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1.
Cognitive deficits have been documented in schizophrenia and spectrum disorders. This study examines cognitive functioning and its relation to symptoms in adolescents with schizotypal personality disorder (SPD). Participants are 89 adolescents recruited for a study of youth at risk for Axis I disorders, especially psychosis. At intake, 34 met criteria for SPD, 38 for another Axis II disorder and/or conduct disorder (Other disorder-OD), and 17 did not currently meet criteria for any DSM-IV disorder (normal control-NC). At initial assessment, cognitive functioning was measured using subtests from the Wechsler Intelligence Scales and Wechsler Memory Scales (WMS), and symptoms were measured using the Structured Interview for Prodromal Symptoms (SIPS). At the time of this report, 50 were readministered the SIPS at 1-year follow-up (T2). The SPD group scored significantly below the NC group on the Arithmetic subtest of the Wechsler Intelligence Scales, but there was only limited evidence of group differences on the WMS. Poorer performance on the Wechsler Intelligence Scales was associated with greater severity of negative and disorganized symptoms. Deficits on the WMS were linked with more severe disorganized symptoms. The findings reported here are consistent with previous reports of limited cognitive deficits in adolescents with SPD, with the most marked deficits in mental arithmetic. The associations between symptoms and cognitive scores parallel those observed in adults with schizophrenia and spectrum disorder, and they are consistent with the notion that negative symptoms are more stable and partially reflect premorbid cognitive functions. 相似文献
2.
OBJECTIVE: Schizophrenia spectrum subjects have cognitive deficits in a variety of domains. Schizotypal personality disordered (SPD) subjects do not have many of the confounds seen in schizophrenic patients, but may have the same pattern of cognitive deficits in attention and executive functioning. HYPOTHESIS: We hypothesized that SPD subjects would have impairments on measures of attention, abstract reasoning, cognitive inhibition, working memory and verbal recognition memory when compared to normal subjects, and that these deficits would be intermediate to those observed in schizophrenic patients. METHOD: SPD subjects (N=20) were compared to age-, gender- and education-matched schizophrenic patients (N=20) and normal comparison subjects (N=20) on a battery of cognitive measures. RESULTS: The data were analyzed using standard statistical methods, including effect sizes. Using a conservative alpha level of 0.01, schizophrenic patients had deficits on many of these measures compared to normal subjects. Although the SPD subjects did not significantly differ from normal comparison subjects at the p < 0.01 level, there were trends (p < 0.019-0.028) toward impairment on measures of working memory and general intellectual functioning. On further effect size analyses, SPD subjects performed intermediate to normals and schizophrenic patients on measures of attention, abstract reasoning, cognitive inhibition, verbal working memory, recognition memory, and general intellectual functioning, with moderate to large effect sizes separating groups. CONCLUSIONS: These results suggest that SPD subjects have possible widespread cognitive deficits that are of lesser magnitude than those observed in schizophrenic patients. 相似文献
3.
S E Sternbach P H Judd A N Sabo T McGlashan J G Gunderson 《Comprehensive psychiatry》1992,33(3):186-189
Clinical vignettes of patients with borderline personality disorder (BPD) and schizotypal personality disorder (STPD) were evaluated and rated for evidence of cognitive and perceptual distortions. The differences in the distortions of each group were then compared. The findings show that while STPD patients have significantly more cognitive and perceptual distortions than borderlines, there is an abundance of such distortions in the borderline group. The borderline group may differ, moreover, in that their cognitive and perceptual distortions were found to be significantly more object-related than those of the schizotypal group. 相似文献
4.
M A Jenike L Baer W E Minichiello C E Schwartz R J Carey 《The American journal of psychiatry》1986,143(4):530-532
Despite advances in the management of patients with obsessive-compulsive disorder, some remain refractory to treatment. The authors retrospectively examined characteristics of 43 treatment-resistant obsessive-compulsive patients and found that those with concomitant schizotypal personality disorder had an extremely high rate of treatment failure. Of the 29 treated nonschizotypal patients, 26 (90%) improved at least moderately; only one of 14 (7%) schizotypal patients improved. In addition, the number of schizotypal features in each patient was strongly negatively correlated with treatment outcome. 相似文献
5.
L J Siever 《Schizophrenia bulletin》1985,11(4):564-575
The establishment of the new diagnostic category, Schizotypal Personality Disorder (SPD), has stimulated biological studies of patients with this disorder. Such studies offer the potential of better understanding the diagnosis and treatment of SPD as well as more clearly defining the boundaries of the schizophrenic disorders. SPD has been studied in the clinical setting, in family studies of schizophrenia, and in the biological high-risk paradigm. In most cases, biological variables associated with schizophrenia have been evaluated. Decreased activities of plasma amine oxidase and platelet monoamine oxidase have been associated with SPD in the families of schizophrenics and in "biological high-risk" studies. Smooth pursuit eye movement (SPEM) impairment has also been associated with SPD in a "biological high-risk" study of college students. Inferior backward masking performance has been demonstrated in SPD patients in the clinical setting. Other studies using psychophysiological measures have been applied to subjects with psychological characteristics similar to DSM-III SPD and found biological abnormalities similar to those reported in schizophrenia. These studies are consistent with the possibility that some individuals with SPD may share common psychobiological abnormalities with schizophrenic individuals and may sharpen our understanding of SPD and its relationship to schizophrenia. 相似文献
6.
There is evidence that reduced cholinergic activity may play a role in the pathophysiology of cognitive impairment in the schizophrenia spectrum. We tested the effects of physostigmine, an anticholinesterase inhibitor, on visuospatial working memory as evaluated by the Dot test, and on verbal learning and recall as measured by a serial learning task in patients with schizotypal personality disorder. Physostigmine tended to improve the Dot test, but not serial verbal learning performance in these patients. 相似文献
7.
L B Jacobsberg P Hymowitz A Barasch A J Frances 《The American journal of psychiatry》1986,143(10):1222-1227
The authors examined the symptoms of 35 patients with schizotypal personality disorder. In contrast to the suggestion, based on studies of nonclinical, familial samples, that patients with schizotypal disorder are best characterized by the negative symptoms of social isolation and impaired functioning, they found that the positive symptoms of odd communication, ideas of reference, magical thinking, and illusions were equally valid discriminators of their clinically based group of patients. The findings argue against the idea that schizotypal personality disorder be redefined in the revision of DSM-III (DSM-III-R) to emphasize negative symptoms and suggest that clinical samples of schizotypal patients may differ from familial samples. 相似文献
8.
Schizotypal personality disorder is the prototype of the schizophrenia-related personality disorders and has been demonstrated
to have phenomenologic, biologic, treatment, and outcome characteristics similar to those of schizophrenic patients. These
studies suggest that patients with schizotypal personality disorder, like schizophrenic patients, show cognitive impairment,
but the impairment is more focal and involves primarily working memory, verbal learning, and sustained attention rather than
generalized intellectual deficits. Schizotypal patients, like schizophrenic patients show reductions in temporal lobe volume,
but seem to be spared the frontal volume reductions found in some studies of schizophrenic patients and in our laboratory.
Better frontal “buffering” may prevent the more severe cognitive and social deterioration associated with schizophrenia. Furthermore,
schizotypal patients appear to show less susceptibility to psychotic symptoms, in part perhaps because of better buffered
subcortical dopaminergic activity as suggested by recent data from a SPECT/amphetamine paradigm, glucose metabolic study,
and structural studies of basal ganglia. These findings are discussed in terms of a model of schizotypal personality disorder
where schizotypal patients have better capacity for compensatory buffering in lateral and subcortical brain regions, protecting
them from the more severe symptoms of chronic schizophrenia. 相似文献
9.
Plasma homovanillic acid in schizotypal personality disorder 总被引:1,自引:0,他引:1
L J Siever F Amin E F Coccaro D Bernstein R J Kavoussi O Kalus T B Horvath P Warne M Davidson K L Davis 《The American journal of psychiatry》1991,148(9):1246-1248
Schizotypal patients were found to have a significantly higher mean plasma HVA concentration than normal comparison subjects. Furthermore, plasma HVA concentration positively correlated with "psychotic-like" schizotypal symptoms. These results implicate dopaminergic mechanisms modulating the psychotic-like symptoms of schizotypal personality disorder. 相似文献
10.
Gurrera RJ Dickey CC Niznikiewicz MA Voglmaier MM Shenton ME McCarley RW 《Schizophrenia Research》2005,80(2-3):243-251
Studies of the five-factor model of personality in schizotypal personality disorder (SPD) have produced inconsistent results, particularly with respect to openness. In the present study, the NEO-FFI was used to measure five-factor personality dimensions in 28 community volunteers with SPD and 24 psychiatrically healthy individuals. Standard multivariate statistical analyses were used to evaluate personality differences as a function of diagnosis and gender. Individuals with SPD had significantly higher levels of neuroticism and significantly lower levels of extraversion, agreeableness and conscientiousness than those without SPD. Female, but not male, SPD subjects had significantly higher openness levels than their healthy counterparts, and this gender-specific group difference persisted when SPD symptom severity was statistically controlled. These findings suggest that gender-associated differences in openness may account for prior inconsistent findings regarding this dimension, and they further underscore the importance of examining gender effects in future studies of SPD. 相似文献
11.
Luis H. Ripoll Jamil Zaki Maria Mercedes Perez-Rodriguez Rebekah Snyder Kathryn Sloan Strike Ayelet Boussi Jennifer A. Bartz Kevin N. Ochsner Larry J. Siever Antonia S. New 《Psychiatry research》2013
Interpersonal dysfunction contributes to significant disability in the schizophrenia spectrum. Schizotypal Personality Disorder (SPD) is a schizophrenia-related personality demonstrating social cognitive impairment in the absence of frank psychosis. Past research indicates that cognitive dysfunction or schizotypy may account for social cognitive dysfunction in this population. We tested SPD subjects and healthy controls on the Empathic Accuracy (EA) paradigm and the Reading of the Mind in the Eyes Test (RMET), assessing the impact of EA on social support. We also explored whether EA differences could be explained by intelligence, working memory, trait empathy, or attachment avoidance. SPD subjects did not differ from controls in RMET, but demonstrated lower EA during negative valence videos, associated with lower social support. Dynamic, multimodal EA paradigms may be more effective at capturing interpersonal dysfunction than static image tasks such as RMET. Schizotypal severity, trait empathy, and cognitive dysfunction did not account for empathic dysfunction in SPD, although attachment avoidance is related to empathic differences. Empathic dysfunction for negative affect contributes to decreased social support in the schizophrenia spectrum. Future research may shed further light on potential links between attachment avoidance, empathic dysfunction, and social support. 相似文献
12.
Eran Chemerinski MD Larry J. Siever MD Harold W. Koenigsberg MD 《Current Psychosis and Therapeutics Reports》2005,3(4):162-168
It has recently been proposed that reduced stimulation of prefrontal cortex DI receptors secondary to hypoactivity of mesocortical
dopamine (DA) projections may explain the cognitive impairments experienced by patients with schizophrenia and the schizophrenia
spectrum. Findings from studies done during the past two decades suggest that schizotypal personality disorder (SPD), the
prototypic disorder of the schizophrenia spectrum, is associated with cognitive deficits and social deterioration that are
qualitatively similar, although less severe, to those observed in schizophrenia. It generally is acknowledged that the psychotic
symptoms of schizophrenia are associated with hyperactivity of mesolimbic DA projections resulting in excessive stimulation
of striatal D2 receptors. In contrast with schizophrenia, dopaminergic interventions improved cognitive function in SPD without
worsening psychotic-like symptoms, raising the possibility that patients with SPD are protected against increases in subcortical
dopaminergic activity associated with psychosis. However, mounting evidence suggests that alterations in other neurotransmitter
systems (eg, glutamate, γ-aminobutyric acid, opioid, serotonergic) may be involved in the pathophysiology of schizophrenia.
This over view focuses on common DA-related neurobiological vulnerabilities shared by schizophrenia and the schizophrenia
spectrum, in addition to factors that protect SPD from the overt psychotic symptoms and more severe social and cognitive deficits
experienced by patients with chronic schizophrenia. 相似文献
13.
Past research has revealed that schizophrenia is associated with voluntary movement abnormalities, as well as higher rates of involuntary movements. On instrumental motor tasks, patients manifest reduced motor stability, excessive force and more contralateral motor overflow (movement in the non-responding hand). In the present study, an instrumental motor task (manual response forced-choice task) was administered to a group of adults with schizotypal personality disorder (SPD) in order to determine whether they show motor deficits similar to those observed in schizophrenia. As predicted, the schizotypal subjects were excessive and more variable in motor force, compared to healthy controls and other personality-disordered subjects. Additionally, the force and variability of the motor responses were positively correlated with ratings of both positive and negative SPD symptoms. Finally, motor overflow and negative symptoms were associated with higher salivary cortisol levels. The pattern of findings is consistent with previous reports linking motor abnormalities and heightened cortisol with schizotypal personality disorder. 相似文献
14.
一名45岁女性咨客几乎没有亲密的朋友。她认为身边亲人虐待自己、想侵占自己的财产,认为自己遭受了不公平对待;曾在遭受情感挫折时有过短暂幻听,两次在半睡半醒时有过短暂幻视;相信前世今生、潜意识催眠;感到"从潜意识中排出了深海生物,全身换血获得新生";与婆婆生气后感到肚子里充满气体。该咨客被诊断为分裂型人格障碍,应采用生物-心理-社会的综合干预。具体做法是鼓励咨客进行运动,使用认知行为疗法(CBT)及正念疗法改善认知、减轻压力,学习应对策略,避免工作压力及复杂人际关系。 相似文献
15.
Evidence of long-standing social difficulties has been well documented in persons with schizophrenia. These deficits are often so rudimentary that a person with schizophrenia may never have developed the skills necessary to present as socially competent. Given the cognitive, biological, and neuroanatomical links between schizophrenia and schizotypal personality disorder (SPD), a study of social skills in persons with SPD may reveal a behavioral link. This study examined persons with SPD and their ability to label emotions in a recognition task, to display socially competent behaviors in a social role-play task, and to select appropriate behaviors from a multiple choice measure of social behavior. Results indicated that the performance of persons with SPD was similar to previously published findings in persons with schizophrenia. In terms of emotion recognition, the SPD group's ability to label positive emotions was significantly worse than their ability to label other emotions. Persons with SPD performed significantly worse than matched control participants on a social role-play task. However, the groups were equivalent in their ability to select socially appropriate behavior from a multiple choice measure. These results suggest that persons with SPD display social skills which mirror those previously reported in persons with schizophrenia. 相似文献
16.
Niznikiewicz MA Shenton ME Voglmaier M Nestor PG Dickey CC Frumin M Seidman LJ Allen CG McCarley RW 《The American journal of psychiatry》2002,159(10):1767-1774
OBJECTIVE: This study examined whether early or late processes in semantic networks were abnormal in women with a diagnosis of schizotypal personality disorder. The N400 component of the EEG event-related potentials was used as a probe of semantic processes. METHOD: Word pairs were presented with short and long stimulus-onset asynchronies to investigate, respectively, early and late semantic processes in 16 women with schizotypal personality disorder and 15 normal female comparison subjects. Event-related potentials were recorded in response to the last words in a pair. RESULTS: With the short stimulus-onset asynchrony, the N400 amplitude was less negative in the schizotypal personality disorder group than in the normal comparison group. No group differences were found with the long stimulus-onset asynchrony. CONCLUSIONS: The finding of a less negative than normal N400 amplitude with the short stimulus-onset asynchrony in women with schizotypal personality disorder supports the hypothesis that persons with this disorder evince an overactivation of semantic networks. The absence of group differences with the long stimulus-onset asynchrony, which is primarily sensitive to processes involved in context integration, suggests that in this group of schizotypal personality disorder subjects, additional demands on working memory may be necessary to bring out the semantic dysfunction. 相似文献
17.
Farmer CM O'Donnell BF Niznikiewicz MA Voglmaier MM McCarley RW Shenton ME 《The American journal of psychiatry》2000,157(5):781-788
OBJECTIVE: Patients affected by schizophrenia show deficits in both visual perception and working memory. The authors tested early-stage vision and working memory in subjects with schizotypal personality disorder, which has been biologically associated with schizophrenia. METHOD: Eleven subjects who met DSM-III-R criteria for schizotypal personality disorder and 12 normal comparison subjects were evaluated. Performance thresholds were obtained for tests of visual discrimination and working memory. Both form and trajectory processing were evaluated for each task. RESULTS: Subjects with schizotypal personality disorder showed intact discrimination of form and trajectory but were impaired on working memory tasks. CONCLUSIONS: These data suggest that subjects with schizotypal personality disorder, unlike patients affected by schizophrenia, have relatively intact visual perception. Subjects with schizotypal personality disorder do show specific deficits on tasks of comparable difficulty when working memory demands are imposed. Schizotypal personality disorder may be associated with a more specific visual processing deficit than schizophrenia, possibly reflecting disruption of frontal lobe systems subserving visual working memory operations. 相似文献
18.
The frequency of DSM-III and DSM-III-R schizotypal personality disorder (SPD) symptoms and diagnosis was explored in 39 inpatients classified as borderline by the Diagnostic Interview for Borderlines (DIB) and 19 inpatient major depressive disorder (MDD) controls. Most SPD symptoms in all groups, except the nondepressed borderlines, derived from social-interpersonal items. By DSM-III, 24 borderlines (62%) but only six controls (32%) had cognitive-perceptual SPD symptoms (P = .03), whereas by DSM-III-R only 14 borderlines (36%) and seven controls (37%) had such symptoms. Of the 24 borderlines showing cognitive-perceptual symptoms, 16 also had MDD, a significant difference from the non-MDD borderlines (P = .04). This difference disappears in DSM-III-R. The results suggest that some SPD symptoms in borderlines may be related to a concurrent affective episode. 相似文献
19.
Shin NY Lee AR Park HY Yoo SY Kang DH Shin MS Kwon JS 《Progress in neuro-psychopharmacology & biological psychiatry》2008,32(2):472-478
OBJECTIVE: This study was a post-hoc analysis of the results from a neuropsychological battery which was conducted to investigate the frontal lobe difference between obsessive-compulsive disorder (OCD) patients with and without schizotypal personality trait (SPT), especially dorsolateral prefrontal and medial frontal functions. METHODS: Fifty-five OCD patients were divided into two groups according to their Personality Disorder Questionnaire-4+ scores. Patients with OCD with SPT (n=17) and OCD without SPT (n=38) were compared to 52 schizophrenia patients and 67 healthy subjects. Two neuropsychological tasks, the Wisconsin Card Sorting Test (WCST) and verbal fluency tests which are considered to reflect dorsolateral and medial frontal functions, were selected for an analysis. RESULTS: OCD with SPT patients and patients with schizophrenia performed significantly worse than controls in both the WCST and verbal fluency tasks, whereas OCD without SPT patients showed no deficits in the same tasks. Moreover, we found no statistically significant difference in either task between patients having OCD with SPT and patients with schizophrenia. CONCLUSION: This study indicate that OCD with SPT may have distinct patterns of neurocognitive deficit that differ from those of OCD without SPT, especially in terms of frontal lobe function. 相似文献