Schizophrenia Spectrum Disorders: An Empirical Benchmark Study of Real-world Diagnostic Accuracy and Reliability Among Leading International Psychiatrists.

Background And Hypothesis: Assigning a psychiatric diagnosis in real-world situations is often difficult, given that the clinical presentation does not usually conform to the list of condensed, simplified behavioral descriptors of mainstream operational taxonomies (MOT) (eg, ICD-11 and DSM-5). The goal of this study was to benchmark diagnostic accuracy and reliability on a central and severe spectrum of psychopathology (ie, the schizophrenia spectrum disorders [SSDs]), adopting a pragmatic approach as close as possible to real-world clinical settings.

Study Design: We examined the diagnostic performance of 30 international psychiatrists experts in SSD.

Positive Reframing of Psychosis Risk Is Seen as More Beneficial and Less Harmful Than Negative Framing by Clinicians: An Experimental Videotaped Simulated Feedback Study.

Background And Hypothesis: Recent studies show that, despite providing some relief, feedback about being at risk for psychosis often triggers negative emotional reactions. Inspired by Tversky and Kahneman's (1981) work on the framing effect and medical framings that favors positive framing like "life-threatening" over "high-risk for death," this study tested the hypothesis that positive reframing of psychosis risk (PR) could alleviate these concerns. To establish the justifiability and feasibility of testing this hypothesis with patients and their families, the study first sought to test whether mental health professionals (MHPs) view positive framing as superior to present state-of-the-art approaches.

The association between deficiencies in paternal and maternal reflective functioning and anorexia nervosa symptomatology.

Background: A large theoretical body of knowledge exists emphasizing the importance of parental mentalizing in the context of anorexia-nervosa (AN). However, the empirical support to these assumptions is still scarce. The aim of the present study was to examine whether parents of patients with AN are characterized by a lower mentalizing ability, and whether it is associated with impaired mentalizing, AN symptomatology and eating disorder (ED) related psychological traits in the daughters.

The dynamic boundaries of the Self: Serial dependence in the Sense of Agency.

The feeling of control over one's actions, termed the Sense of Agency (SoA), delineates one's experience as an embodied self. Although this embodied experience is typically perceived as stable over time, recent theoretical accounts highlight the experience-dependent and dynamic nature of the embodied self. In this study we examined how recent experiences modulate SoA (i.

Participatory Design of a Mobile App to Safeguard Mental Resilience in the Context of Drug Use in Young Adults: Multi-Method Study.

Background: Existing mental health apps are largely not aimed at generally healthy young people who may be experimenting with addictive substances and mind-altering experiences.

Objective: The aim of this study is to examine the interest and expectations of young people regarding a proposed smartphone app designed to help protect and promote mental health and resilience in the face of risks associated with substance use.

Methods: The study was based on agile system development and had 3 empirical substudies.

The scope and nature of prolonged social withdrawal in Israel: An initial quantitative and qualitative investigation.

Objective: Over the past few decades, prolonged social withdrawal (PSW) among young people has been recognized in several countries. Most research has been quantitative and focused on the characteristics of PSW individuals and their families. Little attention has been given to the valuable perspective of professionals providing service to this population.

Assessing the Relationship between Sense of Agency, the Bodily-Self and Stress: Four Virtual-Reality Experiments in Healthy Individuals.

The bodily-self, our experience of being a body, arises from the interaction of several processes. For example, embodied Sense of Agency (SoA), the feeling of controlling our body's actions, is a fundamental facet of the bodily-self. SoA is disturbed in psychosis, with stress promoting its inception.

Basic self-disorders in adolescence predict schizophrenia spectrum disorders in young adulthood: A 7-year follow-up study among non-psychotic help-seeking adolescents.

Background And Goals: Recent studies indicate that basic self-disorder (SD) is a core clinical phenotype of schizophrenia and its spectrum. The goal of the present study was to test the degree to which SD characterizes the pre-onset phase of schizophrenia-spectrum disorders (SSD). A secondary goal was to replicate previous findings regarding the long-term stability of SD.

Metacognition strengthens the association between neurocognition and attenuated psychosis syndrome: Preliminary evidence from a pilot study among treatment-seeking versus healthy adolescents.

Background: In a pilot study, we assessed the potential value of deficits at the metacognitive versus the neurocognitive level of functioning for identifying adolescents with attenuated psychotic syndrome (APS).

Method: Twenty-two treatment-seeking adolescents with APS, 42 treatment-seeking comparisons, and 34 age-matched healthy comparisons were evaluated using the Prodromal Questionnaire, the Structured Interview for Prodromal Syndromes, and the Mood and Anxiety Symptom Questionnaire. Neurocognitive and metacognitive functioning were assessed in two non-social (verbal memory and executive functioning) and two social (facial emotion perception and theory of mind) cognitive domains.

The construct validity of the Inventory of Psychotic-Like Anomalous Self-Experiences (IPASE) as a measure of minimal self-disturbance: Preliminary data.

Aim: The Inventory of Psychotic-Like Anomalous Self-Experiences (IPASE) is a self-report measure of minimal self-disturbance. The aim of the current report was to assess the construct validity of the scale by examining its convergent validity with the gold-standard measure of minimal self-disturbance, the Examination of Anomalous Self-Experience (EASE), and its discriminant validity.

Method: The sample consisted of 46 participants (21 ultra-high risk for psychosis patients, 14 first episode psychosis patients, 11 healthy controls).

Disturbances of the Basic Self and Prodromal Symptoms Among Young Adolescents From the Community: A Pilot Population-Based Study.

Background And Goal: Recent findings have provided preliminary support for the notion that basic self-disturbances (SD) are related to prodromal symptoms among nonpsychotic help-seeking adolescents. As a sizable proportion of adolescents who are at risk do not seek help, this study attempts to assess the extent to which these findings can be generalized to the entire population of adolescents who are at risk for psychosis.

Method: The concurrent relationship between SD and prodromal symptoms was explored in a sample of 100 non-help-seeking adolescents (age 13-15) from the community.

Preliminary assessment of the therapeutic efficacy of continuous theta-burst magnetic stimulation (cTBS) in major depression: a double-blind sham-controlled study.

Background: Theta-burst transcranial magnetic stimulation (TBS) has been shown to induce potent and long lasting effects on cortical excitability. In a previous open study, we demonstrated safety, tolerability and antidepressant properties of continuous TBS (cTBS) in major depression (MD). The present study was aimed to evaluate the therapeutic efficacy of cTBS in depressed patients using a double-blind, sham-controlled design.

Metacognition in non-psychotic help-seeking adolescents: associations with prodromal symptoms, distress and psychosocial deterioration.

Objective: To explore the notion that difficulties in metacognitive functioning are a core pre-psychotic feature of emerging schizophrenia and its spectrum.

Method: Seventy-eight help-seeking, non-psychotic adolescents (age 13-18) were assessed with the Prodromal Questionnaire (PQ), the Structured Interview for Prodromal Syndromes (SIPS), two scales of social and role functioning, and a metacognitive version of two non-social (verbal memory and executive functioning) and two social (facial emotion perception and Theory of Mind) cognition tasks. In addition to the standard administration of the tasks, subjects were also asked to rate their level of confidence in the correctness of each answer, and to choose whether they wanted it to be "counted" toward their overall performance score on the task.

Revisiting poor insight into illness in anorexia nervosa: true unawareness or conscious disagreement?

Background: To investigate and validate a novel approach to distinguishing between two possible sources of poor insight in anorexia nervosa: true unawareness, in which a patient is not aware that other people think there is a problem, and disagreement, in which a patient does recognize that others think there is a problem.

Methods: Thirty-nine patients with anorexia nervosa or eating disorder not otherwise specified-anorexia nervosa were given two versions of the Scale of Unawareness of Mental Disorder (SUMD), one in which they were asked about their own opinion and one in which they were asked about their clinicians' opinion. Clinicians also completed the SUMD with their opinion about the patient's illness.

The nature and evolution of insight in schizophrenia: a multi-informant longitudinal study of first-episode versus chronic patients.

Background And Aims: This study investigated a novel distinction between two possible sources of poor insight in schizophrenia: primary unawareness, in which the ill person is not aware that other people think one has a problem, and secondary unawareness (or disagreement), in which a person does appreciate that other people think one has a problem. A secondary goal was to compare the evolution of insight in first-episode and chronic schizophrenia.

Methods: Sixty-eight first-episode and 51 chronic patients were administered two versions of the Scale of Unawareness of Mental Disorder (SUMD) at three time points: hospital admission, discharge, and 6-month post-discharge.

The neurocognitive basis of insight into illness in anorexia nervosa: a pilot metacognitive study.

The primary goal of the present study was to explore the neuropsychological basis of insight into illness in anorexia nervosa by evaluating its differential and joint links with cognitive vs. metacognitive performance. Participants in the study were 25 women with anorexia nervosa (AN) and 25 healthy comparisons (HC).

Acute stress reactions among medical and non-medical personnel in a general hospital under missile attacks.

Background: Recent mass level traumatic events further boosted the growing interest in understanding the effects of primary (direct) and secondary (indirect) traumatic exposure on "helping professionals." The objectives of this study are: (1) to assess the rates and severity of PTSD symptoms (PS) among hospital workers operating under fire while treating war-related injured patients, (2) to explore the effect of PS on level of functioning in real time, and (3) to estimate the added effect of secondary traumatization over and above that of primary traumatization.

Methods: Rates of PS, level of psychological distress, and level of functioning were assessed in 412 medical and non-medical personnel working in a hospital that was under missile attacks during the Second Lebanon War in the summer of 2006.

The Shedler-Westen Assessment Procedure-200 as a basis for modifying DSM personality disorder categories.

The Shedler-Westen Assessment Procedure-200 (SWAP) is a Q-sort instrument designed to assess personality pathology on the basis of clinician ratings. On the basis of research with the SWAP, its creators have proposed a group of 12 personality disorder (PD) diagnoses that can be used to replace or modify current Axis II categories of the Diagnostic and Statistical Manual of Mental Disorders (DSM). The authors discuss conceptual and empirical issues that require clarification before this proposal can be properly evaluated.

Long-term effects of early parental loss due to divorce on the HPA axis.

We investigated the long-term effects of divorce and early separation from one parent on HPA axis reactivity, in young adults without psychopathology. Participants were 44 young subjects, 22 whose parents divorced before they reached age 10, and 22 controls. Psychiatric symptomatology was measured with the Brief Symptom Inventory (BSI), family perceived stress by the Dyadic Adjustment Scale (DAS), and bonding by the Parental Bonding Instrument (PBI).

Injury increases the risk for PTSD: an examination of potential neurobiological and psychological mediators.

A growing number of common traumatic events involve both physical and emotional injuries. In contrast to previously held beliefs, the rapidly growing body of literature shows quite convincingly that physical injury, over and above exposure to the traumatic event itself, increases rather than decreases the risk for posttraumatic stress disorder (PTSD). A pertinent question becomes how bodily injury contributes to the risk of developing PTSD.

Real-world cognitive--and metacognitive--dysfunction in schizophrenia: a new approach for measuring (and remediating) more "right stuff".

While the role of impaired cognition in accounting for functional outcome in schizophrenia is generally established by now, the overlap is far from complete. Moreover, little is known about the potential mechanisms that bridge between cognition and functional outcome. The aim of this article is to aid in closing this gap by presenting a novel, more ecologically valid approach for neuropsychological assessment.

Negative symptoms and cognitive deficits: what is the nature of their relationship?

Negative symptoms and cognitive deficits in schizophrenia share many features and are correlated in their severity on a cross-sectional basis. The question arises as to the nature of this relationship: are these symptoms the same, caused by the same factor (or factors); or is the nature of their relationship determined by other factors, such as definitional issues and common correlates? In this article we provide a conceptual overview for addressing this question and provide a selective review of the literature on the cross-sectional and longitudinal relationships between these two features of the illness. We describe 4 different models of the "true" relationship between these variables.

Does memory of a traumatic event increase the risk for posttraumatic stress disorder in patients with traumatic brain injury? A prospective study.

Objective: The present study examined prospectively the relationship between memory of the traumatic event and subsequent development of posttraumatic stress disorder (PTSD). More specifically, the aims of this study were to 1) investigate the possibility that lack of memory of the traumatic event might be a protective factor; 2) assess whether memory of the traumatic event equally affects the three symptom clusters of PTSD: reexperiencing, avoidance, and hyperarousal; and 3) explore the predictive value of memory of the traumatic event for the development of subsequent PTSD in the immediate aftermath of the event.

Method: One hundred twenty subjects with mild traumatic brain injury who were hospitalized for observation were assessed immediately after the trauma and followed up 1 week, 3 months, and 6 months later.

The neuropsychological basis of competence to consent in first-episode schizophrenia: a pilot metacognitive study.

Background: This study was designed to explore the neuropsychological basis of competence to consent to treatment in first-episode schizophrenia by evaluating its differential and joint links with cognitive versus metacognitive performance.

Methods: Twenty-one first-episode patients were assessed with the MacArthur Competence Assessment Tool for Treatment (MacCAT-T) and a metacognitive version of the Wisconsin Card Sorting Test (WCST). In addition to the standard administration of the WCST, subjects were also asked to rate their level of confidence in the correctness of each sort (prior to getting the feedback) and to choose whether they wanted each sort to be "counted" toward their overall performance score on the test.