This study investigates, for the first time, clinical, cognitive, social cognitive and metacognit... more This study investigates, for the first time, clinical, cognitive, social cognitive and metacognitive differences in people diagnosed with first-episode of psychosis (FEP) with and without a family history of mental disorder split by maternal and paternal antecedents. A total of 186 individuals with FEP between 18 and 45 years old were recruited in community mental-health services. A transversal, descriptive, observational design was chosen for this study. Results suggest that there is a higher prevalence of maternal history of psychosis rather than paternal, and furthermore, these individuals exhibit a specific clinical, social and metacognitive profile. Individuals with a maternal history of mental disorder scored higher in delusional experiences, inhibition of the response to a stimulus and higher emotional irresponsibility while presenting a poorer overall functioning as compared to individuals without maternal history. Individuals with paternal history of mental disorder score h...
European Archives of Psychiatry and Clinical Neuroscience
Deficits in social cognition and metacognition impact the course of psychosis. Sex differences in... more Deficits in social cognition and metacognition impact the course of psychosis. Sex differences in social cognition and metacognition could explain heterogeneity in psychosis. 174 (58 females) patients with first-episode psychosis completed a clinical, neuropsychological, social cognitive, and metacognitive assessment. Subsequent latent profile analysis split by sex yielded two clusters common to both sexes (a Homogeneous group, 53% and 79.3%, and an Indecisive group, 18.3% and 8.6% of males and females, respectively), a specific male profile characterized by presenting jumping to conclusions (28.7%) and a specific female profile characterized by cognitive biases (12.1%). Males and females in the homogeneous profile seem to have a more benign course of illness. Males with jumping to conclusions had more clinical symptoms and more neuropsychological deficits. Females with cognitive biases were younger and had lower self-esteem. These results suggest that males and females may benefit ...
Research on the multidimensionality of hallucination-like experiences (HLEs) can contribute to th... more Research on the multidimensionality of hallucination-like experiences (HLEs) can contribute to the study of psychotic risk. The Launay-Slade Hallucinations Scale-Extended (LSHS-E) is one of the most widely used tools for research in HLEs, but the correspondence of its paper and online formats has not been established yet. Therefore, we studied the factorial structure and measurement invariance between online and paper-and-pencil versions of LSHS-E in a Chilean population. Two thousand eighty-six completed the online version, and 578 students completed the original paper-and-pencil version. After matching by sex, age, civil status, alcohol and cannabis consumption, and psychiatric treatment received, we selected 543 students from each group. We conducted a confirmatory factor analysis of a four-factor model and a hierarchical model that included a general predisposition to hallucination, explaining the strong relationship between the different types of hallucinations. Both models showed a good fit to the data and were invariant between paper-and-pencil and online versions. Also, the LSHS-E has good reliability in both online and paper-and-pencil formats. This study shows that the online LSHS-E possesses psychometric properties equivalent to the paper-and-pencil version. It should be considered a valuable tool for research of psychosis determinants in the COVID-19 era.
Deficits in social cognition and metacognition impact the course of psychosis. Gender differences... more Deficits in social cognition and metacognition impact the course of psychosis. Gender differences in social cognition and metacognition could explain heterogeneity in psychosis. 174 (58 females) patients with first-episode psychosis completed a clinical, neuropsychological, social cognitive and metacognitive assessment. Subsequent latent profile analysis split by gender yielded 2 clusters common to both genders, a specific male profile characterized by presenting jumping to conclusions and a specific female profile characterized by cognitive biases. Males and females in the homogeneous profile seem to have a more benign course of illness. Males with jumping to conclusions had more clinical symptoms and more neuropsychological deficits. Females with cognitive biases were younger and had less self-esteem. These results suggest that males and females may benefit from specific targeted treatment and highlights the need to consider gender when planning interventions.
Gender differences in symptomatology in people with psychosis have been studied extensively in la... more Gender differences in symptomatology in people with psychosis have been studied extensively in last decades. Previous narrative reviews have shown some evidence of gender differences in depressive, negative and paranoid symptoms, but yielding inconclusive findings. These reviews are limited by not doing systematic searches nor performing quantitative synthesis of the evidence. Therefore, we aimed to systematically investigate if there are gender differences in symptoms in people with psychosis. We describe the protocol for a systematic review and pairwise meta-analysis comparing a range of symptomatic outcome measures between men and women diagnosed with a psychotic spectrum disorder at different stages of the disorder (ultra-high risk for psychosis, early psychosis and established psychosis) in observational studies.
BackgroundPatients with schizophrenia spectrum disorders (SSD) tend to lack insight, which is lin... more BackgroundPatients with schizophrenia spectrum disorders (SSD) tend to lack insight, which is linked to poor outcomes. The effect size of previous treatments on insight changes in SSD has been small. Metacognitive interventions may improve insight in SSD, although this remains unproved.MethodsWe carried out a systematic review and meta-analysis of randomized controlled trials (RCTs) to examine the effects of metacognitive interventions designed for SSD, namely Metacognitive Training (MCT) and Metacognitive Reflection and Insight Therapy (MERIT), on changes in cognitive and clinical insight at post-treatment and at follow-up.ResultsTwelve RCTs, including 10 MCT RCTs (n = 717 participants) and two MERIT trials (n = 90), were selected, totalling N = 807 participants. Regarding cognitive insight six RCTs (n = 443) highlighted a medium effect of MCT on self-reflectiveness at post-treatment, d = 0.46, p < 0.01, and at follow-up, d = 0.30, p < 0.01. There was a small effect of MCT on...
Introduction: People with psychosis show impairments in cognitive flexibility, a phenomenon that ... more Introduction: People with psychosis show impairments in cognitive flexibility, a phenomenon that is still poorly understood. In this study, we tested if there were differences in cognitive and metacognitive processes related to rigidity in patients with psychosis. We compared individuals with dichotomous interpersonal thinking and those with flexible interpersonal thinking.Methods: We performed a secondary analysis using two groups with psychosis, one with low levels of dichotomous interpersonal thinking (n = 42) and the other with high levels of dichotomous interpersonal thinking (n = 43). The patients were classified by splitting interpersonal dichotomous thinking (measured using the repertory grid technique) to the median. The groups were administered a sociodemographic questionnaire, a semi-structured interview to assess psychotic symptoms [Positive and Negative Syndrome Scale (PANSS)], a self-report of cognitive insight [Beck Cognitive Insight Scale (BCIS)], neurocognitive task...
Background The individual Metacognitive Training (MCT+) is useful to reduce positive symptoms in ... more Background The individual Metacognitive Training (MCT+) is useful to reduce positive symptoms in people with schizophrenia, however less is known in people with first-episode psychosis (FEP). The aim of the study is to assess the effectiveness of MCT+ in FEP regarding symptoms and cognitive insight. Methods A random clinical trial was performed with people with FEP from 10 clinical centers of Spain. One group received ten sessions of MCT+ and the other group received TAU. A total of 75 patients were included in the study, however only 40 finished the final assessment. Patients were assessed before treatment, post-treatment and 6 month follow-up. The assessment includes a battery of instruments for the main aims the Positive and Negative Syndrome Scale (PANSS) and the Beck Cognitive Insight (BCIS) will be analyzed. Repeated measures statistical test were used in order to assess differences between groups. Results Both groups improved in Positive symptoms, in the MCT+ group the differ...
Background Previous studies have found that the best predictor of individual risk when developing... more Background Previous studies have found that the best predictor of individual risk when developing one or several mental and neurocognitive disorders is family history of mental disorder, more specifically, first degree relatives. The estimated risk of developing schizophrenia is of approximately 10% in individuals that present a paternal or maternal risk of psychosis, increasing to a 50% if both parents are affected; in comparison to a 1% risk in general population (Hall, 1994; Hannon et al., 2016). Having a first-degree family member with psychosis is the best individual risk predictor in developing mental or neurocognitive disorders (Bhatia et al., 2016; Thorup et al., 2018). However, literature exploring the role of family history of psychosis on symptoms, cognition, social cognition and metacognition in first-episode of psychosis (FEP) is scarce, and there is a dearth of studies examining the influence of the maternal and paternal history of psychosis independently. Methods The ...
Fluctuating asymmetry represents the degree to which the right and left side of the body are asym... more Fluctuating asymmetry represents the degree to which the right and left side of the body are asymmetrical, and is a sign of developmental instability. Higher levels of fluctuating asymmetry have been observed in individuals within the schizophrenia spectrum. We aimed to explore the associations of fluctuating asymmetry with psychotic and affective symptoms in schizophrenia patients, as well as with propensity to these symptoms in nonclinical individuals. A measure of morphological fluctuating asymmetry was calculated for 39 patients with schizophrenia and 60 healthy individuals, and a range of clinical and subclinical psychiatric symptoms was assessed. Regression analyses of the fluctuating asymmetry measure were conducted within each group. In the patient cohort, fluctuating asymmetry was significantly associated with the hallucination and thought disorganisation scores. T-test comparisons revealed that the patients presenting either hallucinations or thought disorganisation were significantly more asymmetrical than were the healthy individuals, while the patients without these key symptoms were equivalent to the healthy individuals. A positive association with the anxiety score emerged in a subsample of 36 healthy participants who were rated on affective symptoms. These findings suggest that fluctuating asymmetry may be an indicator of clinical hallucinations and thought disorganisation rather than an indicator of schizophrenia disease.
Methods: The SFRT-2 was translated and retro-translated into Spanish. After that, one hundred and... more Methods: The SFRT-2 was translated and retro-translated into Spanish. After that, one hundred and one patients with schizophrenia and 100 HC were assessed in order to obtain psychometric properties of the test. First, reliability of the SFRT-2 was studied with Cronbach's alpha coefficients for actions hits, actions false positives, goals hits and goals false positives separately, in both patients and HC. Second, in patients' group, concurrent validity was calculated using Spearman's correlations in order to assess the relationship between SFRT hits and false positives scores and other SC measures such as ToM, EP, AS and global SC. Third, divergent validity was assessed in patients' group by means of Spearman's correlations in order to study the relationship between SFRT-2 and a neurocognition composite score. Finally, discriminant validity of SFRT-2 actions and objectives hits and false positives was obtained comparing schizophrenia and HC groups by means of Receiver Operating Characteristic (ROC) curve analysis. Percentiles for the SFRT-2 scores were also calculated and shown in order to facilitate clinical assessment of SP. Results: Regarding reliability of the test, internal consistency indexes of the SFRT-2 hits and false positives ranged from α = .66 to α = .90 in both groups, with higher indexes corresponding to patients' group. Concerning convergent and divergent validity, SFRT-2 significantly correlated with other measures of SC, especially with ToM (SFRT-2 hits: r = .46, p < .01), and also, but to a lesser extent, with neurocognition composite score (SFRT-2 hits: r = .33, p < .01). Receiver Operating Characteristic (ROC) curve analysis showed that SFRT-2 hits and false positives discriminate well between patients with schizophrenia and HC, being false positives the indexes which best discriminated between both groups (actions false positives: AUC = .74, p < .001; objectives false positives: AUC = .78, p < .001). Discussion: Spanish adaptation and validation of the SFRT-2 showed good psychometric properties in both patients with schizophrenia and HC. In addition, reliability of the instrument seemed to be especially high among patients with schizophrenia. To our knowledge, this is the first adaptation and validation of an existing SP measure into native Spanish-speaking patients with schizophrenia. Given the good psychometric properties obtained by the Spanish adaptation, results further support the use of the SFRT-2 as an adequate measure to assess SP in patients with schizophrenia in both research and clinical practice. To that aim, SFRT-2 percentile scores for Spanish population were also provided in order to contribute to the appropriate detection of SP impairment in Spanish-speaking patients with schizophrenia.
is Social Cognitive Intervention Training (SCIT). This therapy is comprised of three phases (i.e.... more is Social Cognitive Intervention Training (SCIT). This therapy is comprised of three phases (i.e., Introduction & Emotions, Figuring out Situations, Checking it out) administered in a group format. Objective: To evaluate the efficacy of Social Cognition and Interaction Training (SCIT) in improving social cognitive and social functioning deficits of patients with schizophrenia spectrum disorder compared with standard of care, Befriending Therapy (BT). Methods: A 10-week, single-blind, randomized controlled trial (RCT) of SCIT and BT was carried out in 120 patients with schizophrenia spectrum disorder. Primary outcome measure is the total score on the Bell Lysaker Emotion Recognition Task (BLERT) at 12 weeks. Mixed Model for Repeated Measures was used to analyse change in BLERT score from baseline to 3-month follow-up between SCIT and BT groups. Secondary measures of the study are improvements on the Social Functioning Scale, [1] [1] [1] Hinting Task, Social Skills Performance Assessment, Internal, Personal and Situational Attributions Questionnaire, and Meta Cognition Questionnaire. Results: Among 120 patients, the mean age (SD) was 36.8 years (10.4) and 71.7% were males. Of these, 59 were randomized to the BT group and 61 to the SCIT group. The mean age of participants was 36.8 years. 85.8% were receiving government benefit and 50% lived in supported housing. 71.7% were males. Pre/Post data will be presented on the 91 participants who completed the study. Results examining the primary outcome measure found there was insufficient evidence to conclude that the SCIT group was significantly different compared to BT group in terms of emotion recognition (BLERT scores) (SCIT vs BT change: 0.437, 95% CI:-0.14 to 1.01; P = 0.136). There was an overall effect of time where both treatments showed a steady improvement over time from baseline to endpoint and the effect was maintained at the three-month follow-up. There was no significant time x treatment group interaction which indicated that there was no difference in patterns of change in the treatment group over time. Data on secondary outcomes is currently being analysed. Discussion: In this medium sized RCT of social cognition interaction therapy that used an active control, (BT) and standardised measure of emotional recognition, (BLERT) we found no significant difference between the interventions in our primary outcome measure of emotional recognition. Improvement in emotional perception has been found in the majority of studies of social cognitive interventions for schizophrenia. More specifically our results differ to those of Hasson-Ohayon who found significant improvement in emotion recognition in a RCT of SCIT with social mentoring compared with social mentoring alone in people diagnosed with schizophrenia, schizoaffective disorder, depression or bipolar disorder (Hasson-Ohayon 2014). This study is the largest RCT of SCIT to find a negative result in regards to emotion perception.
Background: Emotional facial expressions are vital communicative signals and a lack thereof shoul... more Background: Emotional facial expressions are vital communicative signals and a lack thereof should interfere with successful social interaction. That people with schizophrenia lack emotional facial expression, mostly irrespective of antipsychotic medication, is not only a well-known notion but also backed up by ample evidence. However, a closer look reveals a more complicated picture that implies that maybe only those with expressive negative symptoms (ENS; i.e. blunted affect and alogia) but not those without ENS show reduced facial expressiveness. Furthermore, while the reduction has been found consistently for positive facial expressions, the evidence for negative facial expressions has been mixed. Finally, the social consequences of the reduction are mostly unknown and thus whether or not the reduction actually interferes with social interactions. To address these questions, we tested for the symptom-specificity of reduced positive and negative facial expression (phenomenology) and their social relevance in patients with schizophrenia with versus without ENS. Methods: The frequency of positive and negative facial expressions in an affiliative role-play were assessed with the Facial Expression Coding System (FACES) in people with schizophrenia with (n = 18) and without ENS (n = 30) and in healthy controls (n = 39). Based on observing the role-play, independent raters also rated their willingness for future interactions with each participant. The presence of ENS was assessed via the Positive and Negative Syndrome Scale (PANSS). Results: Patients with schizophrenia and ENS did not differ on positive symptoms and depression or on chlorpromazine equivalent medication dosage from those without ENS. The analysis of the frequency of facial expressions revealed that patients with ENS showed reduced levels of positive facial expressions both compared to those without ENS (d =-0.82) and to controls (d =-1.21). Both patient groups (with and without ENS) showed equally reduced negative facial expressions compared to controls (ds =-0.99 and-0.86). Raters also indicated less willingness for future interactions with patients with ENS than without ENS (d =-0.92). This difference was significantly mediated by the reduced positive facial expressions. Discussion: The findings offer new insights into the phenomenology and the relevance of reduced emotional facial expression in schizophrenia. Our study indicates that the moderate to large mean differences that have been reported in earlier studies comparing samples with more broadly defined schizophrenia to healthy controls could mainly be driven by a reduction in facial expressions that is relatively specific to those with ENS. However, some aspects of reduced facial expression may nevertheless be genuine to more broadly defined schizophrenia given that we found patients with schizophrenia both with and without ENS to exhibit reduced levels of negative facial expressions. Finally, we found that the reduction of the positive facial expressions explained why raters were more willing to interact with those without ENS than with those with ENS. This further highlights the relevance of ENS by showing that they interfere with successful social interaction and go along with immediate social costs.
Background: Despite the evidence related to the role of major life events and childhood trauma in... more Background: Despite the evidence related to the role of major life events and childhood trauma in the development of first-episode psychosis (FEP; Varese et al., 2012; Morgan & Fisher, 2007), there are few studies on environmental exposure to stressful life events (SLEs) and how SLEs might influence the onset of a psychotic disorder, and the role of perceived stress in this population. The proposed analyses will investigate the association between the categories of SLEs (education, work, partner, family, home, legal, finances, social and health) and perceived stress between patients with FEP and healthy controls (HC). Methods: Participants were patients with FEP (n=15) and HC (n=21). This research was part of a longitudinal observational study called the 'PROFEP group' in Catalonia. Stressful life events were assessed with the Questionnaire of stressful life events (QSLE) (Butjosa et al., 2017). We analysed the frequency of the categories of SLEs. Perceived stress was assessed with the Perceived Stress Scale (PSS; Cohen & Williams, 1988). Results: There are more frequency of SLEs in the education (p<0.05) and health (p<0.05) categories, and perceived stress (p<0.05) in FEP sample than HC. Discussion: Results show the relevance of the presence of SLEs (e.g. education and health) and a potent source of perceived stress in FEP sample. Therefore, more studies are needed to evaluate these stressors to apply future psychological interventions in relation to stress management in FEP population. In addition, it would add protective variables in the analyses such as resilience, coping and social support.
same time, Social Functioning Scale (SFS) and SFAS was given to the relatives of the patients who... more same time, Social Functioning Scale (SFS) and SFAS was given to the relatives of the patients who live together. For reliability analyses; internal consistency coefficient, item-total correlation, and split-half reliability was assessed. For validity analyses; explanatory factor analysis, and convergent validity were examined via Spearman correlation. Results: The data from 104 patients with schizophrenia and 26 with schizoaffective disorder whose 75% were males, 69% were single, mean age was 37, the level of education was 10 years was examined. The average onset of the illness was 23 years, and the duration of illness was 14 years. Cronbach's alpha coefficient for SFAS total score was .83, and for factors were between .69 and .77. Split-half reliability coefficient of SFAS was .73. There was a satisfactory correlation between SFAS filled by patients and by relatives (r=.60, p<0.001). For factor analysis, Kaiser-Meyer-Olkin value was .78, and Barlett test was significant (p<0.001). In explanatory factor analysis, SFAS was found to be compose of three factors (self-care, interpersonal relationships and recreation, independent living) and that they can explain 45% of the total variance. Nine items were omitted because of having lower factor value than .40. Self-care factor had 7-item, interpersonal relationships and recreation factor had 7 items and independent living factor had 4 items. Occupational life could not get in any of factors; however, since it was very important for social functioning, it was added to the scale as fourth factor. SFAS total score was correlated with PANSS negative subscale (r=-.35, p<0,001), PANSS-total (r=-.29, p<0,001), CGI-S (r=-.33, p<0,001), GAF (r=.28, p<0,001) and SFS total score (r=.52, p<0,001). Discussion: Regarding the findings of the study, SFAS was considered a culturally-sensitive, easy-to-use, and valid instrument that objectively assesses the social functioning of the patients with schizophrenia in Turkey.
Background: Suicide is the leading cause of surmortality among patients with schizophrenia. Despi... more Background: Suicide is the leading cause of surmortality among patients with schizophrenia. Despite efficient antipsychotic treatments, suicide rates reaches up to 15% of death causes and near half of the patients had at least once attempted suicide. Thereby, the early identification of clinical profiles and risk factors is important for the development of management strategies. Methods: A cross-sectional and retrospective descriptive study was conducted at the "F" psychiatry department at the Razi Hospital, Manouba including 56 patients with schizophrenia in period of clinical stability. The evaluation focused on sociodemographic and clinical characteristics (using the positive and negative syndrome scale (PANSS); The Calgary Depression Scale for Schizophrenia (CDSS); The Global Assessment of Functioning (GAF); The Clinical Global Impression (CGI) rating scales). Personal history of suicidal attempts was assessed. Results: In this study, fourteen patients with schizophrenia (25%) never attempted suicide. 58 % (N=32) committed one or two suicide attempts. Only 8.5% (N= 5) had 3 and 4 attempts each. Number of suicide attempts was negatively correlated with the age of onset (p=0.024, r=-0.442) and the GAF score (p= 0.002, r=-0.483). An association was found between the personal history of suicidal attempts and the existence of a triggering factor of the onset (p=0.03). A positive correlation was found with the number of hospitalization (p=0.14, r=0.663), with the PANSS items: delusions (p=0.41, r=0.358), hallucinations (p=0.12, r=0.402), Suspiciousness/ persecution (p=0.35, r= 0.342) and Somatic concern (p=0.048, r=0.322); with the CDSS guilty ideas of references (p=0.008, r=0.426) and with the CGI efficacy index (p=0.32, r=0.348). Discussion: The rates of suicide are the highest among patients with schizophrenia. Previous studies have estimated the prevalence of suicide attempts in individuals with schizophrenia up to 50%. The increase in suicide attempts is associated with depressive symptoms which are very common within schizophrenia. The risk of suicide is not constant during the evolution of schizophrenia: it is the highest during the first years. A meta-analysis of 29 studies (Hawton et al., 2005) related that risk factors for suicide was higher in schizophrenic Caucasian men, those who live alone, who have recently experienced a loss, who have a family history of depression, who are more educated and have a higher IQ. Alteration of the abnormality the serotonin system may provide a biologic base to this phenomenon. It is essential to try to early detect and carefully assess the demographic and clinical profiles of patients with high risk of suicide.
Background: Psychotic disorders are associated with serious deterioration in functioning even bef... more Background: Psychotic disorders are associated with serious deterioration in functioning even before the first psychotic episode. Also on clinical high risk (CHR) states of developing a first psychotic episode, several studies reported a decreased global functioning. In a considerable proportion of CHR individuals, functional deterioration remains even after (transient) remission of symptomatic risk indicators. Furthermore, deficits in functioning cause immense costs for the health care system and are often more debilitating for individuals than other symptoms. However in the past, CHR research has mostly focused on clinical outcomes like transition and therefore, functioning in CHR patients is under-investigated. The current study aims at predicting functioning at a single subject level applying multi pattern recognition to clinical data for the first time. Methods: PRONIA ('Personalized Prognostic Tools for Early Psychosis Management') is a prospective collaboration project funded by the European Union under the 7th Framework Programme (grant agreement n° 602152). Considering a broad set of variables (sMRI, rsMRI, DTI, psychopathological, life event related and sociobiographic data, neurocognition, genomics and other blood derived parameters) as well as advanced statistical methods, PRONIA aims at developing an innovative multivariate prognostic tool enabling an individualized prediction of illness trajectories and outcome. Seven university centers in five European countries and in Australia
Background People with psychosis experience disruptions in personal identity that affect positive... more Background People with psychosis experience disruptions in personal identity that affect positive and negative symptoms, but the complexity of these phenomena needs to be addressed in an in-depth manner. Using the Personal Construct Theory, we examined whether distinct dimensions of personal identity, as measured with the Repertory Grid Technique along with other cognitive factors, might influence psychotic symptomatology. Method Eighty-five outpatients with schizophrenia-spectrum disorders completed a repertory grid, an observed-rated interview of psychotic symptoms, and measures of cognitive insight, depressive symptoms, neurocognition, and theory of mind. Results Structural equation models revealed that interpersonal dichotomous thinking directly affected positive symptoms. Self-discrepancies influenced positive symptoms by mediation of depressive symptoms. Interpersonal cognitive differentiation and interpersonal cognitive richness mediated the impact of self-reflectivity and ne...
International Journal of Methods in Psychiatric Research, 2018
Objectives: The current study aimed at evaluating the reliability, convergent and divergent valid... more Objectives: The current study aimed at evaluating the reliability, convergent and divergent validity, and factor structure of the Spanish Launay-Slade Hallucinations Scale-Extended version (LSHS-E) in people with mental disorders and healthy controls. Methods: Four hundred and twenty-two individuals completed the Spanish LSHS-E and the Spanish Community Assessment of Psychic Experiences. The convergent and divergent validity of the LSHS-E was assessed with the three dimensions of the Community Assessment of Psychic Experiences (positive, negative, and depressive dimensions) in healthy controls and people with a mental disorder. Factor structure of the LSHS-E was assessed using confirmatory factor analysis and measurement invariance. Results: The LSHS-E had a good reliability in healthy controls and people with a mental disorder (Cronbach's = 0.83 and 0.91, respectively). The LSHS-E was more strongly associated with positive psychotic-like experiences than with depressive and negative symptoms. Four factors were found: (a) "intrusive thoughts"; (b) "vivid daydreams"; (c) "multisensory hallucination-like experiences"; and (d) "auditory-visual hallucination-like experiences" that were invariant between the group of healthy controls and people with a mental disorder. Conclusion: The Spanish version of the LSHS-E possesses adequate psychometric properties, and the confirmatory factor analysis findings provide further support for the multidimensionality of proneness to hallucination in clinical and nonclinical samples.
This study investigates, for the first time, clinical, cognitive, social cognitive and metacognit... more This study investigates, for the first time, clinical, cognitive, social cognitive and metacognitive differences in people diagnosed with first-episode of psychosis (FEP) with and without a family history of mental disorder split by maternal and paternal antecedents. A total of 186 individuals with FEP between 18 and 45 years old were recruited in community mental-health services. A transversal, descriptive, observational design was chosen for this study. Results suggest that there is a higher prevalence of maternal history of psychosis rather than paternal, and furthermore, these individuals exhibit a specific clinical, social and metacognitive profile. Individuals with a maternal history of mental disorder scored higher in delusional experiences, inhibition of the response to a stimulus and higher emotional irresponsibility while presenting a poorer overall functioning as compared to individuals without maternal history. Individuals with paternal history of mental disorder score h...
European Archives of Psychiatry and Clinical Neuroscience
Deficits in social cognition and metacognition impact the course of psychosis. Sex differences in... more Deficits in social cognition and metacognition impact the course of psychosis. Sex differences in social cognition and metacognition could explain heterogeneity in psychosis. 174 (58 females) patients with first-episode psychosis completed a clinical, neuropsychological, social cognitive, and metacognitive assessment. Subsequent latent profile analysis split by sex yielded two clusters common to both sexes (a Homogeneous group, 53% and 79.3%, and an Indecisive group, 18.3% and 8.6% of males and females, respectively), a specific male profile characterized by presenting jumping to conclusions (28.7%) and a specific female profile characterized by cognitive biases (12.1%). Males and females in the homogeneous profile seem to have a more benign course of illness. Males with jumping to conclusions had more clinical symptoms and more neuropsychological deficits. Females with cognitive biases were younger and had lower self-esteem. These results suggest that males and females may benefit ...
Research on the multidimensionality of hallucination-like experiences (HLEs) can contribute to th... more Research on the multidimensionality of hallucination-like experiences (HLEs) can contribute to the study of psychotic risk. The Launay-Slade Hallucinations Scale-Extended (LSHS-E) is one of the most widely used tools for research in HLEs, but the correspondence of its paper and online formats has not been established yet. Therefore, we studied the factorial structure and measurement invariance between online and paper-and-pencil versions of LSHS-E in a Chilean population. Two thousand eighty-six completed the online version, and 578 students completed the original paper-and-pencil version. After matching by sex, age, civil status, alcohol and cannabis consumption, and psychiatric treatment received, we selected 543 students from each group. We conducted a confirmatory factor analysis of a four-factor model and a hierarchical model that included a general predisposition to hallucination, explaining the strong relationship between the different types of hallucinations. Both models showed a good fit to the data and were invariant between paper-and-pencil and online versions. Also, the LSHS-E has good reliability in both online and paper-and-pencil formats. This study shows that the online LSHS-E possesses psychometric properties equivalent to the paper-and-pencil version. It should be considered a valuable tool for research of psychosis determinants in the COVID-19 era.
Deficits in social cognition and metacognition impact the course of psychosis. Gender differences... more Deficits in social cognition and metacognition impact the course of psychosis. Gender differences in social cognition and metacognition could explain heterogeneity in psychosis. 174 (58 females) patients with first-episode psychosis completed a clinical, neuropsychological, social cognitive and metacognitive assessment. Subsequent latent profile analysis split by gender yielded 2 clusters common to both genders, a specific male profile characterized by presenting jumping to conclusions and a specific female profile characterized by cognitive biases. Males and females in the homogeneous profile seem to have a more benign course of illness. Males with jumping to conclusions had more clinical symptoms and more neuropsychological deficits. Females with cognitive biases were younger and had less self-esteem. These results suggest that males and females may benefit from specific targeted treatment and highlights the need to consider gender when planning interventions.
Gender differences in symptomatology in people with psychosis have been studied extensively in la... more Gender differences in symptomatology in people with psychosis have been studied extensively in last decades. Previous narrative reviews have shown some evidence of gender differences in depressive, negative and paranoid symptoms, but yielding inconclusive findings. These reviews are limited by not doing systematic searches nor performing quantitative synthesis of the evidence. Therefore, we aimed to systematically investigate if there are gender differences in symptoms in people with psychosis. We describe the protocol for a systematic review and pairwise meta-analysis comparing a range of symptomatic outcome measures between men and women diagnosed with a psychotic spectrum disorder at different stages of the disorder (ultra-high risk for psychosis, early psychosis and established psychosis) in observational studies.
BackgroundPatients with schizophrenia spectrum disorders (SSD) tend to lack insight, which is lin... more BackgroundPatients with schizophrenia spectrum disorders (SSD) tend to lack insight, which is linked to poor outcomes. The effect size of previous treatments on insight changes in SSD has been small. Metacognitive interventions may improve insight in SSD, although this remains unproved.MethodsWe carried out a systematic review and meta-analysis of randomized controlled trials (RCTs) to examine the effects of metacognitive interventions designed for SSD, namely Metacognitive Training (MCT) and Metacognitive Reflection and Insight Therapy (MERIT), on changes in cognitive and clinical insight at post-treatment and at follow-up.ResultsTwelve RCTs, including 10 MCT RCTs (n = 717 participants) and two MERIT trials (n = 90), were selected, totalling N = 807 participants. Regarding cognitive insight six RCTs (n = 443) highlighted a medium effect of MCT on self-reflectiveness at post-treatment, d = 0.46, p < 0.01, and at follow-up, d = 0.30, p < 0.01. There was a small effect of MCT on...
Introduction: People with psychosis show impairments in cognitive flexibility, a phenomenon that ... more Introduction: People with psychosis show impairments in cognitive flexibility, a phenomenon that is still poorly understood. In this study, we tested if there were differences in cognitive and metacognitive processes related to rigidity in patients with psychosis. We compared individuals with dichotomous interpersonal thinking and those with flexible interpersonal thinking.Methods: We performed a secondary analysis using two groups with psychosis, one with low levels of dichotomous interpersonal thinking (n = 42) and the other with high levels of dichotomous interpersonal thinking (n = 43). The patients were classified by splitting interpersonal dichotomous thinking (measured using the repertory grid technique) to the median. The groups were administered a sociodemographic questionnaire, a semi-structured interview to assess psychotic symptoms [Positive and Negative Syndrome Scale (PANSS)], a self-report of cognitive insight [Beck Cognitive Insight Scale (BCIS)], neurocognitive task...
Background The individual Metacognitive Training (MCT+) is useful to reduce positive symptoms in ... more Background The individual Metacognitive Training (MCT+) is useful to reduce positive symptoms in people with schizophrenia, however less is known in people with first-episode psychosis (FEP). The aim of the study is to assess the effectiveness of MCT+ in FEP regarding symptoms and cognitive insight. Methods A random clinical trial was performed with people with FEP from 10 clinical centers of Spain. One group received ten sessions of MCT+ and the other group received TAU. A total of 75 patients were included in the study, however only 40 finished the final assessment. Patients were assessed before treatment, post-treatment and 6 month follow-up. The assessment includes a battery of instruments for the main aims the Positive and Negative Syndrome Scale (PANSS) and the Beck Cognitive Insight (BCIS) will be analyzed. Repeated measures statistical test were used in order to assess differences between groups. Results Both groups improved in Positive symptoms, in the MCT+ group the differ...
Background Previous studies have found that the best predictor of individual risk when developing... more Background Previous studies have found that the best predictor of individual risk when developing one or several mental and neurocognitive disorders is family history of mental disorder, more specifically, first degree relatives. The estimated risk of developing schizophrenia is of approximately 10% in individuals that present a paternal or maternal risk of psychosis, increasing to a 50% if both parents are affected; in comparison to a 1% risk in general population (Hall, 1994; Hannon et al., 2016). Having a first-degree family member with psychosis is the best individual risk predictor in developing mental or neurocognitive disorders (Bhatia et al., 2016; Thorup et al., 2018). However, literature exploring the role of family history of psychosis on symptoms, cognition, social cognition and metacognition in first-episode of psychosis (FEP) is scarce, and there is a dearth of studies examining the influence of the maternal and paternal history of psychosis independently. Methods The ...
Fluctuating asymmetry represents the degree to which the right and left side of the body are asym... more Fluctuating asymmetry represents the degree to which the right and left side of the body are asymmetrical, and is a sign of developmental instability. Higher levels of fluctuating asymmetry have been observed in individuals within the schizophrenia spectrum. We aimed to explore the associations of fluctuating asymmetry with psychotic and affective symptoms in schizophrenia patients, as well as with propensity to these symptoms in nonclinical individuals. A measure of morphological fluctuating asymmetry was calculated for 39 patients with schizophrenia and 60 healthy individuals, and a range of clinical and subclinical psychiatric symptoms was assessed. Regression analyses of the fluctuating asymmetry measure were conducted within each group. In the patient cohort, fluctuating asymmetry was significantly associated with the hallucination and thought disorganisation scores. T-test comparisons revealed that the patients presenting either hallucinations or thought disorganisation were significantly more asymmetrical than were the healthy individuals, while the patients without these key symptoms were equivalent to the healthy individuals. A positive association with the anxiety score emerged in a subsample of 36 healthy participants who were rated on affective symptoms. These findings suggest that fluctuating asymmetry may be an indicator of clinical hallucinations and thought disorganisation rather than an indicator of schizophrenia disease.
Methods: The SFRT-2 was translated and retro-translated into Spanish. After that, one hundred and... more Methods: The SFRT-2 was translated and retro-translated into Spanish. After that, one hundred and one patients with schizophrenia and 100 HC were assessed in order to obtain psychometric properties of the test. First, reliability of the SFRT-2 was studied with Cronbach's alpha coefficients for actions hits, actions false positives, goals hits and goals false positives separately, in both patients and HC. Second, in patients' group, concurrent validity was calculated using Spearman's correlations in order to assess the relationship between SFRT hits and false positives scores and other SC measures such as ToM, EP, AS and global SC. Third, divergent validity was assessed in patients' group by means of Spearman's correlations in order to study the relationship between SFRT-2 and a neurocognition composite score. Finally, discriminant validity of SFRT-2 actions and objectives hits and false positives was obtained comparing schizophrenia and HC groups by means of Receiver Operating Characteristic (ROC) curve analysis. Percentiles for the SFRT-2 scores were also calculated and shown in order to facilitate clinical assessment of SP. Results: Regarding reliability of the test, internal consistency indexes of the SFRT-2 hits and false positives ranged from α = .66 to α = .90 in both groups, with higher indexes corresponding to patients' group. Concerning convergent and divergent validity, SFRT-2 significantly correlated with other measures of SC, especially with ToM (SFRT-2 hits: r = .46, p < .01), and also, but to a lesser extent, with neurocognition composite score (SFRT-2 hits: r = .33, p < .01). Receiver Operating Characteristic (ROC) curve analysis showed that SFRT-2 hits and false positives discriminate well between patients with schizophrenia and HC, being false positives the indexes which best discriminated between both groups (actions false positives: AUC = .74, p < .001; objectives false positives: AUC = .78, p < .001). Discussion: Spanish adaptation and validation of the SFRT-2 showed good psychometric properties in both patients with schizophrenia and HC. In addition, reliability of the instrument seemed to be especially high among patients with schizophrenia. To our knowledge, this is the first adaptation and validation of an existing SP measure into native Spanish-speaking patients with schizophrenia. Given the good psychometric properties obtained by the Spanish adaptation, results further support the use of the SFRT-2 as an adequate measure to assess SP in patients with schizophrenia in both research and clinical practice. To that aim, SFRT-2 percentile scores for Spanish population were also provided in order to contribute to the appropriate detection of SP impairment in Spanish-speaking patients with schizophrenia.
is Social Cognitive Intervention Training (SCIT). This therapy is comprised of three phases (i.e.... more is Social Cognitive Intervention Training (SCIT). This therapy is comprised of three phases (i.e., Introduction & Emotions, Figuring out Situations, Checking it out) administered in a group format. Objective: To evaluate the efficacy of Social Cognition and Interaction Training (SCIT) in improving social cognitive and social functioning deficits of patients with schizophrenia spectrum disorder compared with standard of care, Befriending Therapy (BT). Methods: A 10-week, single-blind, randomized controlled trial (RCT) of SCIT and BT was carried out in 120 patients with schizophrenia spectrum disorder. Primary outcome measure is the total score on the Bell Lysaker Emotion Recognition Task (BLERT) at 12 weeks. Mixed Model for Repeated Measures was used to analyse change in BLERT score from baseline to 3-month follow-up between SCIT and BT groups. Secondary measures of the study are improvements on the Social Functioning Scale, [1] [1] [1] Hinting Task, Social Skills Performance Assessment, Internal, Personal and Situational Attributions Questionnaire, and Meta Cognition Questionnaire. Results: Among 120 patients, the mean age (SD) was 36.8 years (10.4) and 71.7% were males. Of these, 59 were randomized to the BT group and 61 to the SCIT group. The mean age of participants was 36.8 years. 85.8% were receiving government benefit and 50% lived in supported housing. 71.7% were males. Pre/Post data will be presented on the 91 participants who completed the study. Results examining the primary outcome measure found there was insufficient evidence to conclude that the SCIT group was significantly different compared to BT group in terms of emotion recognition (BLERT scores) (SCIT vs BT change: 0.437, 95% CI:-0.14 to 1.01; P = 0.136). There was an overall effect of time where both treatments showed a steady improvement over time from baseline to endpoint and the effect was maintained at the three-month follow-up. There was no significant time x treatment group interaction which indicated that there was no difference in patterns of change in the treatment group over time. Data on secondary outcomes is currently being analysed. Discussion: In this medium sized RCT of social cognition interaction therapy that used an active control, (BT) and standardised measure of emotional recognition, (BLERT) we found no significant difference between the interventions in our primary outcome measure of emotional recognition. Improvement in emotional perception has been found in the majority of studies of social cognitive interventions for schizophrenia. More specifically our results differ to those of Hasson-Ohayon who found significant improvement in emotion recognition in a RCT of SCIT with social mentoring compared with social mentoring alone in people diagnosed with schizophrenia, schizoaffective disorder, depression or bipolar disorder (Hasson-Ohayon 2014). This study is the largest RCT of SCIT to find a negative result in regards to emotion perception.
Background: Emotional facial expressions are vital communicative signals and a lack thereof shoul... more Background: Emotional facial expressions are vital communicative signals and a lack thereof should interfere with successful social interaction. That people with schizophrenia lack emotional facial expression, mostly irrespective of antipsychotic medication, is not only a well-known notion but also backed up by ample evidence. However, a closer look reveals a more complicated picture that implies that maybe only those with expressive negative symptoms (ENS; i.e. blunted affect and alogia) but not those without ENS show reduced facial expressiveness. Furthermore, while the reduction has been found consistently for positive facial expressions, the evidence for negative facial expressions has been mixed. Finally, the social consequences of the reduction are mostly unknown and thus whether or not the reduction actually interferes with social interactions. To address these questions, we tested for the symptom-specificity of reduced positive and negative facial expression (phenomenology) and their social relevance in patients with schizophrenia with versus without ENS. Methods: The frequency of positive and negative facial expressions in an affiliative role-play were assessed with the Facial Expression Coding System (FACES) in people with schizophrenia with (n = 18) and without ENS (n = 30) and in healthy controls (n = 39). Based on observing the role-play, independent raters also rated their willingness for future interactions with each participant. The presence of ENS was assessed via the Positive and Negative Syndrome Scale (PANSS). Results: Patients with schizophrenia and ENS did not differ on positive symptoms and depression or on chlorpromazine equivalent medication dosage from those without ENS. The analysis of the frequency of facial expressions revealed that patients with ENS showed reduced levels of positive facial expressions both compared to those without ENS (d =-0.82) and to controls (d =-1.21). Both patient groups (with and without ENS) showed equally reduced negative facial expressions compared to controls (ds =-0.99 and-0.86). Raters also indicated less willingness for future interactions with patients with ENS than without ENS (d =-0.92). This difference was significantly mediated by the reduced positive facial expressions. Discussion: The findings offer new insights into the phenomenology and the relevance of reduced emotional facial expression in schizophrenia. Our study indicates that the moderate to large mean differences that have been reported in earlier studies comparing samples with more broadly defined schizophrenia to healthy controls could mainly be driven by a reduction in facial expressions that is relatively specific to those with ENS. However, some aspects of reduced facial expression may nevertheless be genuine to more broadly defined schizophrenia given that we found patients with schizophrenia both with and without ENS to exhibit reduced levels of negative facial expressions. Finally, we found that the reduction of the positive facial expressions explained why raters were more willing to interact with those without ENS than with those with ENS. This further highlights the relevance of ENS by showing that they interfere with successful social interaction and go along with immediate social costs.
Background: Despite the evidence related to the role of major life events and childhood trauma in... more Background: Despite the evidence related to the role of major life events and childhood trauma in the development of first-episode psychosis (FEP; Varese et al., 2012; Morgan & Fisher, 2007), there are few studies on environmental exposure to stressful life events (SLEs) and how SLEs might influence the onset of a psychotic disorder, and the role of perceived stress in this population. The proposed analyses will investigate the association between the categories of SLEs (education, work, partner, family, home, legal, finances, social and health) and perceived stress between patients with FEP and healthy controls (HC). Methods: Participants were patients with FEP (n=15) and HC (n=21). This research was part of a longitudinal observational study called the 'PROFEP group' in Catalonia. Stressful life events were assessed with the Questionnaire of stressful life events (QSLE) (Butjosa et al., 2017). We analysed the frequency of the categories of SLEs. Perceived stress was assessed with the Perceived Stress Scale (PSS; Cohen & Williams, 1988). Results: There are more frequency of SLEs in the education (p<0.05) and health (p<0.05) categories, and perceived stress (p<0.05) in FEP sample than HC. Discussion: Results show the relevance of the presence of SLEs (e.g. education and health) and a potent source of perceived stress in FEP sample. Therefore, more studies are needed to evaluate these stressors to apply future psychological interventions in relation to stress management in FEP population. In addition, it would add protective variables in the analyses such as resilience, coping and social support.
same time, Social Functioning Scale (SFS) and SFAS was given to the relatives of the patients who... more same time, Social Functioning Scale (SFS) and SFAS was given to the relatives of the patients who live together. For reliability analyses; internal consistency coefficient, item-total correlation, and split-half reliability was assessed. For validity analyses; explanatory factor analysis, and convergent validity were examined via Spearman correlation. Results: The data from 104 patients with schizophrenia and 26 with schizoaffective disorder whose 75% were males, 69% were single, mean age was 37, the level of education was 10 years was examined. The average onset of the illness was 23 years, and the duration of illness was 14 years. Cronbach's alpha coefficient for SFAS total score was .83, and for factors were between .69 and .77. Split-half reliability coefficient of SFAS was .73. There was a satisfactory correlation between SFAS filled by patients and by relatives (r=.60, p<0.001). For factor analysis, Kaiser-Meyer-Olkin value was .78, and Barlett test was significant (p<0.001). In explanatory factor analysis, SFAS was found to be compose of three factors (self-care, interpersonal relationships and recreation, independent living) and that they can explain 45% of the total variance. Nine items were omitted because of having lower factor value than .40. Self-care factor had 7-item, interpersonal relationships and recreation factor had 7 items and independent living factor had 4 items. Occupational life could not get in any of factors; however, since it was very important for social functioning, it was added to the scale as fourth factor. SFAS total score was correlated with PANSS negative subscale (r=-.35, p<0,001), PANSS-total (r=-.29, p<0,001), CGI-S (r=-.33, p<0,001), GAF (r=.28, p<0,001) and SFS total score (r=.52, p<0,001). Discussion: Regarding the findings of the study, SFAS was considered a culturally-sensitive, easy-to-use, and valid instrument that objectively assesses the social functioning of the patients with schizophrenia in Turkey.
Background: Suicide is the leading cause of surmortality among patients with schizophrenia. Despi... more Background: Suicide is the leading cause of surmortality among patients with schizophrenia. Despite efficient antipsychotic treatments, suicide rates reaches up to 15% of death causes and near half of the patients had at least once attempted suicide. Thereby, the early identification of clinical profiles and risk factors is important for the development of management strategies. Methods: A cross-sectional and retrospective descriptive study was conducted at the "F" psychiatry department at the Razi Hospital, Manouba including 56 patients with schizophrenia in period of clinical stability. The evaluation focused on sociodemographic and clinical characteristics (using the positive and negative syndrome scale (PANSS); The Calgary Depression Scale for Schizophrenia (CDSS); The Global Assessment of Functioning (GAF); The Clinical Global Impression (CGI) rating scales). Personal history of suicidal attempts was assessed. Results: In this study, fourteen patients with schizophrenia (25%) never attempted suicide. 58 % (N=32) committed one or two suicide attempts. Only 8.5% (N= 5) had 3 and 4 attempts each. Number of suicide attempts was negatively correlated with the age of onset (p=0.024, r=-0.442) and the GAF score (p= 0.002, r=-0.483). An association was found between the personal history of suicidal attempts and the existence of a triggering factor of the onset (p=0.03). A positive correlation was found with the number of hospitalization (p=0.14, r=0.663), with the PANSS items: delusions (p=0.41, r=0.358), hallucinations (p=0.12, r=0.402), Suspiciousness/ persecution (p=0.35, r= 0.342) and Somatic concern (p=0.048, r=0.322); with the CDSS guilty ideas of references (p=0.008, r=0.426) and with the CGI efficacy index (p=0.32, r=0.348). Discussion: The rates of suicide are the highest among patients with schizophrenia. Previous studies have estimated the prevalence of suicide attempts in individuals with schizophrenia up to 50%. The increase in suicide attempts is associated with depressive symptoms which are very common within schizophrenia. The risk of suicide is not constant during the evolution of schizophrenia: it is the highest during the first years. A meta-analysis of 29 studies (Hawton et al., 2005) related that risk factors for suicide was higher in schizophrenic Caucasian men, those who live alone, who have recently experienced a loss, who have a family history of depression, who are more educated and have a higher IQ. Alteration of the abnormality the serotonin system may provide a biologic base to this phenomenon. It is essential to try to early detect and carefully assess the demographic and clinical profiles of patients with high risk of suicide.
Background: Psychotic disorders are associated with serious deterioration in functioning even bef... more Background: Psychotic disorders are associated with serious deterioration in functioning even before the first psychotic episode. Also on clinical high risk (CHR) states of developing a first psychotic episode, several studies reported a decreased global functioning. In a considerable proportion of CHR individuals, functional deterioration remains even after (transient) remission of symptomatic risk indicators. Furthermore, deficits in functioning cause immense costs for the health care system and are often more debilitating for individuals than other symptoms. However in the past, CHR research has mostly focused on clinical outcomes like transition and therefore, functioning in CHR patients is under-investigated. The current study aims at predicting functioning at a single subject level applying multi pattern recognition to clinical data for the first time. Methods: PRONIA ('Personalized Prognostic Tools for Early Psychosis Management') is a prospective collaboration project funded by the European Union under the 7th Framework Programme (grant agreement n° 602152). Considering a broad set of variables (sMRI, rsMRI, DTI, psychopathological, life event related and sociobiographic data, neurocognition, genomics and other blood derived parameters) as well as advanced statistical methods, PRONIA aims at developing an innovative multivariate prognostic tool enabling an individualized prediction of illness trajectories and outcome. Seven university centers in five European countries and in Australia
Background People with psychosis experience disruptions in personal identity that affect positive... more Background People with psychosis experience disruptions in personal identity that affect positive and negative symptoms, but the complexity of these phenomena needs to be addressed in an in-depth manner. Using the Personal Construct Theory, we examined whether distinct dimensions of personal identity, as measured with the Repertory Grid Technique along with other cognitive factors, might influence psychotic symptomatology. Method Eighty-five outpatients with schizophrenia-spectrum disorders completed a repertory grid, an observed-rated interview of psychotic symptoms, and measures of cognitive insight, depressive symptoms, neurocognition, and theory of mind. Results Structural equation models revealed that interpersonal dichotomous thinking directly affected positive symptoms. Self-discrepancies influenced positive symptoms by mediation of depressive symptoms. Interpersonal cognitive differentiation and interpersonal cognitive richness mediated the impact of self-reflectivity and ne...
International Journal of Methods in Psychiatric Research, 2018
Objectives: The current study aimed at evaluating the reliability, convergent and divergent valid... more Objectives: The current study aimed at evaluating the reliability, convergent and divergent validity, and factor structure of the Spanish Launay-Slade Hallucinations Scale-Extended version (LSHS-E) in people with mental disorders and healthy controls. Methods: Four hundred and twenty-two individuals completed the Spanish LSHS-E and the Spanish Community Assessment of Psychic Experiences. The convergent and divergent validity of the LSHS-E was assessed with the three dimensions of the Community Assessment of Psychic Experiences (positive, negative, and depressive dimensions) in healthy controls and people with a mental disorder. Factor structure of the LSHS-E was assessed using confirmatory factor analysis and measurement invariance. Results: The LSHS-E had a good reliability in healthy controls and people with a mental disorder (Cronbach's = 0.83 and 0.91, respectively). The LSHS-E was more strongly associated with positive psychotic-like experiences than with depressive and negative symptoms. Four factors were found: (a) "intrusive thoughts"; (b) "vivid daydreams"; (c) "multisensory hallucination-like experiences"; and (d) "auditory-visual hallucination-like experiences" that were invariant between the group of healthy controls and people with a mental disorder. Conclusion: The Spanish version of the LSHS-E possesses adequate psychometric properties, and the confirmatory factor analysis findings provide further support for the multidimensionality of proneness to hallucination in clinical and nonclinical samples.
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Papers by Susana Ochoa