Biomedical subjects

J J Blanchard

Publications and source records attributed to J J Blanchard.

16 recordsLinked to original sources

PubMed2001

Diagnostic differences in social anhedonia: a longitudinal study of schizophrenia and major depressive disorder.

This study examined the hypothesis that, in schizophrenia, elevated trait social anhedonia (SA) is a stable individual difference, whereas in depression, increased SA is a reflection of a current clinical state that will diminish with recovery. Differences in trait Negative Affect (NA) and Positive Affect (PA) were also examined. Individuals with schizophrenia (n = 55) and depression (n = 34) were evaluated at baseline during hospitalization and compared with nonpsychiatric control participants (n = 41). Participants were assessed again at a 1-year follow-up. At baseline, compared with control participants, individuals with schizophrenia and depression were both characterized by elevated SA, greater NA, and lower PA. In schizophrenic individuals, elevated SA remained stable over the follow-up. However, in recovered depressed patients, SA declined over the follow-up period. Group differences remained in NA and PA over the 1-year follow-up. These results support the view that elevated SA is enduring in schizophrenia but that elevated SA is transiently related to clinical status in depression.

Adult↗

PubMed2000

The co-occurrence of substance use in other mental disorders: editor's introduction.

The co-occurrence of substance use disorders with other mental disorders has a profound impact on theoretical and conceptual issues in the study of psychopathology and poses unique problems regarding assessment and treatment. Given the high rate of comorbidity, it is not possible to simply treat comorbid substance use as error variance that must be eliminated or controlled for in psychopathology research. Rather, it is proposed that the direct study of the co-occurrence of substance use disorders with other mental disorders will enhance the generalizability of research findings and allow for a better understanding of causal processes underlying comorbidity. The contributors to this Special Issue of Clinical Psychology Review have marshaled the latest evidence concerning comorbid substance use in a range of disorders and each contributor proposes integrative perspectives that will facilitate future research.

Comorbidity↗

PubMed2000

Substance use disorders in schizophrenia: review, integration, and a proposed model.

Substance use disorders occur in approximately 40 to 50% of individuals with schizophrenia. Clinically, substance use disorders are associated with a variety of negative outcomes in schizophrenia, including incarceration, homelessness, violence, and suicide. An understanding of the reasons for such high rates of substance use disorders may yield insights into the treatment of this comorbidity in schizophrenia. This review summarizes methodological and conceptual issues concerning the study of substance use disorders in schizophrenia and provides a review of the prevalence of this co-occurrence. Prevailing theories regarding the co-occurrence of schizophrenia and substance use disorders are reviewed. Little empirical support is found for models suggesting that schizophrenic symptoms lead to substance use (self-medication), that substance use leads to schizophrenia, or that there is a genetic relationship between schizophrenia and substance use. An integrative affect-regulation model incorporating individual differences in traits and responses to stress is proposed for future study.

Affect↗

PubMed2000

Hedonic capacity and schizotypy revisited: a taxometric analysis of social anhedonia.

P. E. Meehl (1962) originally conjectured that hedonic capacity was an indicator of the latent class or taxon of schizotypy. However, P. E. Meehl (1989, 1990) subsequently diminished the role of hedonic capacity in his theory, indicating that hypohedonia is one of a dozen normal-range (nontaxonic) individual-differences factors that may potentiate the expression of schizophrenia. This dimensional-only view of hedonic capacity was tested by applying taxometric procedures to the Revised Social Anhedonia Scale (RSAS; M. L. Eckblad, L. J. Chapman, J. P. Chapman, & M. Mishlove, 1982) in a sample of college students (N = 1,526). Analyses indicated that the construct measured by the RSAS is taxonic in nature with a base rate approximating .10. These data are interpreted in the context of other findings suggesting that social anhedonia is an indicator of schizotypy.

Adult↗

PubMed1999

Examining an affect regulation model of substance abuse in schizophrenia. The role of traits and coping.

Comorbid substance use disorders occur frequently in schizophrenia with significant detrimental effects to clinical outcome. Unfortunately, attempts to identify factors associated with comorbid substance use disorders (beyond demographic characteristics such as gender) have not been successful. This study examined an affect regulation model of comorbid substance use in schizophrenia with a focus on personality traits and coping. It was hypothesized that maladaptive coping and the traits of negative affect (NA) and disinhibition (DIS), but not trait positive affect (PA), would be associated with greater substance use problems. Thirty-nine patients with schizophrenia or schizoaffective disorder completed measures of personality traits, coping, and negative consequences associated with substance use. Traits were differentially associated with coping in that NA and DIS, but not PA, were associated with maladaptive coping including the use of drugs and alcohol to cope with stress. Alternatively, PA, but not DIS or NA, was related to adaptive coping strategies. Individuals high in NA and endorsing the use of drugs and alcohol to cope reported the greatest number of negative consequences from substance use. This finding held after controlling for gender. These results are consistent with an affect regulation model of substance use and suggest the advantage of examining the role of affect, traits, and coping in understanding comorbid substance use in schizophrenia.

Adaptation, Psychological↗

PubMed1998

Anhedonia, positive and negative affect, and social functioning in schizophrenia.

This study examines the relationship between anhedonia and the trait dimensions of positive affect (PA) and negative affect (NA) in schizophrenia. The relationship between poor social functioning in schizophrenia and these individual differences in affectivity is also examined. Schizophrenia outpatients (n = 37) and normal controls (n = 15) were assessed at a baseline evaluation and again approximately 90 days later. Consistent with the hypothesized decrease in hedonic capacity in schizophrenia, patients reported significantly greater physical and social anhedonia and less PA than controls. However, the schizophrenia group also reported significantly greater NA and social anxiety than did controls. In support of the dispositional view of these individual differences in affectivity, trait measures demonstrated test-retest reliability, and group differences between the schizophrenia group and controls were stable over the 90-day followup period. Within the schizophrenia group, physical and social anhedonia were comparably negatively correlated with trait PA; however, social but not physical anhedonia was significantly positively correlated with NA and social anxiety. Poor social functioning in the schizophrenia group was associated with greater physical and social anhedonia and greater NA and social anxiety. Alternatively, greater trait PA was related to better social functioning. These findings indicate that schizophrenia is characterized by both low PA and elevated NA and that these affective characteristics are a stable feature of the illness. The results also suggest important links between affect and social functioning in schizophrenia.

Adult↗

PubMed1997

Affect recognition in schizophrenia: a synthesis of findings across three studies.

The results of three studies of affect recognition in schizophrenia, all using the same measures (the Face Emotion Identification Test, the Face Emotion Discrimination Test, and the Test of Facial Recognition), are reviewed. The studies differed on two important subject characteristics: patient chronicity and medication status. One study examined chronically ill, unmedicated patients (Kerr and Neale 1993); a second study included chronically ill, medicated patients (Mueser et al. 1996); and a third study examined acutely ill, medicated patients (Bellack, Blanchard and Mueser 1996). Results across the three studies suggest that chronicity of the illness, but not medication status, was related to poor performance on the affect recognition tests. Furthermore, chronically ill patients tended to perform poorly on the control task (the Test of Facial Recognition) as well as the affect perception tasks, suggesting a generalized impairment in facial perception. The implications of the findings for research on social perception are considered, as well as for interventions designed to improve social competence in schizophrenia.

Acute Disease↗

PubMed1996

Generalization effects of training on the Wisconsin Card Sorting Test for schizophrenia patients.

Several studies have demonstrated that schizophrenia patients can improve their performance on the Wisconsin Card Sorting Test if given appropriate training. However, it is not clear if they are learning a generalizable problem-solving strategy rather than a circumscribed rule. We examined this question by training patients on one of two related problem-solving tests and assessing transfer of training effects across the two instruments; a third group received practice on both tests, but no training. Subjects were 27 schizophrenia patients in the latter stages of an acute hospital admission. While subjects in both training conditions exhibited marked improvement on the trained test, the results failed to reveal any evidence of generalization. Subjects trained on one test performed no better on the other instrument than subjects who received practice only. These results suggest that gains in WCST performance reported in the literature after brief training or instructions may not reflect any meaningful changes in problem solving capacity or in any underlying neurological function. Implications of the findings for rehabilitation programs are discussed, along with limitations of the data and recommendations for future research.

Adult↗

PubMed1996

Emotion recognition and social competence in chronic schizophrenia.

This study evaluated (a) whether chronic, medicated schizophrenia patients show deficits in emotion recognition compared to nonpatients, and (b) whether deficits in emotion recognition are related to poorer social competence. Two emotion recognition tests developed by S. L. Kerr and J. M. Neale (1993) and Benton's Test of Facial Recognition (A. Benton, M. VanAllen, K. Hamsher, & H. Levin, 1978) were given to patients with chronic schizophrenia and nonpatient controls. Patients' social skills, social adjustment, and symptomatology were assessed. Like Kerr and Neale's unmedicated patients, these patients performed worse than controls on both emotion recognition tests and the control test. For patients, facial perception was related to the chronicity of illness and social competence. Chronicity of illness may contribute to face perception deficits in schizophrenia, which may affect social competence.

Adult↗

PubMed1996

Cue availability and affect perception in schizophrenia.

This study examined affect perception in schizophrenia. Subjects were 35 patients with schizophrenia or schizoaffective disorder, 11 with bipolar disorder, and 19 matched nonpatient controls. All patients were in the latter stages of an acute hospitalization. Measures included a videotaped test of affect perception administered with and without sound, two tests of facial affect perception based on photographs, and two measures of nonaffect perception. The patient groups did not differ from one another on any of the affect perception measures, and few differences occurred between schizophrenia patients and nonpatient controls. Affect perception in schizophrenia patients was not correlated with symptomatology or history of illness, and there were no gender differences. Deficits reported in prior studies may reflect limitations in the assessment methodology commonly employed.

Adult↗

PubMed1995

Memory and social skill in schizophrenia: the role of gender.

The relationship between social skill and memory was examined in a group of patients with schizophrenia and schizoaffective disorder. There were few or no differences between male and female patients in history of the illness, symptomatology, memory, and other cognitive factors, or social skill. Despite the absence of differences, impaired memory was related to poorer social skills for the women, but not the men. Reanalysis of data on social skill and memory from an earlier study (Mueser et al., 1991) revealed a similar pattern of results. The findings suggest that the contribution of cognitive factors to impaired social competence in schizophrenia may differ in men and women. Alternatively, the results may reflect sampling bias, whereby more severely ill women are studied than men, relative to their respective populations.

Adolescent↗

PubMed1994

Affective and social-behavioral correlates of physical and social anhedonia in schizophrenia.

The association between scales measuring physical and social anhedonia, self-reports of affective response to emotion-eliciting films, and role play measures of social skill was evaluated in patients with schizophrenia, schizoaffective disorder, and bipolar affective disorder. We hypothesized that patients with schizophrenia would report significantly greater anhedonia than the bipolar patients and that higher scores on the anhedonia scales would be related to attenuated reports of the experience of positive affect and poorer social skill. Patients with schizophrenia and schizoaffective disorder did not differ in ratings of anhedonia, but both groups had higher physical and social anhedonia scores than did bipolar patients. Higher scores on the physical anhedonia scale, but not the social anhedonia scale, were related to attenuated reports of positive affect following viewing of affect-eliciting films in schizophrenia-schizoaffective disorder patients. Neither anhedonia scale was related to role play measures of social skill performance for any patient group.

Adolescent↗

PubMed1994

Flat affect in schizophrenia: a test of neuropsychological models.

This study evaluated the association between neuropsychological indices of frontal lobe and right hemisphere impairment and deficits in the expression of affect in schizophrenia. The advantages of the present study were that unmedicated schizophrenia patients were studied and relevant demographic characteristics were controlled. Furthermore, deficits in affective expression were assessed both in a clinical interview and in subjects' response to affect-eliciting films. Despite the fact that schizophrenia subjects demonstrated significantly higher clinical ratings of affective flattening and less facial expression while viewing films than demographically matched control subjects, neuropsychological performance was not consistently related to these expressive deficits. The results thus failed to support for the proposed neuropsychological models of affective deficits in schizophrenia. The characterization of flat affect as a purely emotional deficit is questioned, and limitations of current neuropsychological theories of emotional expression and neuropsychological methods to test these theories in the study of schizophrenia are discussed as relevant concerns for future research.

Adult↗

PubMed1994

The neuropsychological signature of schizophrenia: generalized or differential deficit?

OBJECTIVE: The aim of this study was to provide a comprehensive assessment of neuropsychological functioning in schizophrenia so as to evaluate hypotheses of lateralized or differential cognitive impairment in this disorder. Furthermore, the study sought to address the potentially confounding factors of medication side effects and relevant demographic variables such as age, education, gender, and handedness. METHOD: The neuropsychological functioning of 28 schizophrenic patients whose medication had been withdrawn for research purposes and 15 demographically matched normal subjects was evaluated. A comprehensive battery of tasks was used to determine whether performance patterns of schizophrenic patients were consistent with models of lateralized or localized neuropsychological impairment in schizophrenia. To facilitate comparison with results of other studies, several analytic strategies were used, including comparisons of group performance on individual tests, composite function scores, and evaluation of performance based on "clinical" criteria of impairment. RESULTS: In contrast to the normal subjects, the schizophrenic patients displayed impairment across measures of motor, sensory, and perceptual functioning, verbal and nonverbal memory, and indexes of frontal lobe functioning. This pattern of generalized dysfunction was evident regardless of the method of analysis used to assess performance. CONCLUSIONS: These findings fail to support conjectures regarding differential neurocognitive deficits in schizophrenia. However, the psychometric limitations of currently available neuropsychological measures may obscure the finding of differential impairment and must be considered in interpreting the results of this study as well as those of any investigation using such instruments.

Adult↗

PubMed1992

Medication status of participants in psychopathology research: selective review of current reporting practices.

The majority of Ss included in studies of psychopathology are typically receiving psychoactive medication. In view of concerns regarding the confounding effects of psychoactive medication, it appears that researchers should provide information regarding at least the drug status of the Ss studied. A review of the articles on adult psychopathology that appeared in the Journal of Abnormal Psychology during a 5-year period, however, revealed that nearly 50% of reports on Ss presumably receiving psychoactive medications failed to specify the medication status of those Ss. Few studies (15%) provided adequate information regarding the types and dosages of psychoactive drugs received by the Ss. It is argued that researchers should provide a full report of the psychoactive drugs received by research participants and, when participants are unmedicated, to indicate the reasons for drug-free status.

Bias↗

PubMed1992

Comorbidity of schizophrenia and substance abuse: implications for treatment.

The problem of substance abuse disorders in schizophrenia patients is reviewed, including the prevalence of co-morbid disorders, assessment, hypothesized mechanisms underlying abuse, and the clinical effects of abuse on the course of illness and cognitive functioning. The principles of treatment for dual-diagnosis schizophrenia patients are outlined, and the limitations of existing interventions are noted. Gaps in current knowledge about the impact of substance abuse on schizophrenia and its treatment are identified, and suggestions are made regarding promising avenues of research in this area.

Alcoholism↗