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It is still unclear to what extent personality may influence the development of psychosis. We aimed to explore significant personality traits in individuals at high-risk (HR) for psychosis. Personalities of forty HR individuals and a matched sample of 40 healthy volunteers (HVs) were evaluated with the Millon Multiaxial Inventory (MCMI-III). They were also assessed with the Positive and Negative Symptoms Scale (PANSS), Beck Depression and Anxiety Inventories (BDI-II and BAI), Global Assessment of Functioning (GAF) and Mini-International Neuropsychiatric Interview (MINI 6.0.0). Fisher's exact test was employed to compare frequency of traits. Mann-Whitney U test and logistic regression were used to establish relationships between traits and symptoms, and the effect of age, sex and symptoms on such traits. Most HR individuals (97.5%) had at least one significant trait; 75% had personality disorders, mainly depressive, borderline or schizotypal. Only histrionic and narcissistic traits were more prevalent in HVs. Negative symptoms were related to schizoid and paranoid traits. Depression was more severe with borderline traits. Most HR individuals (67.6%) had more than one DSM-IV Axis I diagnosis, mainly depressive/anxiety disorders. Transition rate was low (5%). Certain personality profiles may not be markers for conversions to psychosis but contribute to high morbidity in HR individuals. [ABSTRACT FROM AUTHOR]

Experiencing self-agency over one’s own action outcomes is essential for social functioning. Recent research revealed that patients with schizophrenia do not use implicitly available information about their action-outcomes (i.e., prime-based agency inference) to arrive at self-agency experiences. Here, we examined whether this is related to symptoms and/or familial risk to develop the disease. Fifty-four patients, 54 controls, and 19 unaffected (and unrelated) siblings performed an agency inference task, in which experienced agency was measured over action-outcomes that matched or mismatched outcome-primes that were presented before action performance. The Positive and Negative Syndrome Scale (PANSS) and Comprehensive Assessment of Symptoms and History (CASH) were administered to assess psychopathology. Impairments in prime-based inferences did not differ between patients with symptoms of over- and underattribution. However, patients with agency underattribution symptoms reported significantly lower overall self-agency experiences. Siblings displayed stronger prime-based agency inferences than patients, but weaker prime-based inferences than healthy controls. However, these differences were not statistically significant. Findings suggest that impairments in prime-based agency inferences may be a trait characteristic of schizophrenia. Moreover, this study may stimulate further research on the familial basis and the clinical relevance of impairments in implicit agency inferences. [ABSTRACT FROM AUTHOR]

The aim of this study was to investigate whether Ultra High Risk for psychosis (UHR) patients who present with hallucinations alone at identification as UHR are at lower risk of transition to psychosis than UHR patients who present with symptoms other than hallucinations or hallucinations plus other symptoms. Our primary dataset was a retrospective “case-control” study of UHR patients ( N =118). The second, independent dataset was a long-term longitudinal follow up study of UHR patients ( N =416). We performed a survival analysis using Log-rank test and Cox regression to investigate the relationship between symptom variables and transition to a psychotic disorder. Hallucinations alone at baseline were not significantly associated with a reduced risk of transition to psychosis. In the case control study the presence of hallucinations when found in the absence of any thought disorder and visual hallucinations in the absence of substance misuse was associated with a reduced risk of transition to psychosis. In the longitudinal follow-up dataset perceptual disturbance found in the absence of a disorder of affect or emotion was associated with an increased risk of transition to psychosis. [ABSTRACT FROM AUTHOR]

It is well known that patients with bipolar disorder (BD) have cognitive impairments even during periods of euthymia. However, to date it remains unclear the moment when these deficits onset. Therefore, the aim of this study was to review the evidence focusing on the cognitive status of patients with BD in their premorbid stage and in their first episode. An extensive search was conducted through the online databases Pubmed/PsychInfo, covering the period between 1980 and 2014. A total of 23 studies were selected for the review (nine studies explored premorbid stage of people who lately develop BD and 14 examined first-episodes in bipolar patients). There is evidence that general intelligence is not impaired in the premorbid stage. Impairments in verbal memory, attention, and executive functions tend to be present during and after the first episode. Preliminary evidence suggests that these deficits in specific cognitive domains might precede the onset of illness. [ABSTRACT FROM AUTHOR]

Traumatic experiences have been positively associated with both severity of attenuated psychotic symptoms in individuals at high risk (HR) for psychosis and transitions into psychotic disorders. Our aim was to determine what characteristics of the trauma history are more likely to be associated with individuals at HR. The Trauma History Screen (THS) was used to enable emphasis on number and perceived intensity of adverse life events and age at trauma exposure. Sixty help-seeking individuals who met HR criteria were compared to a random sample of 60 healthy volunteers. Both groups were aged 16–35 and resided in the same geographical location. HR participants experienced their first trauma at an earlier age, continued to experience trauma at younger developmental stages, especially during early/mid adolescence and were exposed to a high number of traumas. They were more depressed and anxious, but did not experience more distress in relation to trauma. Both incidences of trauma and age at which trauma occurred were the most likely predictors of becoming HR. This work emphasises the importance of assessing trauma characteristics in HR individuals to enable differentiation between psychotic-like experiences that may reflect dissociative responses to trauma and genuine prodromal psychotic presentations. [ABSTRACT FROM AUTHOR]

Abstract: The Mood and Feelings Questionnaire (MFQ) is widely used for the assessment of depression in adolescents. The main aim of this study was to examine the concurrent and predictive validity of a composite of four MFQ items related to suicidal ideation using an interview measure of suicidal ideation. A prospective 3-wave high-risk study of offspring of parents with recurrent depression was used including 294 families where children were initially aged 9–17 years. Measures included four parent and child rated MFQ items assessing suicide-related ideation (referred to here as the “MFQ-SI”) and a clinically-defined interview measure of suicidal ideation. A parent–child combined MFQ-SI subscale performed well as a screening tool against the interview measure of suicidal ideation (baseline area under the curve (AUC) (95% CI):0.92 (0.85–1.00)). Longitudinally, this measure showed reasonable predictive validity against future suicidal ideation (AUC (95% CI):0.73 (0.58–0.88)). Lastly, there was evidence that a child-rated MFQ-SI scale performed better than a parent-rated one in detecting concurrent suicidal ideation. Longitudinally, both parent and child scales showed reasonable predictive validity against future suicidal ideation. In summary, a brief screen using four MFQ items related to suicidal ideation performs well in identifying concurrent and future suicidal ideation in high-risk adolescents. [Copyright &y& Elsevier]

Abstract: Depressed adults have shown blunted or elevated cortisol reactivity in response to various forms of psychosocial stress. However, there have been few studies of cortisol reactivity in children who had early onset depression or a history of depression during the preschool–school period. The present study utilized a laboratory stress paradigm and collected salivary cortisol from preschoolers at baseline (ages 3–5 years) and 24-month follow-up (ages 5–7 years). Repeated-measures multivariate analyses of variance (MANOVAs) were used to compare cortisol reactivity to mild stress between children with Major Depressive Disorder (MDD), elevated symptoms of depression (sub-syndromal MDD), and healthy controls. For healthy children, a quadratic cortisol reactivity curve was found at baseline (n=73), which appeared flatter under similar stressful situations at follow-up (n=14), which may reflect acclimation to the paradigm. In contrast, children with MDD (n=46) and sub-syndromal MDD (n=76) showed a peak cortisol response to the novelty of lab arrival and then reduced and blunted responses to stressors at baseline. These cortisol responses persisted at follow-up in children with a history of MDD (n=41) or sub-syndromal MDD (n=73). These results suggest that the hypothalamic–pituitary–adrenal (HPA) axis shows a blunted response to stress and failed to acclimate to familiar stressful situations in depressed and sub-syndromal depressed children. [Copyright &y& Elsevier]

Abstract: P300 amplitude in childhood predicts substance use disorders by young adulthood. Trajectories of visual P300 amplitude show an association between low amplitude P300 and familial risk for alcohol dependence (AD). Variation in the cholinergic muscarinic receptor gene (CHRM2) has previously been associated with P300 amplitude and AD. The present study used group based trajectory modeling of auditory P300 data collected longitudinally from offspring in families with and without familial loading for AD to determine if specific trajectories would be associated with familial risk and CHRM2 variation. Trajectory modeling confirms previous reports of an association between the low visual P300 trajectory with high familial risk in male offspring. This association was detected in offspring in the 8–12 age range, but not in 13–18 or 19–29 year olds or in high-risk female offspring. CHRM2 association analysis with P300 finds 8–12 year olds who are homozygous for the T allele of rs1824024 are 2.6 times more likely to follow a P300 trajectory characterized by lower and slower change regardless of familial loading. Combining the odds for being male and having a TT genotype results in odds of 6.5 that individuals will follow the low P300 trajectory. [Copyright &y& Elsevier]

Abstract: Multiplex families ascertained through multiple alcohol dependent individuals appear to transmit alcohol and drug use disorders at higher rates than randomly selected families of alcoholics. Our goal was to investigate the risk of developing specific psychiatric diagnoses during childhood or adolescence in association with familial risk status (high-risk [HR] or low-risk [LR]) and parental diagnosis. Using a prospective longitudinal design, HR offspring from three generation multiplex alcohol dependence families and LR control families were followed yearly. Data analysis was based on consensus diagnoses from 1738 yearly evaluations conducted with the offspring and a parent using the K-SADS, and separately modeled the effects of familial susceptibility and exposure to parental alcohol dependence. Multiplex family membership and parental alcohol and drug dependence significantly increased the odds that offspring would experience some form of psychopathology during childhood or adolescence, particularly externalizing disorders. Additionally, parental alcohol dependence increased the odds that adolescent offspring would have major depressive disorder (MDD). While it is well known that parental substance dependence is associated with externalizing psychopathology, the increased risk for MDD seen during adolescence in the present study suggests the need for greater vigilance of these children. [Copyright &y& Elsevier]

• We explore several neurocognitive and functional impairments of schizophrenia. • 3 samples at different risk levels were compared. • Memory, executive function, social and complex cognition were significantly impaired. • Functional outcomes were severely impaired in affected and at-risk individuals. • Implications to intervention strategies with patients and caretakers are discussed. Schizophrenia is a complex heritable brain disorder that entails significant social, neurocognitive, and functional deficits, and significant psychosocial challenges to affected and unaffected family members. In this cross-sectional study, we explore impairments in specific neurocognitive and social cognition processes in patients affected with schizophrenia, unaffected relatives, and in controls to provide a characterization of a genetically homogenous European sample from an endophenotypic and functional standpoint. A sample of 38 affected patients, 28 first-degree relatives, and 97 controls performed a series of computerized and skills-based assessments. Samples were compared across several neurocognitive, social, and functional domains. Significant impairments in episodic memory, executive function, social cognition, complex cognition, sensorimotor domains were found in patients and first-degree relatives. Findings also showed increased processing speed in memory and other complex cognitive processes relevant to autonomous living. A discriminant function analysis yielded 2 functions allowing 79% of correct group classifications based on social cognition and functional skills, neurocognition, and age. The study highlights the importance of resourcing to wide-ranging assessment methodologies, of developing research efforts to further understand the decline of social and neurocognitive processes, and the need for designing more targeted intervention strategies to be implemented both with affected patients and families. [ABSTRACT FROM AUTHOR]