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Biomedical subjects

D Braff

Publications and source records attributed to D Braff.

18 recordsLinked to original sources
PubMed1998

The relationship between skin conductance hyporesponsivity and perseverations in schizophrenia patients.

BACKGROUND: It has been reported that approximately 45% of schizophrenia patients versus 10% of normal comparison subjects are classified as skin conductance hyporesponders (SCOR-HR: the lack of a robust orienting response) when exposed to innocuous tones. We studied the skin conductance orienting response (SCOR) of schizophrenia patients during the exposure to complex and abstract stimuli. We investigated two questions: 1) would the same percentage of schizophrenia patients be classified as SCOR-HR when the orienting stimuli are complex and abstract as when they are innocuous tones; and 2) whether SCOR-HR schizophrenia patients have associated frontally mediated neurocognitive deficits. METHODS: Thirty-one schizophrenia patients and 29 normal comparison subjects were presented with the Rorschach inkblot test while their SCORs were recorded. Schizophrenics were divided in two groups: SCOR-HR and SCOR responders. Demographic and clinical comparisons were made between the two groups. Rorschach responses were scored for the presence of perseverations. RESULTS: Forty-five percent of the schizophrenia patients were classified as SCOR-HR versus 10% of the normal comparison subjects. Among the schizophrenia patients, SCOR-HR was associated with increased perseverations, which were in turn correlated with the Scale for the Assessment of Negative Symptoms scores. CONCLUSIONS: It appears that SCOR-HR in schizophrenia is not a function of the "meaningfulness" of the stimuli. When SCOR status was combined with the measure of stuck-in-set perseverations, a pattern of results emerged lending indirect support to the hypothesis that relates SCOR-HR to frontal impairment and to the idea that SCOR-HR schizophrenia patients may represent a specific subgroup.

Adult↗
PubMed1998

Relationship of neuropsychological and MRI measures to age of onset of schizophrenia.

Age of onset of schizophrenia (AOS) may be largely determined by neurobiological factors. We examined in a diverse sample of schizophrenia out-patients the relationships of AOS with neuropsychological abilities and structural brain abnormalities as measured on cerebral magnetic resonance imaging (MRI). A total of 82 out-patients meeting DSM-III-R criteria for schizophrenia were evaluated with a comprehensive neuropsychological battery and semi-automated quantitatively analysed cerebral MRI. Earlier AOS correlated with poorer performance in learning and abstraction/cognitive flexibility, and with larger volumes of caudate and lenticular nuclei, and smaller volume of thalamus on MRI. A model for predicting AOS consisting of abstraction and thalamic and caudate volumes remained significant after controlling for duration of illness, current age and daily neuroleptic dose. In conclusion, AOS may be related to specific rather than general measures of cognitive performance and structural brain abnormalities.

Adult↗
PubMed1997

Is it possible to be schizophrenic yet neuropsychologically normal?

This study identified and characterized a group of schizophrenic patients without neuropsychological (NP) impairment. A comprehensive NP battery was administered to 171 schizophrenic outpatients and 63 normal comparison participants. Each participant's NP status was classified through blind clinical ratings by 2 experienced neuropsychologists; 27% of the schizophrenics were classified as NP normal. The NP-normal and NP-impaired schizophrenics were similar in terms of most demographic, psychiatric, and functional characteristics, except that NP-normal patients had less negative and extrapyramidal symptoms, were on less anticholinergic medication, socialized more frequently, and were less likely to have had a recent psychiatric hospitalization. The existence of NP-normal schizophrenics suggests that the pathophysiology underlying the cognitive deficits often associated with schizophrenia may be distinct from that causing some of its core psychiatric features.

Adult↗
PubMed1995

The nature of learning and memory impairments in schizophrenia.

The California Verbal Learning Test was used to characterize the learning and memory impairment in schizophrenia (SC) and to evaluate potential clinical and demographic factors associated with this impairment. SC patients (n = 175) performed worse than normal comparison (NC) subjects (n = 229) on all learning, recall, and recognition memory measures. The most important clinical correlates of these impairments were earlier age of onset, more negative symptoms, and greater anticholinergic medication dosage. SC patients showed a prominent retrieval deficit as indicated by disproportionate improvement when tested in a recognition, rather than a free recall, format. A residual impairment seen with recognition testing suggests a mild encoding deficit as well. In contrast, the relative absence of a storage deficit is suggested by the lack of rapid forgetting. Using a discriminant function analysis that differentiates cortical dementia [i.e., Alzheimer's disease (AD)], subcortical dementia [i.e., Huntington's disease (HD)], and normals, it was found that 50% of the SC patients were classified as having a subcortical memory profile and 35% were classified as having a normal profile, whereas only 15% were classified as having a cortical memory profile. Although these findings reflect the clinical heterogeneity often found in SC, results suggest that most SC patients demonstrate a pattern of learning and memory impairments that resembles the pattern seen in patients with primary subcortical (specifically striatal) pathology.

Adult↗
PubMed1995

Gender differences on thought disturbance measures among schizophrenic patients.

OBJECTIVE: This study examined gender differences on three measures of thought disturbance among patients with schizophrenia and the relation between thought disturbance and social competency. METHOD: Fifty-three male and 34 female patients diagnosed with schizophrenia according to the DSM-III-R criteria were assessed on measures of thought disturbance: subscales of the Scale for the Assessment of Positive Symptoms (SAPS), subscales of the Brief Psychiatric Rating Scale (BPRS), and the Ego Impairment Index. Gender differences on the three measures of thought disturbance and the relation of these measures to demographic variables and other variables, such as social competency, were examined. RESULTS: Male and female schizophrenic patients demonstrated similar degrees of thought disturbance on the pertinent subscales of the SAPS and the BPRS, but the male schizophrenic patients had scores showing greater impairment on the Ego Impairment Index. Furthermore, a relationship between thought disturbance and social competency was confirmed. CONCLUSIONS: These findings support other studies in which female patients were found to have a "milder" form of schizophrenia, generally characterized by better social functioning, than their male counterparts. The literature regarding gender-related differences in thought disturbance in schizophrenia has been unclear and complicated by design issues such as obtaining adequate samples of subjects and optimizing measurement selection. The findings of this study suggest that use of a converging-measures strategy allows a better assessment of thought disturbance in severely ill schizophrenic patients and an understanding of the importance of thought disorder with respect to gender-related patterns of clinical characteristics, such as social competency.

Adult↗
PubMed1995

Amphetamine on Rorschach measures in normal subjects.

Twenty-two normal undergraduate men were administered either d-amphetamine (0.2 mg/kg or 0.4 mg/kg) or placebo in a double-blind, counterbalanced design. The test sessions were exactly three weeks apart and included, among other measures, the Rorschach test. Rorschach anxiety and thought disorder variables were measured under drug and placebo conditions. The results suggest that amphetamine causes an increase in Rorschach anxiety indices but does not elevate Rorschach indices of thought disorder. The observed dissociation of anxiety and thought disorder on the Rorschach has implications for the role of the Rorschach in studying anxiety disorders and schizophrenic disorders.

Adult↗
PubMed1994

Neuropsychological deficits in schizophrenics. Relationship to age, chronicity, and dementia.

BACKGROUND: We sought to determine whether neuropsychological impairment in schizophrenia is related to current age, age at onset, or duration of illness, and whether the pattern of such impairment can be distinguished from that caused by progressive dementias of Alzheimer's type. We administered a comprehensive neuropsychological test battery to a normal control group (n = 38), a group of ambulatory patients with Alzheimer's disease (n = 42), and three ambulatory schizophrenic groups: early onset-young (n = 85), early onset-old (n = 35), and late onset (n = 22). Tests were grouped and analyzed according to eight major ability areas, and published procedures were used to remove the expected effects of normal aging. RESULTS: The three schizophrenic groups were found to be neuropsychologically similar to one another and different from normal controls and patients with Alzheimer's disease. There were no significant differences among the schizophrenic groups in level or pattern of neuropsychological functioning. Patients with Alzheimer's disease demonstrated less efficient learning and particularly more rapid forgetting than did the other groups. CONCLUSIONS: These findings suggest that neuropsychological impairment in schizophrenia is unrelated to current age, age at onset, or duration of illness. The study further suggests that the encephalopathy associated with schizophrenia is essentially nonprogressive and produces a pattern of deficits that is different from that seen in progressive cortical dementias.

Adult↗
PubMed1992

Startle gating deficits occur across prepulse intensities in schizophrenic patients.

The effects of prepulse stimuli of different intensities in inhibiting the startle reflex was assessed in 14 age-matched and gender-matched schizophrenic patients and 14 normal controls. The subjects were presented with startling stimuli consisting of bursts of white noise (106 dBA) with or without prepulse stimuli. Four intensities of prepulse stimuli were utilized: 75, 80, 85, and 90 dBA. Throughout the testing, the background noise was maintained at 70 dBA. The prepulse stimuli more effectively inhibited the startle reflex in the control group compared to the schizophrenic patients who showed deficient prepulse inhibition (gating) of the startle reflex. These results suggest that schizophrenics have impaired central inhibitory mechanisms over a fairly broad range of background noise to prepulse ratios. Further studies are needed to clarify exactly which ratios are optimal in eliciting prepulse inhibition (PPI) and in differentiating between schizophrenic and control groups.

Adult↗
PubMed1992

Past substance abuse and clinical course of schizophrenia.

To evaluate the effects of previous alcohol and drug use on the course and symptoms of schizophrenia, the authors compared 34 patients with schizophrenia who had histories of substance abuse with 17 patients with schizophrenia who were lifelong abstainers. Surprisingly, they did not find that individuals with past histories of abuse were more impaired or had more symptoms.

Adult↗
PubMed1992

The Ego Impairment Index and schizophrenia: a validation study.

This study is an extension of our work on a new scale, the Ego Impairment Index (EII; Perry & Viglione, 1991). The index is theoretically based on Beres's (1956) model of ego assessment and was empirically developed on a sample of melancholic, depressed outpatients, diagnosed according to the Diagnostic and Statistical Manual of Mental Disorders (3rd ed. [DSM-III]; American Psychiatric Association, 1980). The EII is derived from the Rorschach Inkblot Test and offers a single composite score of ego impairment. This study validates the use of the EII with a heterogeneous sample of schizophrenic patients. In support of the trait-like characteristics of the scale, the EII continues to be expressed as a single factor, with a correlation of .98 when comparing the original factor derived from a melancholic population with this sample of schizophrenic patients. Significant correlations were also found between the EII and other clinical indices, including the Magical Ideation Scale, the Schizophrenia Index, and the Minnesota Multiphasic Personality Inventory (MMPI). Finally, the EII was found to differentiate between a paranoid subgroup and a mixed undifferentiated/disorganized subgroup who theoretically have more ego impairment. These results offer support for the use of the EII as an empirical means of quantitatively and qualitatively assessing thought disorder within a theoretical framework. Further research is needed to understand the application of the EII across different diagnostic groups and its relationship to other indices of psychological disturbance.

Adult↗
PubMed1990

Effects of rare non-target stimuli on brain electrophysiological activity and performance.

In order to assess the effects of non-target stimuli on task performance and electrophysiological activity, 16 subjects performed reaction time (RT) experiments under 3 conditions. In all conditions, subjects had to press a button upon detection of rare (15%) target stimuli (1600 Hz) presented among frequent (85%) non-target stimuli. The 3 conditions differed based on their non-target stimuli. In one condition, the non-targets consisted of 'standard' stimuli (900 Hz). In the two other conditions, rare and deviant non-target stimuli were randomly added to the standard stimuli. These deviant non-target stimuli consisted of either constant (700-Hz tones) or novel (buzzes, filtered noises and other unusual sounds) stimuli. Both the rare target and non-target stimuli elicited P300, responses. Behavioral (RT) and electrophysiological (event-related potential) data showed that stimuli that followed standard stimuli were processed differently compared to stimuli that followed deviant non-target stimuli. In the conditions containing deviant non-target stimuli, the P3b to the target stimuli was smaller and later, and the mean RT longer than in the condition with no deviant stimuli. These behavioral and electrophysiological changes induced by the deviant non-target stimuli were discussed with reference to two factors, distraction and increased level of task difficulty. It was suggested that each of these factors were differentially sensitive to the novelty of the rare deviant stimuli.

Acoustic Stimulation↗
PubMed1980

Effect of practice on visual backward masking.

Five experiments studied practice effects for 4, 7, 11 subjects on visual backward masking using a signal-detection procedure under various conditions. Exp. I determined the minimum perceptible critical stimulus duration (CSD) for criterion identification of a target stimulus, the letter T or A. In Exp. II, the stimulus was presented at the critical stimulus duration (CSD) followed by a pattern mask at intervals of 20 to 120 msec. for 15 separate sessions. In Exp. III (N = 4) the mask followed the CSD in intervals of 2-msec. increments until subjects reached criterion accuracy. Exps. IV and V (Ns = 4, 7) provided partial replications of Exps. II and III. Naive subjects were used, and the stimulus duration was constant for all subjects. When masking functions were obtained at a threshold, considerable variability was found and subjects improve slowly or not at all over sessions. With a fixed supra-threshold stimulus, all subjects improve with practice. The inportance of these findings is discussed as they relate to common (and largely untested) assumptions made in the backward masking and perception literature.

Adult↗
PubMed1979

Therapist A--B score and treatment outcome with psychiatric in patients: a table of random numbers.

The study evaluated the relationship between therapist personality and treatment success for 141 schizophrenics and 94 non-schizophrenics randomly assigned to short or long hospitalization. The 47 therapists were self-rated on the Whitehorn--Betz A--B scale in both the original and the Campbell versions. Outcome was assessed on the Health--Sickness Rating Scale and the Psychiatric Evaluation Form at discharge and at 1 and 2 year follow-up. The hypothesis of greater success for A--type therapists with schizophrenics was not confirmed, nor were alternative relationships evident in the data.

Affective Symptoms↗
PubMed1978

Unresponsiveness of catatonic symptoms to naloxone.

A case report of a catatonic patient is presented. Because of the similarity of catatonia to the animal behavior produced by intracerebral administration of beta-endorphin, an endogenous opioid, naloxone was administered. No effect was observed with naloxone, whereas both amobarbital and diazepam were able to reverse catatonic behavior. Testing of catatonic patients with naloxone may help further elucidate naloxone's reported anti-psychotic properties.

Adult↗
PubMedDate not supplied

Clinical and experimental characteristics of "hypothetically psychosis prone" college students.

The study of individuals at the boundaries of schizophrenia has historically involved genetic relatives of schizophrenia patients or individuals who meet criteria for schizotypal personality disorder (SPD). Recently, many investigators have turned to the use of psychometric scales, developed to measure psychotic traits or vulnerability to developing schizophrenia, to screen large populations of college students in order to identify individuals who are "psychosis prone" or "schizotypal". To help answer the question of whether students identified with psychometric scales are indeed psychosis prone, we screened 1115 college students with the Perceptual Aberration/ Magical Ideation (PerMag) and Physical Anhedonia (PhysAn) Scales. Individuals who scored 2 standard deviations (SD) above the mean on the scales were selected as experimental subjects (N = 13 PerMag, N = 10 PhysAn) and a subpopulation of matched subjects who scored less than 0.5 SD above the mean were selected as control subjects (N = 24). All subjects then received a full battery of tests, including structured clinical interviews, the MMPI, and psychophysiological measures of information processing, including prepulse inhibition and habituation of the human startle response, visual backward masking and reaction time measures. The results suggest that the PerMag scale, but not the PhysAn scale, identifies individuals with some psychotic, affective and anxiety symptoms when compared to the controls. Neither scale predicts a diagnosis of schizotypal personality disorder or deficits on measures of information processing that characterize schizophrenia or schizotypal personality disordered patients.

Female↗