extremes of the FD continuum. The N scale was chosen because it taps a narrow behavior band, the individual's vulnerability to break down under stress. The major hypothesis that FD and N would be functionally related was based on previous empirical findings (Cattell, 1955) and Seligman's (1975) theory of "learned helplessness." Similarly, it was expected that age and sex (i.e., being female) were related functionally to FD. The latter hypotheses were supported. The hypothesis that the profiles of inpatients, professionals and paraprofessionals would throw more light on the high FD found among inpatients was not supported. The relationship between FD and N was discussed in terms of Seligman's (1975) concept of learned helplessness.     

Posed facial expressions of emotion in schizophrenia and depression.

The goals of the present study were to explore: (1) whether schizophrenics, depressives, and normals differ in their likelihood of expressing different emotions; and (2) whether the types of expressions subjects exhibit are associated with their level of reported depressive symptomatology. Subjects were asked to imagine: seeing, smelling, or tasting something disgusting; and having something wonderful happen to them. Subjects were asked to show the experimenter what their face would look like if these things happened. The groups differed in how frequently they exhibited anger or contempt in the first condition and happiness in the second condition. The depressives were most likely to exhibit anger/contempt and least likely to exhibit happiness. Using Beck Depression Inventory scores as dependent variables, there were significant interactions between diagnostic group and the type of facial expressions exhibited. The associations between facial expressions and BDI scores were in the opposite directions for depressives and schizophrenics.     

The perception of life events in depressed inpatients and hospitalized controls

Causal and consequence explanations for past life events, future life events, and a set of hypothetical events were obtained from depressed inpatients (N = 18) and a group of matched hospitalized controls (N = 18). Most of the causal dimensions were found to distinguish depressives from controls in the direction predicted by the Reformulated Learned Helplessness Theory, but the strongest support was obtained with the hypothetical events rather than with past or future events.     

A multifactor model of the Halstead-Reitan Neuropsychological Test Battery and its relationship to cognitive status and psychiatric diagnosis

An oblique, five-factor model of a modified Halstead-Reitan Neuropsychological Test Battery is presented. One hundred fifty-one neuropsychiatric inpatients (94 men, 57 women) were examined on 44 neuropsychological indices. Five correlated dimensions (r = .25), viz., Verbal Comprehension, Perceptual Organization, Sensory-attention, Primary Motor, and Tactile-spatial abilities, were identified by maximum likelihood factor analyses of this correlation matrix. These findings are quite similar to those reported earlier by Fowler, Richards, Berent, and Boll (1985, 1987) and Royce, Yeudall, and Bock (1976). The factors may be broadly categorized using the distinction made by Lezak (1983) for verbal, nonverbal, and mental activity variables. MANOVAs revealed systematic relationships between simple-weighted factor scores and: (1) the overall level of cognitive functioning (p less than .01), as well as (2) psychiatric diagnosis (p less than .01). Implications of these findings for understanding the impact of neuropsychiatric disorders on the structure of abilities for such patients are developed.     

Social perception and communication skills among schizophrenics and nonschizophrenics

This study examined the performance of both schizophrenic (N = 13) and nonschizophrenic patients (N = 7), as well as that of a nonpatient contrast group (N = 18), on standardized measures of both social perception and social skill. Social judgment and self-perception also were examined. Schizophrenics were less skillful and less socially perceptive than members of both other groups. Members of the nonschizophrenic patient group also were significantly impaired on the dependent measures when compared to contrast subjects. Results point to the multi-component nature of skills deficits in schizophrenics. Implications for assessment and treatment programs on communication skills training with schizophrenics are discussed.     

Executive dysfunction and memory in older patients with major and minor depression.

Executive function, known to be impaired during late-life depression, is dependent on frontostriatal pathways. Memory is also frequently observed to be impaired among late-life depressed patients, so we assessed the possibility that executive function mediates the learning and recall deficit as a "downstream" effect of the frontostriatal compromise in executive function. A cross-sectional sample of minor and major depressed patients (N=95) and nondepressed volunteers (N=71), screened for other Axis I disorders, dementia, medical comorbidity, and severity of depression, completed a neuropsychological battery that included the California Verbal Learning Test and other tests selected for convergent and divergent validity testing. Depressed patients differed from controls on learning the word list and on verbal and nonverbal executive tasks. Executive function was a mediator for depressed patients verbal learning scores (z=-2.67, p=.01). A nonverbal executive score also mediated verbal learning (z=-2.18, p=.03) indicating convergent validity of executive dysfunction during verbal learning exercises. In conclusion, the verbal memory deficits typically attributed to late-life depression may result from impaired executive functioning during the learning phase of the recall task.     

Verbal and nonverbal memory processing in patients with obsessive-compulsive disorder: its relationship to clinical variables

Memory deficits have been reported in several neuropsychological studies of obsessive-compulsive disorder (OCD). Dysfunction in nonverbal memory has been consistently reported, whereas findings on verbal memory are more heterogeneous. The authors studied 50 patients with OCD who were matched for sex, age, educational level, and hand dominance with 50 healthy controls (HC). Cognitive performance in both groups was assessed on verbal and nonverbal memory tasks, and several clinical variables were also assessed in the patient group. Patients with OCD showed a pattern of cognitive dysfunction with alterations in areas of nonverbal memory (recall and recognition), and verbal memory (learning and recall). Older age at onset of OCD was associated with poorer performance on verbal memory tasks. Low scores on some verbal memory tasks were associated with severity of OCD, and nonverbal memory was influenced by depressive symptoms. The study suggests the existence of dysfunction in the execution of verbal and nonverbal memory tasks in OCD; the influence of clinical variables depends on the specific neuropsychological function.     

Chronic depressions. Part 2. Sleep EEG differentiation of primary dysthymic disorders from anxious depressions

In this clinical, psychometric and polysomnographic study, primary dysthymics (N = 20) were compared with anxious depressives (N = 22), and non-psychiatric controls (N = 11). Beck and MMPI depression scores were similar in the two affective groups. Prominent insomnia occurred in 82% of the anxious group; hypersomnia was more characteristic of the dysthymic group. On night 1, the anxious group had the poorest sleep efficiency (P less than 0.001), while dysthymics had the highest REM% (P less than 0.05) and shortest REM latency (P less than 0.01). On night 2, differences tended to be minimized, although the number of awakenings was still high (P less than 0.05) in the anxious group, and REM% was highest (P less than 0.01) and REM latency shortest (P less than 0.01) in the dysthymics. These findings suggest that patients with primary anxiety disorders experience greater sleep continuity difficulties on the adaptation night. Despite significant clinical overlap in depressive symptomatology between the two groups, REM% and REM latency appear as sturdy psychophysiological markers in differentiating primary dysthymics and anxious depressives on both nights. These data suggest that distinct anxious depressive and subaffective dysthymic subtypes can be distinguished within the universe of the atypical depressions.     

Effects of certainty, modality shift and guess outcome on evoked potentials and reaction times in chronic schizophrenics

Evoked potentials and reaction times were obtained from chronic schizophrenics and normal controls to light and sound stimuli presented in random order. In the 'certain' condition subjects were told what the next stimulus would be, in the 'uncertain' condition they were asked to guess. Amplitudes were usually larger for normals than for schizophrenics, for 'uncertain' than for 'certain' conditions, and in cross- than in ipsimodal stimulus-sequences. The effect of certainty was stronger in normals across 4 leads; so was the effect of modality shift at vertex. While these findings replicate earlier results from acute schizophrenics, no condition X group interactions could be found in the reaction time measures. Two additional results were interpreted as showing basically different attitudes with respect to the predictability of events: (1) there was a slow positivity between the verbal information and the following stimuli which was largest for schizophrenics in the conditions of certainty; (2) while normals showed long-term habituation only in N1- but not in P3-amplitudes, the reverse was true for schizophrenics.     

Recovery of visual-spatial learning and memory in chronic alcoholics

Administered the Memory-for-Designs Test and a verbal and Visuospatial paired associate learning test to separate groups of alcoholics (N = 32) 3 and 11 weeks abstinent from alcohol and to a matched control group (N = 16). Alcoholics were not impaired in verbal learning. Alcoholics 3 weeks abstinent performed significantly less well than controls on all nonverbal tasks and less well than 11-weeks alcoholics on one nonverbal measure. No significant differences were found between 11-week alcoholics and controls. The results suggest that some recovery of function may occur in alcoholics after 10 weeks of abstinence. The data also support the hypothesis of impaired right hemisphere in alcoholics.     

MMPI codetypes characteristic of DSM-III schizophrenics, depressives, and bipolars

The association between various MMPI codetypes and DSM-III schizophrenics, depressives, and bipolars (manic or depressed) (N = 169) was examined. Most codetypes predictive of bipolar-depressed also predicted major depression, yet these codetypes were not characteristic of bipolar-manic. Furthermore, "affective" codetypes often overlapped with a diagnosis of schizophrenia.     

Verbal and nonverbal short‐term memory in patients with Alzheimer's disease and in healthy elderly subjects

Short‐term memory (STM) deteriorates with the progression of Alzheimer's disease (AD). The purpose of the present study was to characterize this decline by examining component processes of STM. Accordingly, AD patients whose dementia ranged from mild to severe and healthy, age‐matched subjects received the Brown‐Peterson distractor task, in which class of material (verbal and nonverbal), number of memoranda (one, two, and three), and agent of forgetting (time and distraction) were manipulated. Healthy elderly subjects showed the expected pattern of performance: When distraction was present, forgetting was greater with longer retention intervals and larger memory loads; when distraction was absent, recall was perfect. AD patients showed significant forgetting at shorter intervals and with smaller memory loads than healthy elderly subjects when distraction was present; without distraction, AD patients' recall of nonverbal (but not verbal) material was impaired, which may be attributable to the greater difficulty of the nonverbal task over the verbal one and to a diminished rehearsal capacity of AD patients for nonverbal material. Data from individual patients suggest that the verbal and nonverbal systems can deteriorate independently.     

Serial malingering on verbal and nonverbal fluency and memory measures: an analog investigation.

Analysis of response consistency on neuropsychological test performance, both within and across testing sessions, can be an important method of detecting malingering. Little systematic research, however, has examined how suspected malingerers perform across repeat evaluations, a common forensic occurrence. To address this issue, we examined performance across a 3-week interval in an analogue malingering design on the California Verbal Learning Test (CVLT), the Rey Complex Figure, the Controlled Oral Word Association Test, and the Ruff Figural Fluency Test. Malingering simulators (n = 21) performed more poorly on all measures than the controls (n = 21) and demonstrated practice effects on the nonverbal, but not the verbal, tests. Controls demonstrated practice effects on all measures across time. Contrary to hypotheses, malingering simulators demonstrated high and similar levels of between and within time consistency as controls when assessed via a series of correlations. Despite this consistency, when qualitative performance patterns were assessed on the CVLT, simulators were less likely to consistently recall the same word across successive learning trials. The following issues are discussed: (a) the differential pattern of practice effects on verbal and nonverbal tasks, (b) qualitative and quantitative differences in assessment of consistency, and (c) how future research should study consistency/inconsistency.     

16PF source traits associated with DSM-III symptoms for four diagnostic groups

Provided evidence of 16PF validity by meta-analysis of source-trait profiles from nine studies for four psychiatric groups (N = 916) (nonparanoid schizophrenics, major depressives, anxiety disorders, alcoholics). All groups had mean sten profiles that deviated markedly from normal personality, and there was considerable convergence between salient traits and diagnostic criteria except for alcoholics.     

Perceived dominance in physicians: Are female physicians under scrutiny?

Objective

This research aims at identifying how specific physician verbal and nonverbal behaviors are related to perceived dominance of female and male physicians.

Method

Analogue patients (163 students) watched videotaped excerpts of eight physicians and indicated how dominant they perceived each physician to be.

Results

Female physicians who spoke more, talked more while doing something else, spoke with louder voices, modulated their voices more, were oriented more toward the patients, sat at a smaller interpersonal distance, were more expansive, and had a more open arm position were perceived as more dominant. These relations were significantly more pronounced in female than in male physicians. With respect to verbal behavior, not agreeing with the patient, structuring the discussion, setting the agenda, and asking questions were related to being perceived as significantly more dominant in female than in male physicians.

Conclusion

Patients interpret verbal and nonverbal female and male physicians’ cues differently. If a behavior contradicts gender stereotypes regarding women, this behavior is perceived as particularly dominant in female physicians.

Practice implications

To provide optimal care, physicians need to be aware of the expectations their patients harbor toward them—especially expected behavior related to the gender of the physician.     

The development of verbal and nonverbal factorially derived memory measures

Sets of verbal and nonverbal memory tests were subjected to a factor analysis, and the factor composite scores were used to discriminate between 57 braindamaged and 34 non-brain-damaged subjects. The derived factors clearly represented verbal and nonverbal factors. The brain-damaged group performed significantly less well on both the verbal and nonverbal factor composite scores. It is suggested that a battery of verbal and nonverbal scales be used to discriminate left and right lateralized brain-damaged patient groups.