On the boundaries of blunt affect/alogia across severe mental illness: Implications for Research Domain Criteria

Cohen, Alex S.; Najolia, Gina M.; Kim, Yunjung; Dinzeo, Thomas J.

doi:10.1016/j.schres.2012.07.001

Cited by 45 publications

(52 citation statements)

References 18 publications

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“…Previously-mentioned efforts from the National Institute of Mental Health to reclassify mental disorders as a whole based on biological observations, in their Research Domain Criteria 35 , represents a parallel effort in this direction, although psychosis does not necessarily fit comfortably in this schema. Initial efforts to fit specific psychotic symptoms such as alogia/ blunted affect and hallucinations within RDoC are being made 36, 37 and the general strategy that biological data should be gathered across current diagnostic categories is shared by both RDoC and B-SNIP 38 . The reconceptualization of psychosis categories based on biology holds the promise of new directions in disease classification and hopefully will lead to novel treatment strategies that one hopes will emerge over the next few years.…”

Section: Take-home Messages – and The Futurementioning

confidence: 99%

Does Biology Transcend the Symptom-based Boundaries of Psychosis?

Pearlson

Clementz

Sweeney

et al. 2016

Psychiatric Clinics of North America

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Synopsis Psychotic disorders, as defined by clinical features alone, overlap considerably in terms of symptoms, familial patterns, risk genes, outcome and treatment response. As a result, numerous neurobiological measurements also fail to distinguish patients with the most prevalent classic psychotic syndromes (schizophrenia, schizo-affective and bipolar with psychosis). Statistical methods applied to such biological measurements in large numbers of psychosis patients yield novel categories, that cut across traditional diagnostic boundaries, called “Biotypes”, i.e. biologically-defined presumptive disease entities. Such new classification approaches within psychosis hopefully represent an opportunity to transcend clinical phenomenologically-defined syndromes in psychiatry with neurobiologically-defined diseases that can advance drug discovery and support precision medicine approaches in psychiatry.

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Section: Take-home Messages – and The Futurementioning

confidence: 99%

Does Biology Transcend the Symptom-based Boundaries of Psychosis?

Pearlson

Clementz

Sweeney

et al. 2016

Psychiatric Clinics of North America

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“…Deficits in speech communication, defined in terms of reduced production (e.g., alogia), variability (e.g., blunted affect) and content (e.g., poverty of content – speech that lacks meaning, irrespective of quantity of speech) are a staple of SMI (e.g., depression, schizophrenia, bipolar disorder; American Psychiatric Association [APA], 2013, Cohen et al, 2012, Tremeau et al, 2005). These deficits are often chronic in course, medication resistant and related to poor prognosis (Kirkpatrick et al, 2001).…”

Section: Introductionmentioning

confidence: 99%

Speech deficits in serious mental illness: A cognitive resource issue?

Cohen

McGovern

Dinzeo

et al. 2014

Schizophrenia Research

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Speech deficits, notably those involved in psychomotor retardation, blunted affect, alogia and poverty of content of speech, are pronounced in a wide range of serious mental illnesses (e.g., schizophrenia, unipolar depression, bipolar disorders). The present project evaluated the degree to which these deficits manifest as a function of cognitive resource limitations. We examined natural speech from 52 patients meeting criteria for serious mental illnesses (i.e., severe functional deficits with a concomitant diagnosis of schizophrenia, unipolar and/or bipolar affective disorders) and 30 non-psychiatric controls using a range of objective, computer-based measures tapping speech production (“alogia”), variability (“blunted vocal affect”) and content (“poverty of content of speech”). Subjects produced natural speech during a baseline condition and while engaging in an experimentally-manipulated cognitively-effortful task. For correlational analysis, cognitive ability was measured using a standardized battery. Generally speaking, speech deficits did not differ as a function of SMI diagnosis. However, every speech production and content measure was significantly abnormal in SMI versus control groups. Speech variability measures generally did not differ between groups. For both patients and controls as a group, speech during the cognitively-effortful task was sparser and less rich in content. Relative to controls, patients were abnormal under cognitive load with respect only to average pause length. Correlations between the speech variables and cognitive ability were only significant for this same variable: average pause length. Results suggest that certain speech deficits, notably involving pause length, may manifest as a function of cognitive resource limitations. Implications for treatment, research and assessment are discussed.

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“…Social withdrawal, which is a prominent aspect of the motivation component of negative symptoms, may partially reflect anxiety (Birchwood, 2003;Chudleigh et al, 2011;Lysaker et al, 2010;Penn et al, 1994), whereas diminished expressiveness appears unrelated to anxiety (Cohen et al, 2012;Huppert and Smith, 2001;Kelley et al, 1999). There is also evidence that the motivational component has more implications for everyday functioning than diminished expression Green et al, 2012;Rocca et al, 2014;Sayers et al, 1996;Strauss et al, 2013), although these findings may be confounded by the prominence of observed functioning in the assessment of negative symptoms related to motivation (Leifker et al, 2009;Ventura et al, 2009).…”

Section: Introductionmentioning

confidence: 99%