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Biomedical subjects

Sam B Hutton

Publications and source records attributed to Sam B Hutton.

5 recordsLinked to original sources

Relationship between insight, cognitive function, social function and symptomatology in schizophrenia: the West London first episode study.

OBJECTIVE: To examine the nature and clinical correlates of insight in first-episode schizophrenia, and how these differ from findings in established schizophrenia. METHOD: Insight (and insight dimensions), clinical symptoms, neurocognitive function and social function were assessed in 94 patients with first-episode schizophrenia or schizophreniform disorder according to DSM-IV criteria. RESULTS: Greater global insight was associated with more severe depression. Poor overall insight was associated significantly with more severe negative and disorganisation symptoms as well as poor working memory, and at a trend level with lower current IQ. Patients with poor insight perceived themselves to have a better level of independent performance at daily living activities. CONCLUSION: In first-episode psychosis, the clinical correlates of poor insight are similar to those reported for established schizophrenia. Those patients with greater insight may be at risk of depression. The complex relationships between insight, positive and negative symptoms, neurocognitive dysfunction and social function may reflect the multidimensional nature of insight.

Adolescent↗

Drug expectancy is necessary for stimulus control of human attention, instrumental drug-seeking behaviour and subjective pleasure.

BACKGROUND: It has been suggested that drug-paired stimuli (S+) control addictive behaviour by eliciting an explicit mental representation or expectation of drug availability. AIMS: The aim of the present study was to test this hypothesis by determining whether the behavioural control exerted by a tobacco-paired S+ in human smokers would depend upon the S+ eliciting an explicit expectation of tobacco. DESIGN: In each trial, human smokers (n=16) were presented with stimuli for which attention was measured with an eyetracker. Participants then reported their cigarette reward expectancy before performing, or not, an instrumental tobacco-seeking response that was rewarded with cigarette gains if the S+ had been presented or punished with cigarette losses if the S- had been presented. Following training, participants rated the pleasantness of stimuli. RESULTS: The S+ only brought about conditioned behaviour in an aware group (those who expected the cigarette reward outcome when presented with the S+). This aware group allocated attention to the S+, performed the instrumental tobacco-seeking response selectively in the presence of the S+ and rated the S+ as pleasant. No conditioned behaviour was seen in the unaware group (those who did not expect the cigarette reward outcome in the presence of the S+). CONCLUSIONS: Drug-paired stimuli control selective attention, instrumental drug-seeking behaviour and positive emotional state by eliciting an explicit expectation of drug availability.

Adult↗

Contingency knowledge is necessary for learned motivated behaviour in humans: relevance for addictive behaviour.

AIMS: Many forms of human conditioned behaviour depend upon explicit knowledge of the predictive contingency between stimuli, responses and the reinforcer. However, it remains uncertain whether the conditioning of three key behaviours in drug addiction-selective attention, instrumental drug-seeking behaviour and emotional state--are dependent upon contingency knowledge. To test this possibility, we employed an avoidance procedure to generate rapidly these three forms of conditioned behaviour without incurring the methodological problems of drug conditioning. DESIGN: In two experiments, participants (16 students) were trained on a schedule in which one stimulus (S +) predicted the occurrence of a startling noise, which could be cancelled by performing an instrumental avoidance response. MEASUREMENTS: The allocation of attention to the S + and the rate and probability of the avoidance response in the presence of S + were measured. Following training, participants were tested for their knowledge of the stimulus-noise contingencies arranged in the study and rated the emotional qualities of the stimuli. FINDINGS: Both experiments showed that S + gained control of selective attention, instrumental avoidance behaviour and subjective anxiety, but only in participants who reported explicit knowledge of the Pavlovian contingency between the S + and the startling noise. CONCLUSIONS: The implication of the present findings is that the control of selective attention, instrumental drug-seeking behaviour and emotional state by drug-paired stimuli is mediated by cognitive knowledge of the predictive contingency between the stimulus and the drug.

Adult↗

Comorbid substance use and age at onset of schizophrenia.

BACKGROUND: Substance use may be a risk factor for the onset of schizophrenia. AIMS: To examine the association between substance use and age at onset in substance use and age at onset in a UK, inner-city sample of people with recent-onset schizophrenia. METHOD: The study sample consisted of 152 people recruited to the West London First-Episode Schizophrenia Study. Self-reported data on drug and alcohol use, as well as information on age at onset of psychosis, were collected. Mental state, cognition (IQ, memory and executive function) and social function were also assessed. RESULTS: In total, 60% of the participants were smokers, 27% reported a history of problems with alcohol use, 35% reported current substance use (not including alcohol), and 68% reported lifetime substance use (cannabis and psychostimulants were most commonly used). Cannabis use and gender had independent effects on age at onset of psychosis, after adjusting for alcohol misuse and use of other drugs. CONCLUSIONS: The strong association between self-reported cannabis use and earlier onset of psychosis provides further evidence that schizophrenia may be precipitated by cannabis use and/or that the early onset of symptoms is a risk factor for cannabis use.

Adolescent↗

Cognitive heterogeneity in first-episode schizophrenia.

BACKGROUND: Studies of chronic schizophrenia suggest that there are subgroups with different profiles of cognitive impairment. AIMS: To determine whether such heterogeneity is present at illness onset and any relationship to clinical variables. METHOD: Ninety-three community patients with first-episode schizophrenia and 50 healthy volunteers were assessed for premorbid (Revised National Adult Reading Test) and current IQ, memory and executive function. RESULTS: Half of those with schizophrenia had preserved IQ in the normal range but there was evidence of a specific impairment in spatial working memory even in those with high/average IQ; 37 out of 93 (40%) had generalised cognitive decline. Those with low premorbid IQ were significantly younger at illness onset. For the entire group, age at onset correlated positively with premorbid but not current IQ. CONCLUSIONS: At illness onset, cognitive heterogeneity is present in people with schizophrenia, with a high proportion having undergone general cognitive decline. However, working memory impairment may be a common feature. Lower premorbid IQ is a risk factor for an earlier onset.

Adult↗