1. ASSOCIATIONS BETWEEN REASONS FOR LIVING AND DIMINISHED SUICIDE INTENT AMONG AFRICAN AMERICAN FEMALE SUICIDE ATTEMPTERS. Kelci C. Flowers, M.S., Rheeda L. Walker, Ph.D., Martie P. Thompson, Ph.D., Nadine J. Kaslow, Ph.D., ABPP.
African American women are at high risk for suicide ideation and suicide attempts, and use emergency psychiatric services at disproportionately high rates relative to men and other ethnic groups. Yet, suicide death rates are low for this population. The present study evaluated self-reported reasons for living as a protective factor against suicidal intent and suicide attempt lethality in a sample of African American female suicide attempters (n = 150). Regression analyses revealed that reasons for living were negatively associated with suicidal intent, even after controlling for spiritual well-being and symptoms of depression. These results indicate that the ability to generate and contemplate reasons for valuing life may serve as a protective characteristic against life-threatening suicidal behavior among African American women.
2. THE SELECTIVE EFFECT OF NEUROCOGNITION ON DIFFERENT THEORY OF MIND DOMAINS IN FIRST-EPISODE PSYCHOSIS. Sol Fernandez-Gonzalo, M.D., Merce Jodar, Ph.D., Esther Pousa, Ph.D., Marc Turon,M.D., Rebeca Garcia ,Carla Hernandez Rambla , Diego Palao, Ph.D.
Our goal was to investigate the influence of neurocognition in affective and cognitive theory of mind (ToM) tasks in early phases of psychosis. In a cross-sectional study of 60 first-episode schizophrenia/schizoaffective disorder patients, the implication of neurocognition in first and second order ToM stories, Hinting Task and Reading the Mind in the Eyes Test (RMET) were analyzed. Regression models were used, controlling for clinical symptoms and antipsychotic dose. Executive functions and clinical symptoms were related to ToM performance in first-episode schizophrenia patients although different patterns of relationship were observed in each ToM task.
3. SELF-EFFICACY AND QUALITY OF LIFE AMONG PEOPLE WITH BIPOLAR DISORDER. Kristen M. Abraham, Ph.D., Christopher J. Miller, Ph.D.,Denis G. Birgenheir, Ph.D., Zongshan Lai, MPH, Amy M. Kilbourne, Ph.D., MPH.
People with bipolar disorders report a lower quality of life than the general population, and few mutable factors associated with health-related quality of life (HRQoL) among people with bipolar disorders have been identified. Using a cross-sectional design, these analyses examined whether self-efficacy was associated with mental and physical HRQoL in a sample of 141 patients with bipolar disorder who completed baseline assessments for two randomized controlled trials. Multiple linear regression analyses indicated that higher levels of self-efficacy were associated with higher mental and physical HRQoL, after controlling for demographic factors and clinical factors (including mood symptoms, co-morbid medical conditions, and substance use).
4. ANTIBODIES TO TOXOPLASMA GONDII AND COGNITIVE FUNCTIONING IN SCHIZOPHRENIA, BIPOLAR DISORDER, AND NON-PSYCHIATRIC CONTROLS. Faith Dickerson, Ph.D., M.P.H., Cassie Stallings, R.N., M.A., Andrea Origoni, B.A., Emily Katsafanas, B.A., Lucy Schweinfurth, B.A., Christina Savage, M.A., Sunil Khushalani, M.D., Robert Yolken, M.D.
Increased rates of exposure to Toxoplasma gondii have been found in individuals with schizophrenia and bipolar disorder but the association between Toxoplasma and cognitive functioning has not previously been examined. We measured IgG and IgM class antibodies to Toxoplasma in 408 non-elderly individuals with schizophrenia, 347 with bipolar disorder, and 352 non-psychiatric controls. Cognitive functioning was measured with the Repeatable Battery for the Assessment of Neuropsychological Status. Multivariate linear and regression analyses showed significant associations between Toxoplasma IgM antibody level and cognitive scores within the control group and the bipolar disorder group but not the schizophrenia group. Within the control group, having an elevated Toxo IgM antibody level, >= 50th and 75th level of the control group, was associated with significantly elevated odds of a low total cognitive score. Exposure to Toxoplasma may confer risk of lower cognitive functioning in persons without a psychiatric disorder and those with bipolar disorder.
5. NEUROCOGNITIVE IMPAIRMENT OF MENTAL ROTATION IN MAJOR DEPRESSIVE DISORDER: EVIDENCE FROM EVENT-RELATED BRAIN POTENTIALS. Jiu Chen, PhD, Wentao Ma, MD, Yan Zhang, MD, Lai-qi Yang, MD, Zhijun Zhang, MD, PhD, Xingqu Wu, MD, and Zihe Deng , MD.
Mental rotation performance may be used as an index of mental slowing or bradyphrenia, and may reflect speed of motor preparation. Previous studies suggest that patients with major depressive disorder (MDD) present the correlates of impaired behavioral performance for mental rotation and psychomotor disturbance. The present study was the first to investigate the event-related brain potential (ERP) correlates of mental rotation and mental slowing or bradyphrenia in MDD. ERPs were recorded while we tested 25 MDD and 26 healthy controls by evaluating the performance of MDD on hand and letter rotation tasks at different orientations, and their 400–600 ms time window was measured and analyzed for latencies and peak amplitudes over the parietal electrodes. dFirst, individuals with MDD were slower and made more errors in mentally rotating hands and letters than healthy controls, and individuals with MDD exhibited a greater difference in response times and errors than controls between hands and letters. Second, the mean peak amplitude was signiﬁcantly lower, and the mean latency was signiﬁcantly longer in 400–600 ms time window at parietal site in the hand tasks in MDD than controls, but that was not seen in letter task. MDD patients present the absence of a typical mental rotation function for the amplitude of the rotation-related negativity in the hand and letter tasks. Third, the scalp activity maps in MDD exhibited the absence of activation in the left parietal site for the mental rotation of hands as shown in healthy participants. In contrast, their brain activation for letter task was similar to those of healthy participants. These data suggest that mental imagery of hands and letters relies on different cognitive and neural mechanisms and indicate that the left posterior parietal lobe is a necessary structure for mental transformations of human hands. Importantly, MDD deficits were more seriously present specific to the hands than the letters.
6. DEPRESSIVE SYMPTOMS AND MAJOR DEPRESSIVE DISORDER IN PATIENTS AFFECTED BY SUBCLINICAL HYPOTHYROIDISM: A CROSSSECTIONAL STUDY. Benedetta Demartini, M.D., Rebecca Ranieri, Annamaria Masu, Valerio Selle, Silvio Scarone, Orsola Gambini.
Our objective was to compare the prevalence of depressive symptoms and major depressive disorder in a population of patients affected by subclinical hypothyroidism and a control group without thyroid disease. We enrolled 123 consecutive outpatients affected by subclinical hypothyroidism undergoing follow-up at the endocrinology department of San Paolo Hospital in Milan and 123 controls without thyroid disease under the charge of general physicians. Patients affected by subclinical hypothyroidism had a prevalence of depressive symptoms of 63.4% at HAM-D and 64.2% at MADRS; 22 patients (17.9%) had a diagnosis of depressive episode (DSM-IV-TR criteria). The control group had a prevalence of depressive symptoms of 27.6% at HAM-D and 29.3% at MADRS and only seven controls had a diagnosis of depressive episode. The prevalence of depressive symptoms between these two groups was statistically different. This study underlines a strong association between subclinical hypothyroidism and depressive symptoms which could have some important diagnostic and therapeutic implications in the clinical practice.
7. STRESS REACTIVITY OF EMOTIONAL AND VERBAL SPEECH CONTENT IN SCHIZOPHRENIA. Margaret Dombrowskih, Ph.D., Amanda McCleery, Ph.D., Stanford W.Gregory, Jr., Ph.D., & Nancy M. Docherty, Ph.D.
Speech fundamental frequencies (SFF) are non-verbal sound frequencies that convey emotion in speech. The degree of SFF long term averaged spectra (LTAS) convergence between conversants reflects aspects of conversant-reported quality of the interaction (e.g., emotional synchrony). This study investigated whether SFF LTAS convergence between inpatients diagnosed with schizophrenia (n=20) and an interviewer was associated with severity of illness (SOI), formal speech disturbance (FSD), and stress reactivity of FSD. Participants provided speech samples describing stressful and non-stressful life experiences. In the stress condition, SFF LTAS was negatively correlated with SOI and FSD. Moreover, patients exhibiting stress reactivity of FSD also evidenced stress reactivity of SFF LTAS. These findings suggest that the emotional and verbal content of speech are disrupted by stress in schizophrenia, and SOI is associated with FSD and reduced emotional communication during stressful conditions. The interaction between stress reactivity of FSD and SFF LTAS supports the construct validity of a reactivity dimension in schizophrenia.
8. HEART RATE VARIABILITY AND THE ANXIOUS CLIENT: CARDIAC AUTONOMIC AND BEHAVIORAL ASSOCIATIONS WITH THERAPEUTIC ALLIANCE. Trisha Stratford, PhD, Sara Lal, PhD , Alan Meara, MGT,
This exploratory study was designed to investigate the link between a client’s heart rate variability (HRV) and the forming of a therapeutic alliance (TA) during psychotherapy. Cardiac effects were evaluated during therapy in thirty symptomatically anxious clients using heart rate variability (HRV) during six weekly one-hour therapy sessions (S1-S6). Therapeutic index (TI) a measure of TA was evaluated using skin conductance resonance between client and therapist. Working Alliance Inventory provided a subjective measure of TA. State and trait anxiety and mood states were also assessed. Most HRV parameters were highest during S4. The sympathovagal balance was highest in S1 but stabilised after S2. In S4, TI was linked to high HRV parameters. Overall higher anxiety levels appear to be associated to lower HRV parameters. Conversely, in S4 high HRV parameters were linked to higher mood scores. This study found that subjective measure of therapeutic alliance (TA) contradicted the physiological outcome.
9. BRIEF REPORT. Anxiety Sensitivity in Bereaved Adults with and without Complicated Grief. Donald J. Robinaugh, M.A, Richard J. McNally, Ph.D., Nicole J. LeBlanc, B.S., Kimberly Pentel, B.A., Noah Schwarz, B.A., Riva M. Shah, B.A., Mireya Nadal-Vicens, M.D., Ph.D , Cynthia W. Moore, Ph.D., Luana Marques, Ph.D., Eric Bui, M.D., Ph.D., and Naomi M. Simon, M.D., M.Sc.
Complicated grief (CG) is a bereavement specific syndrome chiefly characterized by symptoms of persistent separation distress. Physiological reactivity to reminders of the loss and repeated acute pangs or waves of severe anxiety and psychological pain are prominent features of CG. Fear of this grief-related physiological arousal may contribute to CG by increasing the distress associated with grief reactions and increasing the likelihood of maladaptive coping strategies and grief-related avoidance. Here, we examined anxiety sensitivity (i.e., the fear of anxiety-related sensations; AS) in two studies of bereaved adults with and without CG. In both studies, bereaved adults with CG exhibited elevated AS relative to those without CG. In Study 2, AS was positively associated with CG symptom severity among those with CG.
10. BRIEF REPORT. TWITTER PSYCHOSIS: A RARE VARIATION OR A DISTINCT SYNDROME? Jan Kalbitzer, M.D., Ph.D., Thomas Mell, M.D., Felix Bermpohl, M.D., Michael A. Rapp M.D., Ph.D. and Andreas Heinz, M.D., Ph.D.
The authors report the development of psychosis in a young woman coinciding with excessive use of the online communication system Twitter and the results of an experimental account to argue that Twitter may have a high potential to induce psychosis in predisposed users.
10. BOOK REVIEW. The Making of DSM-III. A Diagnostic Manual’s Conquest of American Psychiatry. Hannah S. Decker (2013) Oxford University Press. xi+443 pp. Reviewed by Steven Sharfstein, M.D.
A historian from the University of Houston, Hannah Decker, PhD, has written this highly engaging, readable, well written narrative of the history of the making of the DSM-III, the breakthrough manual published in 1980. This volume is not a dry recounting of the manual itself and the diagnoses that emerged. It is much more the story of the human beings who were brought together by the creative process of putting the manual together and the broad changes that have taken place in psychiatry in the 20th century, moving away from the psychoanalytic perspective to more phenomenological and biological perspectives of today.