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Introduction: Auditory verbal hallucinations (AVH) are a cardinal symptom of schizophrenia but are also reported in the general population without need for psychiatric care. Previous evidence suggests that AVH may reflect an imbalance of prior expectation and sensory information, and that altered salience processing is characteristic of both psychotic and non-clinical voice hearers. However, it remains to be shown how such an imbalance affects the categorisation of vocal emotions in perceptual ambiguity. Methods: Neutral and emotional nonverbal vocalisations were morphed along two continua differing in valence (anger; pleasure), each including 11 morphing steps at intervals of 10%. College students (N = 234) differing in AVH proneness (measured with the Launay-Slade Hallucination Scale) evaluated the emotional quality of the vocalisations. Results: Increased AVH proneness was associated with more frequent categorisation of ambiguous vocalisations as ‘neutral’, irrespective of valence. Similarly, the perceptual boundary for emotional classification was shifted by AVH proneness: participants needed more emotional information to categorise a voice as emotional. Conclusions: These findings suggest that emotional salience in vocalisations is dampened as a function of increased AVH proneness. This could be related to changes in the acoustic representations of emotions or reflect top-down expectations of less salient information in the social environment.

Need for closure (NFC) is a cognitive bias that has been implicated in the pathogenesis of delusions. A general population sample (N = 1465) was dichotomized into high versus low schizotypal participants and matched based on core social demographic characteristics (each n = 98). For the first time, we aimed at capturing NFC subjectively (with the NFC Scale) and objectively with a new experimental paradigm, the Ambiguous Movie Scene Task. In this task, participants viewed video scenes with either open or closed endings (i.e., high or low ambiguity) and rated their (emotional) reactions to the clips. Open endings were expected to lead to more frustration (i.e., due to increased need for closure) and to induce greater eagerness to learn about the possible resolution among those high on positive schizotypy. High schizotypal individuals displayed higher scores on the NFC Scale than low schizotypal individuals. Contrary to our expectations, high schizotypal participants did not recognize video scenes with open endings as ambiguous and were less eager to learn about a possible resolution than low schizotypal individuals. In the Ambiguous Movie Scene Task, high schizotypal individuals showed evidence of a jumping to conclusions bias rather than frustration over unresolved storylines. We found an overall stronger emotional response in schizotypal participants and overconfidence in their judgments. The NFC Scale and selected scores of the new task correlated moderately. The study corroborates earlier evidence for a dissociation between objective and subjective biases in the psychosis spectrum.

Schizophrenia is associated with a number of deficits in decision-making, but the scope, nature, and cause of these deficits are not completely understood. Here we focus on a particular type of decision, known as the explore/ exploit dilemma, in which people must choose between exploiting options that yield relatively known rewards and exploring more ambiguous options of uncertain reward probability or magnitude. Previous work has shown that healthy people use two distinct strategies to decide when to explore: directed exploration, which involves choosing options that would reduce uncertainty about the reward values (information seeking), and random exploration (exploring by chance), which describes behavioral variability that is not goal directed. We administered a recently developed gambling task designed to quantify both directed and random exploration to 108 patients with schizophrenia (PSZ) and 33 healthy volunteers (HVs). We found that PSZ patients show reduced directed exploration relative to HVs, but no difference in random exploration. Moreover, patients’ directed exploration behavior clusters into two qualitatively different behavioral phenotypes. In the first phenotype, which accounts for the majority of the patients (79%) and is consistent with previously reported behavior, directed exploration is only marginally (but significantly) reduced, suggesting that these patients can use directed exploration, but at a slightly lower level than community controls. In contrast, the second phenotype, comprising 21% of patients, exhibits a form of “extreme ambiguity aversion,” in which they almost never choose more informative options, even when they are clearly of higher value. Moreover, in PSZ, deficits in directed exploration were related to measures of intellectual function, whereas random exploration was related to positive symptoms. Taken together, our results suggest that schizophrenia has differential effects on directed and random exploration and that investigating the explore/exploit dilemma in psychosis patients may reveal subgroups of patients with qualitatively different patterns of exploration.

Objective Numerous studies have identified impaired decision making (DM) under both ambiguity and risk in adult patients with schizophrenia. However, the assessment of DM in patients with adolescent-onset schizophrenia (AOS) has been challenging as a result of the instability and heterogeneity of manifestations. The Iowa Gambling Task (IGT) and Game of Dice Task (GDT), which are frequently used to evaluate DM respectively under ambiguity and risk, are sensitive to adolescents and neuropsychiatric patients. Our research intended to examine the performance of DM in a relatively large sample of patients with AOS using the above-mentioned two tasks. We also aimed to take a closer look at the relationship between DM and symptom severity of schizophrenia. Methods We compared the performance of DM in 71 patients with AOS and 53 well-matched healthy controls using IGT for DM under ambiguity and GDT for DM under risk through net scores, total scores and feedback ration. Neuropsychological tests were conducted in all participants. Clinical symptoms were evaluated by using Positive and Negative Syndrome Scale (PANSS) in 71 patients with AOS. Pearson’s correlation revealed the relationship among total score of DM and clinical and neuropsychological data. Results Compared to healthy controls, patients with AOS failed to show learning effect and had a significant difference on the 5th block in IGT and conducted more disadvantageous choices as well as exhibited worse negative feedback rate in GDT. Apart from DM impairment under risk, diminished DM abilities under ambiguity were found related to poor executive function in AOS in the present study. Conclusions Our findings unveiled the abnormal pattern of DM in AOS, mainly reflected under the risky condition, extending the knowledge on the performance of DM under ambiguity and risk in AOS. Inefficient DM under risk may account for the lagging impulse control and the combined effects of developmental disease. In addition, our study demonstrated that the performance on IGT was related to executive function in AOS.

Perceptual inference depends on an optimal integration of current sensory evidence with prior beliefs about the environment. Alterations of this process have been related to the emergence of positive symptoms in schizophrenia. However, it has remained unclear whether delusions and hallucinations arise from an increased or decreased weighting of prior beliefs relative to sensory evidence. To investigate the relation of this prior-to-likelihood ratio to positive symptoms in schizophrenia, we devised a novel experimental paradigm which gradually manipulates perceptually ambiguous visual stimuli by disambiguating stimulus information. As a proxy for likelihood precision, we assessed the sensitivity of individual participants to sensory evidence. As a surrogate for the precision of prior beliefs in perceptual stability, we measured phase duration in ambiguity. Relative to healthy controls, patients with schizophrenia showed a stronger increment in congruent perceptual states for increasing levels of disambiguating stimulus evidence. Sensitivity to sensory evidence correlated positively with the individual patients’ severity of perceptual anomalies and hallucinations. Moreover, the severity of such experiences correlated negatively with phase duration. Our results indicate that perceptual anomalies and hallucinations are associated with a shift of perceptual inference toward sensory evidence and away from prior beliefs. This reduced prior-to-likelihood ratio in sensory processing may contribute to the phenomenon of aberrant salience, which has been suggested to give rise to the false inferences underlying psychotic experiences.

Background: Organizational climate relates to how employees perceive and describe the characteristics of their employing organization. It has been found to have an impact on healthcare professionals’ and patients’ experiences of healthcare (e.g. job satisfaction, patient satisfaction), as well as organizational outcomes (e.g. employee productivity). This research used organizational theory to explore dynamics between health care professionals (pharmacists, doctors and nurses) in mental health outpatients’ services for patients taking clozapine, and the perceived influence on patient care. Setting: Seven clozapine clinics (from one NHS mental health Trust in the UK) which provided care for people with treatment resistant schizophrenia. Methods: This study used qualitative methods to identify organizational climate factors such as deep structures, micro-climates and climates of conflict that might inhibit change and affect patient care. Using Interpretative Phenomenological Analysis, semi-structured interviews were conducted with 10 healthcare professionals working in the clinics to explore their experiences of working in these clinics and the NHS mental health Trust the clinics were part of. Main outcome measure: Health Care Professionals’ perceptions of the care of patients with treatment resistant schizophrenia. Results: Three superordinate themes emerged from the data: philosophy of care, need for change and role ambiguity. Participants found it difficult to articulate what a philosophy of care was and in spite of expressing the need for change in the way the clinics were run, could not see how ‘changing things would work’. There was considerable role ambiguity with some ‘blurring of the boundaries between roles’. Factors associated with organizational climate (role conflict; job satisfaction) were inhibiting team working and preventing staff from identifying the patients’ health requirements and care delivery through innovation in skill mix. There were mixed attitudes towards the pharmacist’s inclusion as a team member.Conclusion: Our findings suggest deficiencies within the clinics that may be manifestations of the wider culture of the NHS. The implications for mental health outpatient clinics are that local initiatives are crucial to the implementation of recovery models; clear guidance should be provided on the skill mix required in clozapine clinics and interprofessional learning should be encouraged to reduce role conflict. Keywords: United Kingdom; NHS; organizational climate; philosophy of care; role ambiguity; organizational change; schizophrenia; clozapine; pharmacist prescriber; medication management. Impact of these research findings: •The role and skill mix of multidisciplinary teams delivering clinical care should be better defined. •Pharmacists can have a positive impact on the health of patients taking clozapine for treatment resistant schizophrenia. •Pharmacists should be included in all clinical teams to ensure that patients’ medication needs are met.

Objective: Negative symptoms can be grouped into two factors, expressive deficits and social-emotional withdrawal. We aimed to examine the neural correlates of the two negative symptom factors during a social cognition task, which measures emotional ambiguity in a social context by presenting an array of faces with varying degrees of consistency in emotional expressions. Methods: Patients with schizophrenia (N=38) and healthy controls (N=20) performed a social cognition task during fMRI that probed both affect and ambiguity. Differences in brain activation between the healthy controls and patients were non-parametrically tested. Subsequently, the expressive deficits and social-emotional withdrawal factors were regressed against task-related brain activation. Results: Severity of expressive deficits was negatively correlated with activation of the ventromedial prefrontal cortex when comparing ambiguous emotional decisions to ambiguous gender decisions. During emotional ambiguity, severity of expressive deficits was negatively correlated with activation in thalamic, prefrontal, precentral, parietal and temporal brain areas. No associations between social-emotional withdrawal and brain activation were observed. Conclusion: Hypoactivation of the fronto-thalamic circuitry during ambiguous social appraisal may imply a reduced action readiness in social situations, underlying expressive deficits but not social-emotional withdrawal. The findings provide further evidence for different neurobiological bases of the two factors of negative symptoms.

When making decisions in everyday life, we often have to choose between uncertain outcomes. Economic studies have demonstrated that healthy people tend to prefer options with known probabilities (risk) than those with unknown probabilities (ambiguity), which is referred to as "ambiguity aversion." However, it remains unclear how patients with schizophrenia behave under ambiguity, despite growing evidence of their altered decision-making under uncertainty. In this study, combining economic tools and functional magnetic resonance imaging (fMRI), we assessed the attitudes toward risk/ambiguity and investigated the neural correlates during decision-making under risk/ambiguity in schizophrenia. Although no significant difference in attitudes under risk was observed, patients with schizophrenia chose ambiguity significantly more often than the healthy controls. Attitudes under risk and ambiguity did not correlate across patients with schizophrenia. Furthermore, unlike in the healthy controls, activation of the left lateral orbitofrontal cortex was not increased during decision-making under ambiguity compared to under risk in schizophrenia. These results suggest that ambiguity aversion, a well-established subjective bias, is attenuated in patients with schizophrenia, highlighting the need to distinguish between risk and ambiguity when assessing decision-making under these situations. Our findings, comprising important clinical implications, contribute to improved understanding of the mechanisms underlying altered decision-making in patients with schizophrenia.

Background: This study is concerned with the comprehension of ambiguous idiomatic statements in schizophrenic and depressive patients. Aims: Using a multiple-choice procedure, we simultaneously tested the presence of concrete and literal elements in the understanding of idiomatic statements. Method: Fourteen schizophrenic and 10 patients undergoing a major depressive episode as well as 14 control subjects completed a questionnaire with 10 idiomatic expressions with two possible interpretations (figurative and literal) of equivalent prominence. The participants had to choose one word linked with the different interpretations of these idioms (figurative, literal, concrete or inappropriate meaning). Results: The main results show that, in all the subjects, the contextual characteristics of the task induced a bias in favor of figurative interpretations despite the equivalent prominence of the literal interpretations of the idioms. The selection of responses relating to the concrete meaning of a single word in the idiom constituted a response mode common to both the schizophrenic and depressed patients. Despite the contextual constraints of the task, the schizophrenics opted for the literal responses more often than the other participants. The descriptive analysis argues in favor of a cognitive and clinical heterogeneity of schizophrenic patients. Conclusion: Results support the idea that literality and concreteness in idiomatic interpretation are possibly due to distinct cognitive impairments, though only some are specific to schizophrenic patients.

In the last decade many research reports have provided evidences, that high-frequency oscillatory (HFO) brain activity is inevitably involved in the organization of human perception. Especially the contribution of beta- and gamma-oscillations, has been discussed extensively. Thereto researchers often use the bottom-up and top-down-processing dichotomy to characterize electrophysiological activities. Hence this work investigates HFO electrophysiological correlates of multistable perception in an ambiguous visual motion pattern, the stroboscopic alternative motion, in healthy subjects. In a second study correlates of an auditory sustained attention paradigm were investigated in schizophrenics and healthy controls. The results bear several new aspects of the contribution of HFO, especially in the beta-activity range, to the investigated phenomena and underpin the need for new causal experimental approaches to confirm the functional role of these oscillations. The bottom-up top-down-dichotomy did not prove to be helpful as a nomenclature to characterize the underlying oscillatory processes.

Abnormal decision-making has been described as a key-concept to understand some behavioral disturbances in schizophrenia. However, whether schizophrenia patients display impairments in profitable decision-making on experimental designs is still controversial (1) to assess performance on decision-making paradigms under ambiguity and under risk conditions in a large sample of schizophrenia patients and (2) to study the impact of clinical variables on decision-making performance in schizophrenia. The Iowa gambling task (IGT) and the game of dice task (GDT) were administered to assess, respectively, decision-making under ambiguity and under risk in 63 schizophrenia patients and 67 healthy controls. In addition, clinical variables (e.g., schizophrenic symptoms, self-reported depression, and impulsivity) were evaluated using appropriate questionnaires the same day. Pharmacological treatments were reported. Schizophrenia patients had impaired performances on both IGT and GDT tasks. No correlation between the decision-making tasks performance and clinical variables was found. Lower gains on the GDT were associated with executive dysfunctioning in schizophrenia. These findings give evidence that schizophrenia patients display impairments in both decision-making under ambiguity and under risk.

Schizophrenia is an important health issue affecting almost 1% of the population with significant unmet medical needs. The classical drug targets for the treatment of schizophrenia are dopamine D2 receptors. Second-generation ('atypical') drugs block more receptors of the G-protein-coupled receptor (GPCR) class 1 (e.g., clozapine is a D(2)-5HT(2) antagonist).In this article, the author presents the new targets for GPCR as well as ligand-gated ion. Furthermore, the author reviews the opportunities for drug design offered by the structures solved recently.For drug design, the availability of these protein structures, or the possibility to build high quality models, allows to shift the paradigm from ligand-based to target-based drug design. The analysis of the drugs, both on the market and in development, shows that numerous targets are being considered which may reveal an ambiguity on the ideal drug target. This situation may be simplified, in the future, owing to recent integrative projects: the 'Human Brain Project' and the 'Brain Activity Map' that aim at modeling the brain as well as the Allen Atlas.

A replication of the "levels effect" and reported correlation of "projection" and "pathology" was undertaken using a selected set of Thematic Apperception Test (Murray, 1943) cards varied for ambiguity and scored for pathology and projection. The levels effect was not found for pathology in either a normal or psychiatric group, but was found for projection in the normal group. The correlation between projection and pathology was again clearly confirmed. It was concluded that failure to take into consideration the stimulus properties of the cards and the context in which the test was administered may lead to false attribution of pathology to normal test-takers.

The judgement of healthy subject rating the emotional expressions of a set of schematic drawn faces is validated (study 1) to examine the relationship between mood (depressed/elated) and judgement of emotional expressions of these faces (study 2).Study 1: 30 healthy subjects judged 12 faces with respect to the emotions they express (fear, happiness, anger, sadness, disgust, surprise, rejection and invitation). It was found that a particular face could reflect various emotions. All eigth emotions were reflected in the set of faces and the emotions were consensually judged. Moreover, gender differences in judgement could be established.Study 2: In a cross-over design, 24 healthy subjects judged the faces after listening to depressing or elating music. The faces were subdivided in six 'ambiguous' faces (i.e., expressing similar amounts of positive and negative emotions) and six 'clear' faces (i.e., faces showing a preponderance of positive or negative emotions). In addition, these two types of faces were distinguished with respect to the intensity of emotions they express.11 subjects who showed substantial differences in experienced depression after listening to the music were selected for further analysis. It was found that, when feeling more depressed, the subjects perceived more rejection/sadness in ambiguous faces (displaying less intensive emotions) and less invitation/happiness in dear faces. In addition, subjects saw more fear in clear faces that express less intensive emotions. Hence, results show a depression-related negative bias in the perception of facial displays.

In the last half-century, human neuroscience methods provided a way to study schizophrenia in vivo, and established that it is associated with subtle abnormalities in brain structure and function. However, efforts to understand the neurobiological bases of the clinical symptoms that the diagnosis is based on have been largely unsuccessful. In this paper, we provide an overview of the conceptual and methodological obstacles that undermine efforts to link the severity of specific symptoms to specific neurobiological measures. These obstacles include small samples, questionable reliability and validity of measurements, medication confounds, failure to distinguish state and trait effects, correlation-causation ambiguity, and the absence of compelling animal models of specific symptoms to test mechanistic hypotheses derived from brain-symptom correlations. We conclude with recommendations to promote progress in establishing brain-symptom relationships. © 2012 Mathalon and Ford.

Schizophrenic patients are impaired in vocal affect recognition leading to great defect in their social functioning. These deficits have been demonstrated with explicit paradigms thus far: emotional prosody should be evaluated with an implicit manner in this pathology. 20 schizophrenic patients and 21 control subjects matched on age and sex ratio have been recruited. Firstly we have demonstrated impairment in explicit recognition of vocal emotions for schizophrenic patients. Then we have used a vocal emotional Stroop paradigm (conflict between emotions conveyed by the meaning of a word and by the voice with which it was pronounced) in order to measure implicit influence of emotional prosody on semantic emotional judgment. We have demonstrated a greater vocal emotional Stroop effect with error rate for schizophrenic patients. It was interpreted as a vocal emotional conflict resolution deficit. Vocal emotional Stroop effect with reaction times was positively correlated with social anhedonia for schizophrenic patients. This validated the paradoxical hypothesis of a hyper sensibility to vocal emotion in schizophrenic anhedonia. Finally we have explored implicit processing of linguistic prosody for the same participants. We used a psycho linguistic paradigm exploring lexical and prosodic segmentation strategies. We have demonstrated that schizophrenic patients were as able as control participants to perceive and use prosodic cues contained in phonological phrase boundaries to constrain lexical access. We concluded to dissociation between altered explicit recognition and preserved implicit perception of emotional and linguistic prosody in schizophrenia. Our results have refuted an entirely sensorial explanation of schizophrenic impairment in vocal affect recognition. They are in favour of a deficit in the cognitive stage of explicit judgment.; Les patients schizophrènes présentent des déficits en reconnaissance des émotions vocales qui ont de graves conséquences sur leur fonctionnement social. Ces déficits ont été jusqu'à présent mis en évidence à l'aide de paradigmes explicites : la perception implicite de la prosodie émotionnelle reste à être explorée dans cette pathologie. Nous avons recruté 20 patients schizophrènes et 21 sujets contrôles appariés sur l'âge et le sexe. Nous avons d'abord démontré dans notre groupe de patients un déficit en reconnaissance explicite de prosodie émotionnelle. Nous avons ensuite utilisé un paradigme de Stroop émotionnel vocal (conflit entre l'émotion du sens du mot et de la voix avec lequel il est prononcé) permettant d'évaluer l'influence implicite de la prosodie émotionnelle sur le jugement émotionnel sémantique. Nous avons démontré un effet de Stroop émotionnel vocal plus important en taux d'erreur chez les patients que chez les témoins traduisant un déficit de résolution des conflits émotionnels vocaux. Chez les patients, l'effet de Stroop émotionnel vocal en temps de réaction est positivement corrélé à l'anhédonie sociale, validant ainsi l'hypothèse originale d'une hypersensibilité aux émotions vocales dans l'anhédonie schizophrénique. Nous avons également exploré le traitement implicite de la prosodie linguistique chez les mêmes participants. Nous avons démontré à l'aide d'une tâche psycholinguistique évaluant les stratégies de segmentation lexicale et prosodique que les patients schizophrènes étaient tout à fait capables de percevoir et d'utiliser les indices prosodiques contenus dans des frontières de groupe de mots pour segmenter le signal de parole. Nous concluons à une dissociation entre une reconnaissance explicite altérée et une perception implicite préservée de prosodie émotionnelle et linguistique dans la schizophrénie. Nos résultats réfutent l'explication entièrement sensorielle du trouble schizophrénique en reconnaissance des émotions vocales. Ils sont plutôt en faveur d'un déficit de l'étape cognitive de jugement émotionnel.

The capacity for transitive inference (TI), a form of relational memory organization, is impaired in schizophrenia patients. In order to disambiguate deficits in TI from the effects of ambiguous reinforcement history and novelty, 28 schizophrenia and 20 nonpsychiatric control subjects were tested on newly developed TI and non-TI tasks that were matched on these 2 variables. Schizophrenia patients performed significantly worse than controls on the TI task but were able to make equivalently difficult nontransitive judgments as well as controls. Neither novelty nor reinforcement ambiguity accounted for the selective deficit of the patients on the TI task. These findings implicate a disturbance in relational memory organization, likely subserved by hippocampal dysfunction, in the pathophysiology of schizophrenia.

Schizophrenic patients are impaired in vocal affect recognition leading to great defect in their social functioning. These deficits have been demonstrated with explicit paradigms thus far: emotional prosody should be evaluated with an implicit manner in this pathology. 20 schizophrenic patients and 21 control subjects matched on age and sex ratio have been recruited. Firstly we have demonstrated impairment in explicit recognition of vocal emotions for schizophrenic patients. Then we have used a vocal emotional Stroop paradigm (conflict between emotions conveyed by the meaning of a word and by the voice with which it was pronounced) in order to measure implicit influence of emotional prosody on semantic emotional judgment. We have demonstrated a greater vocal emotional Stroop effect with error rate for schizophrenic patients. It was interpreted as a vocal emotional conflict resolution deficit. Vocal emotional Stroop effect with reaction times was positively correlated with social anhedonia for schizophrenic patients. This validated the paradoxical hypothesis of a hyper sensibility to vocal emotion in schizophrenic anhedonia. Finally we have explored implicit processing of linguistic prosody for the same participants. We used a psycho linguistic paradigm exploring lexical and prosodic segmentation strategies. We have demonstrated that schizophrenic patients were as able as control participants to perceive and use prosodic cues contained in phonological phrase boundaries to constrain lexical access. We concluded to dissociation between altered explicit recognition and preserved implicit perception of emotional and linguistic prosody in schizophrenia. Our results have refuted an entirely sensorial explanation of schizophrenic impairment in vocal affect recognition. They are in favour of a deficit in the cognitive stage of explicit judgment., Les patients schizophrènes présentent des déficits en reconnaissance des émotions vocales qui ont de graves conséquences sur leur fonctionnement social. Ces déficits ont été jusqu'à présent mis en évidence à l'aide de paradigmes explicites : la perception implicite de la prosodie émotionnelle reste à être explorée dans cette pathologie. Nous avons recruté 20 patients schizophrènes et 21 sujets contrôles appariés sur l'âge et le sexe. Nous avons d'abord démontré dans notre groupe de patients un déficit en reconnaissance explicite de prosodie émotionnelle. Nous avons ensuite utilisé un paradigme de Stroop émotionnel vocal (conflit entre l'émotion du sens du mot et de la voix avec lequel il est prononcé) permettant d'évaluer l'influence implicite de la prosodie émotionnelle sur le jugement émotionnel sémantique. Nous avons démontré un effet de Stroop émotionnel vocal plus important en taux d'erreur chez les patients que chez les témoins traduisant un déficit de résolution des conflits émotionnels vocaux. Chez les patients, l'effet de Stroop émotionnel vocal en temps de réaction est positivement corrélé à l'anhédonie sociale, validant ainsi l'hypothèse originale d'une hypersensibilité aux émotions vocales dans l'anhédonie schizophrénique. Nous avons également exploré le traitement implicite de la prosodie linguistique chez les mêmes participants. Nous avons démontré à l'aide d'une tâche psycholinguistique évaluant les stratégies de segmentation lexicale et prosodique que les patients schizophrènes étaient tout à fait capables de percevoir et d'utiliser les indices prosodiques contenus dans des frontières de groupe de mots pour segmenter le signal de parole. Nous concluons à une dissociation entre une reconnaissance explicite altérée et une perception implicite préservée de prosodie émotionnelle et linguistique dans la schizophrénie. Nos résultats réfutent l'explication entièrement sensorielle du trouble schizophrénique en reconnaissance des émotions vocales. Ils sont plutôt en faveur d'un déficit de l'étape cognitive de jugement émotionnel.

We present a case of schizophrenia with the multiplication of other persons. The delusion in our case may be considered as that of Capgras syndrome but the former is different from the latter in some ways. In the delusion of our case, there occurred the disintegration of mind and body. We considered this disintegration in relation to schizophrenic destruction. We recognize the destruction of ambiguity in schizophrenia. That is, two dimensions that construct ambiguity are broken up and become independent from each other. In the delusion of our case, the ambiguity in the living body was destroyed. This destruction seems to be based on the schizophrenic though disorder: the cohesion of the concrete and overabstract.

Our previous work showed a semantic bias in interpreting ambiguous words in schizophrenia, with disproportionate misinterpretation of subordinate meanings (toast at a wedding). We proposed pre-selection in schizophrenia of dominant-meaning networks at points of lexical ambiguity, thereby misleading thought. This selection bias may be due to semantic memory hyper-priming causing strong associates to dominate cognition. Alternately, later verbal memory maintenance failure may cause weaker associates to fade more quickly than stronger associates from memory due to less initial activation. To further examine this semantic bias, patients and controls were presented short 4 word long sentences (The toast was buttered). The second word was a homograph or unambiguous noun. The last word disambiguated homographs (dominant or subordinate meaning) or was congruent or incongruent with unambiguous nouns. Previously, we showed increasingly larger N400 from unambiguous associates to dominate associates to subordinate associates to unambiguous non-associates in controls. Pre-selection of dominant meanings predicts that schizophrenia patients would show small N400 to dominant associates and as large N400 to subordinate associates as to incongruous endings. Here, controls again showed graded N400 amplitudes. Patients with schizophrenia showed small N400 to congruent and dominant endings and large N400 to subordinate and incongruous endings. These data suggest early pre-selection of dominant associates in schizophrenia. This effect is unlikely solely due to verbal memory maintenance failure, as patients were able to detect incongruity, albeit with a smaller N400 effect, and displayed generally larger N400 to all stimuli. These results suggest alterations in semantic memory associative networks coupled with verbal working memory maintenance decay in schizophrenia.

A consistent body of studies suggests that schizophrenia patients are extremely hasty when making decisions, and generally opt for the strongest response alternative. This pattern of results is primarily based on studies conducted with the beads task, which requires participants to determine from which of two possible jars a series of beads has been drawn. We have recently proposed a liberal acceptance (LA) bias to account for decision-making biases in schizophrenia, which claims that under heightened ambiguity the jump to conclusions (JTC) bias is abolished in schizophrenia.A total of 37 schizophrenia patients were compared with 37 healthy controls on different versions of the beads paradigm. For the first task, participants were required to rate the probability that a bead was being drawn from one of two jars, and had to evaluate after each bead whether the amount of presented information would justify a decision. The second task was a classical draws to decision experiment with two jars. The third task confronted participants with four possible jars. If JTC was ubiquitous in schizophrenia hasty convergence on one alternative would be predicted for all three tasks. In contrast, the LA account predicts an abolishment of the JTC effect in the final task.Tasks 1 and 2 provide further evidence for the well-replicated JTC pattern in schizophrenia patients. In accordance with the LA hypothesis, no group differences were detected for task 3.The present results confirm that JTC is not ubiquitous in schizophrenia: in line with the LA account a JTC bias in schizophrenia occurred under low but not high ambiguity. LA may partly explain the emergence of fixed, false beliefs.

Introduction Schizophrenic patients have shown by experience to have reduced sense of humor and do not understand jokes completely. Objectives It is unclear whether this is the result of a global emotional numbness, a dysfunctional abstract thinking or problem of semantic field. Besides, the relevance of this issue in mood disturbances in psychotic patients must be reappraised. Aims Increase of sociability in schizophrenic patients by way of augmenting sense of humor. Methods Hundred schizophrenic patients were evaluated by way of interview and three questionnaires for their sense of humor and abstract thinking in response to non sexual jokes. They were asked to tell ten jokes and grade them in regard to funniness. In addition ten jokes were told to them and asked them to grade these jokes in a 10 strength scale. These steps were repeated after 12 weeks of conventional antipsychotic treatment in addition to short courses of psychotherapies. Results Schizophrenic patients have an overall reduced sense of humor for jokes even if they can understand the core reality of them hence not a matter of deranged abstract thinking. They show also reduced expression of joy in response to jokes that they have rated highest. This denotes some degrees of emotional numbness. Treatment of patients with conventional antipsychotics cannot completely restore the sense of humor even after a 3 months period. Conclusions We conclude that sense of humor is a central issue in social functioning and some additional treatments must be used to normalize patients with schizophrenia.

As the study of sex differences in schizophrenia gains popularity, inconsistent use of terms such as "sex," "gender," "sex-related," and "sex-linked" can lead to conceptual ambiguity. I review briefly why precise terminology is important and draw the reader's attention to a well-developed literature, a knowledge of which should benefit our studies. Adoption of the term "sex" in reference to comparisons based on the demographic categories of female and male and the term "gender" in reference to comparisons of femaleness and maleness, as suggested by Kay Deaux (1993), is urged in the study of schizophrenia.

first group performed better in all the above tasks; there was also statistic significance in the quality of wrong answers. The first group scored fewer semantic [(F = 1.36) = 0.023, p < 0.05) and phonological total wrong answers [(F = 0.040), p < 0.05]. The two groups showed statistical difference in the total semantic wrong answers for adjectives [(F = 1.36) = 0.023, p < 0.05] b) The scale of positive syndrome correlated in a positive way with the total score of semantically wrong answers in adjectives (r = 0.334, p < 0.05). The negative scale correlated in a negative way with the total correct answers for nouns (r = -0.362, p < 0.05), total correct answers for verbs (r = -0.407, p < 0.05) and total correct answers for words (r = -0.441, p < 0.001). The general psychopathology correlated in a negative way with the total correct answers for verbs, (r = -0.327, p < 0.05) and the total correct answers for words (r = -0.400, p < 0.05), while it correlated positively with the total score of phonologically wrong answers in nouns (r = 0.441, p < 0.001).

This paper reports a re-evaluation of seven sets of findings appearing in the research literature. The findings were derived from questionnaire studies of feelings of guilt and other feelings in diagnosed depressives and other psychiatric groups. The publications did not provide sufficient information to evaluate important inconsistencies in the findings. However, an examination of the structure and content of the questionnaires which were used made it possible to account for the discrepancies. There were three main conclusions. The first was that the only way to minimize the ambiguity of questionnaire responses was to avoid the use of multiple-item scales and only to use single-item questions which were constructed as simply as possible. The second was that depressives were not much different from other people in the degree of outwardly and inwardly directed hostility. The third was that, while guilt feelings, with certain provisos, tended to be associated with the diagnosis of depression, other feelings appeared to be both more prominent in and more strongly associated with depression. These feelings consisted of increments in feelings of loss, in the most general sense of the word, and decrements in general positive pleasant feelings.

McGlashan and Carpenter (1979) have critiqued our article (Goplerud and Depue 1978), in which we suggested that postpsychotic depression and bipolar depressive disorder may well be related. Their critique has many problems and, most importantly, raises new ambiguities concerning the definition of postpsychotic depression. Therefore, we have attempted to clarify the issues their discussion raises.

When the psychiatrist functions as medical backup, i.e., in a setting of delegated clinical responsibility, a number of problems may arise, originating from factors in the patient, in the physician, in the staff member to whom responsibility is delegated, and in the setting itself. The authors delineate these problem areas through case examples and discuss the implications for multidisciplinary training.

In musing upon my assignment for this Congress, I became aware of limitations that I must impose upon myself, inherent in the title of the address. First, the words “Psychotic Disorders” point to the fact that the whole province of Psychiatry is not included in its scope, and whilst it is pertinent to include with the psychoses, suicide, which is a not infrequent feature of the psychotic disorders, and the epilepsies, which commonly have a psychotic aspect, the large areas of the psychiatric field characterized as mental defect, psychoneurosis, psychosomatic conditions, psychopathic personalities, and sexual deviations (including homosexuality) are not relevant to to-day's talk. Nor is it my prerogative to treat of recent developments in the realm of chromosome anomalies, such as the trisomy underlying Mongolism, karyotypes and the sexing of cells. In the second place, the term “Classification” suggests to me that my task is to confine myself to the findings of genetic studies in our field of discourse and not stray into the tempting pastures of eugenics, or biochemical genetics with its rich promise of reversibility and cure by modern pharmaceutical means. Even now with our feet firmly on the ground of genetic fact, after this preliminary delimitation, we are not entirely free on the semantic side of things, for, if I mistake not, some appearance of ambiguity would seem to lurk in our title. Is its meaning that within the discipline of Psychiatry we are to attempt a classification of the psychoses from a genetic point of view, or, is it that as an exercise within the realm of Genetics we are seeking to classify the specific and non-specific hereditary mechanisms, which have been postulated as underlying different psychotic disorders? I incline to the view that both of these programmes are significant, and appropriate to the endeavour to which this paper is dedicated.

The processing of lexical ambiguity in context was investigated in eight individuals with schizophrenia and a matched control group. Participants made speeded lexical decisions on the third word in auditory word triplets representing concordant (coin-bank-money), discordant (river-bank-money), neutral (day-bank-money), and unrelated (river-day-money) conditions. When the interstimulus interval (ISI) between the words was 100 ms, individuals with schizophrenia demonstrated priming consistent with selective, context-based lexical activation. At 1250 ms ISI, a pattern of nonselective meaning facilitation was obtained. These results suggest an attentional breakdown in the sustained inhibition of meanings on the basis of lexical context.