Previous studies on sensorimotor adaptation revealed no awareness of the nature of the perturbation after adaptation to an abrupt 30° rotation of visual feedback or after adaptation to gradually introduced perturbations. Whether the degree of awareness depends on the magnitude of the perturbation, though, has as yet not been tested. Instead of using questionnaires, as was often done in previous work, the present study used a process dissociation procedure to measure awareness and unawareness. A naïve, implicit group and a group of subjects using explicit strategies adapted to 20°, 40° and 60° cursor rotations in different adaptation blocks that were each followed by determination of awareness and unawareness indices. The awareness index differed between groups and increased from 20° to 60° adaptation. In contrast, there was no group difference for the unawareness index, but it also depended on the size of the rotation. Early adaptation varied between groups and correlated with awareness: The more awareness a participant had developed the more the person adapted in the beginning of the adaptation block. In addition, there was a significant group difference for savings but it did not correlate with awareness. Our findings suggest that awareness depends on perturbation size and that aware and strategic processes are differentially involved during adaptation and savings. Moreover, the use of the process dissociation procedure opens the opportunity to determine awareness and unawareness indices in future sensorimotor adaptation research.

Background and objectives: The emergence of the recovery movement has led to the development of the Recovering Quality of Life Questionnaire (ReQoL) in the UK. This study aims to describe and evaluate the Dutch translation. Methods: The ReQoL was administered in two samples: 62 students completed the ReQoL-20, MANSA, EQ-5D-5 L, PHQ-9 and GAD-7 through an online survey link. The ReQoL was tested for reliability and a first impression was obtained of convergent and known group validity. In addition, 164 patients with a psychotic disorder that were part of the UP'S cohort study completed the ReQoL-10, PHQ9 and GAD-7. Results: The ReQoL-10 and ReQoL-20 showed to be reliable in the student sample and the patient sample. Indices of the convergent and known-group validity showed that the ReQoL was predominantly associated with quality of life and was able to distinguish between scores of patient and student samples. Conclusion: The Dutch translation of the ReQoL-10 and ReQoL-20 yielded results in line with those of the original English version.

Background Recovery in psychotic disorder patients is a multidimensional concept that can include personal, symptomatic, societal and functional recovery. Little is known about the associations between personal recovery (PR) and functional recovery (FR). FR involves a person’s ability to recover or compensate for impaired cognition, such as executive functions, and the loss of skills. Method In this cross-sectional study (the UP’S study), we used measures of executive functioning and personal recovery to assess a cohort of people with a psychotic disorder. PR was measured using the Recovering Quality of Life (ReQOL) and Individual Recovery Outcomes (I.ROC). FR was assessed using two forms of assessment. The Behavioral Rating Inventory of Executive Functioning Adult version (BRIEF-A) was used for self-rated executive functioning, and the Tower of London (TOL) for performance-based executive functioning. Regression models were calculated between executive functioning (BRIEF-A and TOL) and PR (ReQOL and I.ROC). Model selection was based on the Wald test. Results The study included data on 260 participants. While total scores of BRIEF-A had a small negative association with those of the ReQOL (β = -0.28, p > 0.001) and the I.ROC (β = -0.41, p >0.001), TOL scores were not significantly associated with the ReQOL scores (β = 0.03, p = 0.76) and the I.ROC scores (β = 0.17, p = 0.17). Conclusion Self-reported EF, which measures the accomplishment of goal pursuit in real life was associated with PR. However, processing efficiency and cognitive control as measured by performance-based EF were not.

Despite growing evidence for the role of attachment in psychosis, no quantitative review has yet been published on the relationship in this population between insecure attachment and recovery in a broad sense. We therefore used meta-analytic techniques to systematically appraise studies on the relationship between attachment and symptomatic, social and personal recovery in clients with a psychotic disorder. Using the keywords attachment, psychosis, recovery and related terms, we searched six databases: Embase, Medline Epub (OVID), Psycinfo (OVID), Cochrane Central (trials), Web of Science, and Google Scholar. This yielded 28 studies assessing the associations between adult attachment and recovery outcome in populations with a psychotic disorder. The findings indicated that insecure anxious and avoidant attachment are both associated with less symptomatic recovery (positive and general symptoms), and worse social and personal recovery outcomes in individuals diagnosed with a psychotic disorder. The associations were stronger for social and personal recovery than for symptomatic recovery. Attachment style is a clinically relevant construct in relation to the development and course of psychosis and recovery from it. Greater attention to the relationship between attachment and the broad scope of recovery (symptomatic, social, and personal) will improve our understanding of the illness and efficacy of treatment for this population.