Association between processing speed and subclinical psychotic symptoms in the general population: Focusing on sex differences

Rössler, Wulf; Ajdacic-Gross, Vladeta; Müller, Mario; Rodgers, Stephanie; Kawohl, Wolfram; Haker, Helene; Hengartner, Michael Pascal

doi:10.1016/j.schres.2015.05.026

Cited by 10 publications

(5 citation statements)

References 63 publications

(81 reference statements)

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“…In study 1 we found that neurocognitive deficits, both in the DSST and error in visual short-term memory, were related to positive, and not negative, symptom-like experiences. Similarly, Rossler et al (2015) found that processing speed in the DSST was related to anomalous perception in healthy adults. Abu-Akel et al (2016), though, found that participants with predominantly negative and few positive symptoms were less accurate in a visual-spatial working memory task.…”

Section: Discussionmentioning

confidence: 85%

Psychosis and Psychotic-Like Symptoms Affect Cognitive Abilities but Not Motivation in a Foraging Task

et al. 2020

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Background and Objective: Goal-directed behavior is a central feature of human functioning. It requires goal appraisal and implicit cost-benefit analyses, i.e., how much effort to invest in the pursuit of a certain goal, against its value and a confidence judgment regarding the chance of attainment. Persons with severe mental illness such as psychosis often struggle with reaching goals. Cognitive deficits, positive symptoms restricting balanced judgment, and negative symptoms such as anhedonia and avolition may compromise goal attainment. The objective of this study was to investigate to what degree symptom severity is related to cognitive abilities, metacognition, and effort-based decision-making in a visual search task. Methods: Two studies were conducted: study 1: N = 52 (healthy controls), and study 2: N = 46 (23 patients with psychosis/23 matched healthy controls). Symptoms were measured by the CAPE-42 (study 1) and the PANSS (study 2). By using a visual search task, we concomitantly measured (a) accuracy in short-term memory, (b) perceived accuracy by participants making a capture area or confidence interval, and (c) effort by measuring how long one searched for the target. Perseverance was assessed in trials in which the target was omitted and search had to be abandoned. Results: Higher levels of positive symptoms, and having a diagnosis of psychosis, were associated with larger errors in memory. Participants adjusted both their capture area and their search investment to the error of their memory. Perseverance was associated with negative symptoms in study 1 but not in study 2. Conclusion: By simultaneously assessing error and confidence in one's memory, as well as effort in search, we found that memory was affected by positive, not negative, symptoms in healthy controls, and was reduced in patients with psychosis. However, impaired memory did not concur with overconfidence or less effort in search, i.e., goal directed behavior was unrelated to symptoms or diagnosis. Metacognition and motivation were neither affected by cognitive abilities nor by negative symptoms. Clinically, this could indicate that struggles with goal directed behavior in psychosis may not solely be dependent on primary illness factors.

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Section: Discussionmentioning

confidence: 85%

Psychosis and Psychotic-Like Symptoms Affect Cognitive Abilities but Not Motivation in a Foraging Task

et al. 2020

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“…Cognitive alterations, including the JTC task did not discriminate between PE-only and PE + NPD outcomes, in agreement with previous work (Niarchou et al ., 2013 ; Gur et al ., 2014 ; Rossler et al ., 2015 ). The results are compatible with the suggestion that cognitive alterations may not represent the ‘core’ of the psychosis syndrome (van Os et al ., 2020 ; Richards et al ., 2020 ), but instead become associated with the current poor-outcome definition of psychotic disorders because they moderate, together with PRS-SZ, the outcome of early non-psychotic states (van Os et al ., 2020 ).…”

Section: Discussionmentioning

confidence: 99%

“…Also, attenuated psychotic symptoms in isolation are either not (Jones et al ., 2016 ; van Os et al ., 2020 ), negatively (Hatzimanolis et al ., 2018 ) or weakly (Pain et al ., 2018 ; Legge et al ., 2019 ) associated with polygenic risk for schizophrenia (PRS-SZ), but tend to show progressively stronger association with PRS-SZ in combination with more environmental exposure, more affective comorbidity and more clinical relevance (Hatzimanolis et al ., 2018 ; Guloksuz et al ., 2019 ; Guloksuz et al ., 2020 ). PE may be associated with subjective (Koyanagi et al ., 2018 ) or objective cognitive alterations (Niarchou et al ., 2013 ; Gur et al ., 2014 ; Rossler et al ., 2015 ); there is evidence, however, that the association with cognitive alterations is dependent on the degree of comorbid non-psychotic psychopathology (Reininghaus et al ., 2019 ). Indeed, recent follow-back studies from representative incidence samples of psychotic disorder have shown that the origins of psychotic disorder can be traced to NPDs, the severest of which develop a degree of psychosis admixture over time (Cupo et al ., 2021 ).…”

Section: Introductionmentioning

confidence: 99%

What makes the psychosis ‘clinical high risk’ state risky: psychosis itself or the co-presence of a non-psychotic disorder?

Hasmi

Pries

Have

et al. 2021

Epidemiol Psychiatr Sci

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Aims Although attenuated psychotic symptoms in the psychosis clinical high-risk state (CHR-P) almost always occur in the context of a non-psychotic disorder (NPD), NPD is considered an undesired ‘comorbidity’ epiphenomenon rather than an integral part of CHR-P itself. Prospective work, however, indicates that much more of the clinical psychosis incidence is attributable to prior mood and drug use disorders than to psychosis clinical high-risk states per se. In order to examine this conundrum, we analysed to what degree the ‘risk’ in CHR-P is indexed by co-present NPD rather than attenuated psychosis per se. Methods We examined the incidence of early psychotic experiences (PE) with and without NPD (mood disorders, anxiety disorders, alcohol/drug use disorders), in a prospective general population cohort (n = 6123 at risk of incident PE at baseline). Four interview waves were conducted between 2007 and 2018 (NEMESIS-2). The incidence of PE, alone (PE-only) or with NPD (PE + NPD) was calculated, as were differential associations with schizophrenia polygenic risk score (PRS-Sz), environmental, demographical, clinical and cognitive factors. Results The incidence of PE + NPD (0.37%) was lower than the incidence of PE-only (1.04%), representing around a third of the total yearly incidence of PE. Incident PE + NPD was, in comparison with PE-only, differentially characterised by poor functioning, environmental risks, PRS-Sz, positive family history, prescription of antipsychotic medication and (mental) health service use. Conclusions The risk in ‘clinical high risk’ states is mediated not by attenuated psychosis per se but specifically the combination of attenuated psychosis and NPD. CHR-P/APS research should be reconceptualised from a focus on attenuated psychotic symptoms with exclusion of non-psychotic DSM-disorders, as the ‘pure' representation of a supposedly homotypic psychosis risk state, towards a focus on poor-outcome NPDs, characterised by a degree of psychosis admixture, on the pathway to psychotic disorder outcomes.

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“…Cognitive deficits were also associated with greater general health problems as reported on a self-report questionnaire at age 53, however this association was not significant after controlling for psychotic-like experiences, suggesting that childhood cognitive deficits are a specific risk factor for the experience of psychosis in adulthood. Presence of sub-clinical psychosis has been associated with processing speed deficits as measured by the digit symbol task (Rossler et al 2015). In data from the Human Connectome Project, 21.6% of individuals endorsed at least one psychotic-like experience, and psychotic-like experiences were significantly negatively associated with general cognitive ability, replicating previous findings (Sheffield et al 2016).…”

Section: Introductionmentioning

confidence: 99%

Cognitive Deficits in Psychotic Disorders: A Lifespan Perspective

Karcher²,

2018

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Individuals with disorders that include psychotic symptoms (i.e. psychotic disorders) experience broad cognitive impairments in the chronic state, indicating a dimension of abnormality associated with the experience of psychosis. These impairments negatively impact functional outcome, contributing to the disabling nature of schizophrenia, bipolar disorder, and psychotic depression. The robust and reliable nature of cognitive deficits has led researchers to explore the timing and profile of impairments, as this may elucidate different neurodevelopmental patterns in individuals who experience psychosis. Here, we review the literature on cognitive deficits across the life span of individuals with psychotic disorder and psychotic-like experiences, highlighting the dimensional nature of both psychosis and cognitive ability. We identify premorbid generalized cognitive impairment in schizophrenia that worsens throughout development, and stabilizes by the first-episode of psychosis, suggesting a neurodevelopmental course. Research in affective psychosis is less clear, with mixed evidence regarding premorbid deficits, but a fairly reliable generalized deficit at first-episode, which appears to worsen into the chronic state. In general, cognitive impairments are most severe in schizophrenia, intermediate in bipolar disorder, and the least severe in psychotic depression. In all groups, cognitive deficits are associated with functional outcome. Finally, while the generalized deficit is the clearest and most reliable signal, data suggests specific deficits in verbal memory across all groups, specific processing speed impairments in schizophrenia and executive functioning impairments in bipolar disorder. Cognitive deficits are a core feature of psychotic disorders that provide a window into understanding developmental course and risk for psychosis.

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Association between processing speed and subclinical psychotic symptoms in the general population: Focusing on sex differences

Cited by 10 publications

References 63 publications

Psychosis and Psychotic-Like Symptoms Affect Cognitive Abilities but Not Motivation in a Foraging Task

Psychosis and Psychotic-Like Symptoms Affect Cognitive Abilities but Not Motivation in a Foraging Task

What makes the psychosis ‘clinical high risk’ state risky: psychosis itself or the co-presence of a non-psychotic disorder?

Cognitive Deficits in Psychotic Disorders: A Lifespan Perspective

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