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Contrary to popular lore, optimal visual acuity is typically better than 20/20. Could correcting acuity beyond 20/20 offer any benefit? An affirmative answer could present new confounds in studies of aging, development, psychiatric illness, neurodegenerative disorders, or any other population where refractive error might be more likely. An affirmative answer would also offer a novel explanation of inter-observer variability in visual performance. To address the question, we had individuals perform two well-studied visual tasks, once with 20/20 vision and once with optical correction, so that observers could see one line better on an eye chart. In the contour integration task, observers sought to identify the screen quadrant location of a sparsely defined (integrated) shape embedded in varying quantities of randomly oriented "noise" elements. In the collinear facilitation task, observers sought to detect a low-contrast element flanked by collinear or orthogonal high-contrast elements. In each case, displays were scaled in size to modulate element visibility and spatial frequency (4–12 cycles/deg). We found that improving acuity beyond 20/20 improved contour integration for the high spatial frequency displays. Although improving visual acuity did not affect collinear facilitation, it did improve detection of the central low-contrast target, especially at high spatial frequencies. These results, which were large in magnitude, suggest that optically correcting beyond 20/20 improves the detection and integration of contour elements, especially those that are smaller and of higher spatial frequency. Refractive blur within the normal range may confound special population studies, explain inter-observer differences, and meaningfully impact performance in low-visibility environments. [ABSTRACT FROM AUTHOR]

The prediction error account of delusions has had success. However, its explanation of delusions with different contents has been lacking. Persecutory delusions and paranoia are the common unfounded beliefs that others have harmful intentions towards us. Other delusions include believing that one's thoughts or actions are under external control or that events in the world have specific personal meaning. We compare learning in two different cognitive tasks, probabilistic reversal learning and Kamin blocking, that have relationships to paranoid and non-paranoid delusion-like beliefs, respectively. We find that clinical high-risk status alone does not result in different behavioural results in the probabilistic reversal learning task but that an individual's level of paranoia is associated with excessive switching behaviour. During the Kamin blocking task, paranoid individuals learned inappropriately about the blocked cue. However, they also had decreased learning about the control cue, suggesting more general learning impairments. Non-paranoid delusion-like belief conviction (but not paranoia) was associated with aberrant learning about the blocked cue but intact learning about the control cue, suggesting specific impairments in learning related to cue combination. We fit task-specific computational models separately to behavioural data to explore how latent parameters vary within individuals between tasks and how they can explain symptom-specific effects. We find that paranoia is associated with low learning rates in the probabilistic reversal learning task and the blocking task. Non-paranoid delusion-like belief conviction is instead related to parameters controlling the degree and direction of similarity between cue updating during simultaneous cue presentation. These results suggest that paranoia and other delusion-like beliefs involve dissociable deficits in learning and belief updating, which, given the transdiagnostic status of paranoia, might have differential utility in predicting psychosis. [ABSTRACT FROM AUTHOR]

Young people who are at clinical high-risk for psychosis experience suicidal thoughts and behaviors at a greater rate than young people in the general population. However, no suicide prevention interventions have been specifically designed for or tested with this group of young people. To address this gap, we need to identify and leverage malleable potential intervention targets that can be measured at multiple levels of analysis. Here, we argue that social network structure, or the pattern of relationships in which a person is embedded, offers one potential target for intervention. We first provide a select review of what is currently known about social network structure and suicide risk, social network disruption among people at clinical high-risk for psychosis, and inflammatory processes as a potential underlying metric of social bond disruption. We then propose opportunities to advance suicide prevention research focused on young people at clinical high-risk for psychosis, with an eye toward establishing a foundation for future interventions that can account for biological, psychological, and social domains. [ABSTRACT FROM AUTHOR]

An altered use of context and experience to interpret incoming information has been posited to explain schizophrenia symptoms. The visual system can serve as a model system for examining how context and experience guide perception and the neural mechanisms underlying putative alterations. The influence of prior experience on current perception is evident in visual aftereffects, the perception of the "opposite" of a previously viewed stimulus. Aftereffects are associated with neural adaptation and concomitant change in strength of lateral inhibitory connections in visually responsive neurons. In a previous study, we observed stronger aftereffects related to orientation (tilt aftereffects) but not luminance (negative afterimages) in individuals diagnosed with schizophrenia, which we interpreted as potentially suggesting altered cortical (but not subcortical) adaptability and local changes in excitatory-inhibitory interactions. Here, we tested whether stronger tilt aftereffects were specific to individuals with schizophrenia or extended to individuals with bipolar disorder. We measured tilt aftereffects and negative afterimages in 32 individuals with bipolar disorder, and compared aftereffect strength to a previously reported group of 36 individuals with schizophrenia and 22 healthy controls. We observed stronger tilt aftereffects, but not negative afterimages, in individuals with schizophrenia as compared to both controls and individuals with bipolar disorder, who did not differ from each other. These results mitigate concerns that stronger tilt aftereffects in schizophrenia are a consequence of medication or of the psychosocial consequences of a severe mental illness. [ABSTRACT FROM AUTHOR]

Punctal occlusion using punctal plugs has been successfully used to treat the signs and symptoms of dry eye disease. However, the effects of punctal occlusion on the symptoms of allergic conjunctivitis (AC) have been less well documented. There is some concern among clinicians that punctal occlusion may make signs/symptoms of allergic conjunctivitis worse by trapping allergens on the eye. The objective of this post hoc analysis was to address this question and thus assess the effect of punctal occlusion alone on ocular itching and conjunctival redness associated with AC. This was a pooled post hoc analysis of three randomized, double-blind, placebo insert-controlled clinical trials in subjects with AC. Enrolled subjects were generally healthy adults with ocular allergies and a positive skin test reaction to perennial and/or seasonal allergens. The study used a modified version of the traditional conjunctival allergen challenge (CAC) model, which included multiple, repeated allergen challenges following placement of the intracanalicular insert. Subjects were rechallenged on Days 6, 7 and 8; Days 13, 14 and 15; and Days 26, 27 and 28. The data set included 128 subjects that were administered placebo. Baseline mean (SD) ocular itching and conjunctival redness scores were 3.52 (0.44) and 2.97 (0.39), respectively. On post-insertion Days 7, 14 and 28, mean itching scores were 2.62, 2.26 and 1.91, respectively, representing 26%, 36% and 46% itching reductions, respectively (p < 0.001). On Days 7, 14 and 28, mean conjunctival redness scores were 1.98, 1.90, and 2.08, respectively, representing 33%, 36%, and 30% redness reductions, respectively (p < 0.001). Based on this post hoc pooled analysis, punctal occlusion with a resorbable hydrogel intracanalicular insert did not worsen ocular itching or conjunctival redness in this patient population. [ABSTRACT FROM AUTHOR]

• Polygenic risk for schizophrenia was associated with inner retinal layer thinning. • Polygenic risk for schizophrenia was not related to retinal microvascular features. • Retinal thinning in schizophrenia may reflect a neurodegenerative process. • Retinal microvascular abnormalities may be secondary consequences of schizophrenia. We examined the relationship between genetic risk for schizophrenia (SZ), using polygenic risk scores (PRSs), and retinal morphological alterations. Retinal structural and vascular indices derived from optical coherence tomography (OCT) and color fundus photography (CFP) and PRSs for SZ were analyzed in N = 35,024 individuals from the prospective cohort study, United Kingdom Biobank (UKB). Results indicated that macular ganglion cell-inner plexiform layer (mGC-IPL) thickness was significantly inversely related to PRS for SZ, and this relationship was strongest within higher PRS quintiles and independent of potential confounders and age. PRS, however, was unrelated to retinal vascular characteristics, with the exception of venular tortuosity, and other retinal structural indices (macular retinal nerve fiber layer [mRNFL], inner nuclear layer [INL], cup-to-disc ratio [CDR]). Additionally, the association between greater PRS and reduced mGC-IPL thickness was only significant for participants in the 40–49 and 50–59 age groups, not those in the 60–69 age group. These findings suggest that mGC-IPL thinning is associated with a genetic predisposition to SZ and may reflect neurodevelopmental and/or neurodegenerative processes inherent to SZ. Retinal microvasculature alterations, however, may be secondary consequences of SZ and do not appear to be associated with a genetic predisposition to SZ. [ABSTRACT FROM AUTHOR]

Purpose: People with vision loss are at increased risk for major depressive disorder (MDD) and subclinical depression. However, screening for depression is rarely done in eye care settings or among groups in the general population known to have vision disorders. Methods: We examined the prevalence of depression, using the Patient Health Questionnaire – 2 (PHQ‐2), among a group of older adults (N = 204; mean age = 82.15) at two senior living facilities (SLFs) and determined the relationships between severity of depression and objective visual findings, visual function, beliefs about taking an active role in one's own eye care (i.e., patient activation) and level of social support. Results: Approximately 50% of the sample had impaired vision in at least one eye, and close to 30% of the sample obtained a score on the PHQ‐2 indicating the likely presence of major depressive disorder. Visual testing findings were related to visual function (e.g., ability to read), but not to depression. Patient activation was also not significantly related to the level of depression. However, impaired visual functioning and less social support were both strong predictors of depression. These two variables and their interaction accounted for 17% of the total PHQ‐2 score variance. Conclusions: These data indicate the potential utility of screening for depression as part of vision care in populations likely to have significant vision loss. The findings also suggest that a comprehensive approach to depression prevention and/or reduction in SLF and similar populations may require interventions to address reduced visual functioning and methods to strengthen social networks. [ABSTRACT FROM AUTHOR]

Purpose: An estimated 2.2 billion people are visually impaired worldwide. Given that age-related vision loss is a primary cause of vision impairment, this number is projected to rise with increases in average lifespan. Vision loss often results in significant disability and is associated with a substantial economic burden, reduced quality-of-life, concurrent medical issues, and mental health problems. In this review, the mental health needs of people with vision impairment are examined. Patients and methods: A review of recent literature on mental health outcomes and current treatments in people with visual impairment was conducted. Results: Considerable data indicate that rates of depression and anxiety are elevated among people with visual impairments. Moreover, individuals of lower socioeconomic status may be at increased risk for vision impairment and subsequent mental health problems. Existing psychosocial interventions for improving mental health in people with visual impairment show some promise, but are limited by low adherence and lack generalizability. Conclusion: In order to improve outcomes, a better understanding of the mechanisms linking visual impairment and poor mental health is needed. It will also be essential to develop more effective interventions and expand access to services to improve the detection and treatment of mental health problems in this population. [ABSTRACT FROM AUTHOR]

Background: Differences between people with schizophrenia and psychiatrically healthy controls have been consistently demonstrated on measures of retinal function such as electroretinography (ERG), and measures of retinal structure such as optical coherence tomography (OCT). Since our 2015 review of this literature, multiple new studies have been published using these techniques. At the same time, the accumulation of data has highlighted the "fault lines" in these fields, suggesting methodological considerations that need greater attention in future studies.Methods: We reviewed studies of ERG and OCT in schizophrenia, as well as data from studies whose findings are relevant to interpreting these papers, such as those on effects of the following on ERG and OCT data: comorbid medical conditions that are over-represented in schizophrenia, smoking, antipsychotic medication, substance abuse, sex and gender, obesity, attention, motivation, and influences of brain activity on retinal function.Results: Recent ERG and OCT studies continue to support the hypothesis of retinal structural and functional abnormalities in schizophrenia, and suggest that these are relevant to understanding broader aspects of pathophysiology, neurodevelopment, and neurodegeneration in this disorder. However, there are differences in findings which suggest that the effects of multiple variables on ERG and OCT data need further clarification.Conclusions: The retina, as the only component of the CNS that can be imaged directly in live humans, has potential to clarify important aspects of schizophrenia. With greater attention to specific methodological issues, the true potential of ERG and OCT as biomarkers for important clinical phenomena in schizophrenia should become apparent. [ABSTRACT FROM AUTHOR]

Objectives: The present study evaluated early visual processing, in terms of the contrast sensitivity function (CSF), in bipolar disorder (BPD) patients. Methods: Data were recorded in 17 healthy participants and 17 outpatients with type 1 BPD, from 20 to 45 years of age. The CSF was measured at spatial frequencies of 0.2, 0.6, 3.1, 8.0, 16.0 and 20.0 cycles per degree (cpd) using Gabor patches and a two-alternative, forced-choice, logarithmic staircase method. The groups were matched for gender, age and level of education. Results: The CSF differed between groups. Patients with BPD had lower discrimination at spatial frequencies of 0.2 cpd (P < 0.001), 0.6 cpd (P < 0.001), 16.0 cpd (P < 0.001) and 20.0 cpd (P < 0.001) compared with healthy subjects. No differences were observed at 3.1 cpd (P > 0.05) and 8.0 cpd (P > 0.05). This visual impairment was related both to longer duration of illness and to greater severity of manic symptoms. Conclusions: The differences in visual processing were pronounced in patients with BPD, which justifies further investigations of the pathophysiological mechanisms that are involved in sensorial alterations. [ABSTRACT FROM AUTHOR]

Introduction: This small pilot study is the first direct comparison of the currently marketed formulations of bromfenac (0.07% solution) and nepafenac (0.3% suspension) using identical dosing regimens and including an extra pre-surgical "pulse" dose in patients undergoing cataract surgery. Methods: Adults scheduled for unilateral phacoemulsification with intraocular lens implantation were randomly assigned to bromfenac 0.07% or nepafenac 0.3%, each given once-daily 1 day prior to surgery, on the day of surgery plus an extra dose 1 h before surgery, and for 14 days after surgery. Assessments included summed ocular inflammation score (SOIS), visual acuity (VA), and retinal thickness measured via optical coherence tomography. Results: The study population included 49 patients (bromfenac, n = 24; nepafenac, n = 25). The percentage of patients with a SOIS = 0 (no cells or flare) at post-surgical day 15 (primary efficacy endpoint) was statistically similar between the bromfenac (57.1%) and nepafenac (50.0%) treatment groups (intent-to-treat with last observation carried forward) (P = 0.6318). The proportions of patients with an SOIS of 0 at days 3 and 8 were significantly (P < 0.05) higher in the bromfenac group (23.8 and 52.4%, respectively) versus the nepafenac group (0.0 and 20.8%, respectively). Visual acuity was similar between groups at each study visit, as were mean retinal thickness and change from baseline in retinal thickness. Rescue medication (typically difluprednate) was given on or before day 15 to 13 patients in each treatment group (bromfenac, 54.2%; nepafenac, 52.0%). There were no adverse events considered to be related to either treatment. Conclusions: The results of this small pilot study suggest that once-daily bromfenac 0.07% produces similar benefits with regard to postsurgical inflammation, VA, and retinal thickness as once-daily nepafenac 0.3%, and possibly has a faster onset of anti-inflammatory action, when compared using identical dosing regimens. Funding: Bausch & Lomb Incorporated. Trial Registration: NCT03886779. [ABSTRACT FROM AUTHOR]

This study investigated relations between a measure of early-stage visual function and self-reported visual anomalies in individuals at clinical high risk for psychosis (CHR-P). Eleven individuals at CHR identified via the Structured Interview for Psychosis-Risk Syndromes (SIPS) were recruited from a CHR-P research program in NYC. The sample was ~36% female, ranging from 16 to 33 years old (M = 23.90, SD = 6.14). Participants completed a contrast sensitivity task on an iPad with five spatial frequencies (0.41–13 cycles/degree) and completed the self-report Audio-Visual Abnormalities Questionnaire. Higher contrast sensitivity (better performance) to low spatial frequencies was associated with higher perceptual (r = 0.616, p = 0.044) and visual disturbances (r = 0.667, p = 0.025); lower contrast sensitivity to a middle spatial frequency was also associated with higher perceptual (r = −0.604, p = 0.049) and visual disturbances (r = −0.606, p = 0.048). This relation between the questionnaire and contrast sensitivity to low spatial frequency may be indicative of a reduction in lateral inhibition and "flooding" of environmental stimuli. The association with middle spatial frequencies, which play a critical role in face processing, may result in a range of perceptual abnormalities. These findings demonstrate that self-reported perceptual anomalies occur in these individuals and are linked to performance on a measure of early visual processing. [ABSTRACT FROM AUTHOR]

There is growing evidence of disproportionate retinal thinning in schizophrenia, but doubts are still raised regarding its significance in the context of the neurobiology of the disease. Therefore, we examined whether these abnormalities are significantly associated with neurological soft signs (NSS) which are closely related to the risk of schizophrenia. This cross-sectional study analyzing linear correlations between variables involved 56 schizophrenia inpatients and 60 controls. The results confirmed such relationships, and only in the patient sample. In addition, retinal abnormalities and NSS were significantly correlated with duration of illness. These findings provide further evidence for linked neurodevelopmental and neurodegenerative aspects of schizophrenia. [ABSTRACT FROM AUTHOR]

• Abnormal use of prior experience to interpret sensory information in schizophrenia. • Visual aftereffects measure influence of prior experience on perception. • Evidence for alterations of visual aftereffects in schizophrenia. • Significant variability in findings due to type of aftereffect and clinical factors. • Findings allow for mechanistic interpretations for altered visual aftereffects. Psychosis—a cardinal symptom of schizophrenia—has been associated with a failure to appropriately create or use stored regularities about past states of the world to guide the interpretation of incoming information, which leads to abnormal perceptions and beliefs. The visual system provides a test bed for investigating the role of prior experience and prediction, as accumulated knowledge of the world informs our current perception. More specifically, the strength of visual aftereffects, illusory percepts that arise after prolonged viewing of a visual stimulus, can serve as a valuable measure of the influence of prior experience on current visual processing. In this paper, we review findings from a largely older body of work on visual aftereffects in schizophrenia, attempt to reconcile discrepant findings, highlight the role of antipsychotic medication, consider mechanistic interpretations for behavioral effects, and propose directions for future research. [ABSTRACT FROM AUTHOR]

Schizophrenia patients (SCZ) demonstrate deficits in many domains of mental functioning, including visual perception. An issue that has been relatively unexplored, in terms of explaining variation in visual function in SCZ, however, is medication use. The present study explored potential medication effects on color vision in SCZ, a process that is strongly linked to dopaminergic function in the retina. SCZ patients who had clear-cut either typical (n = 29) or atypical (n = 29) monotherapy, without any other concurrent medication, and a group of age- and gender-matched healthy controls participated in the study. Color vision was assessed by the Cambridge Colour Test, using the Trivector and Ellipse subtests. The results demonstrated impaired color perception in patients with schizophrenia, especially in those receiving typical antipsychotics, but these deficits were subtle and not generalized to all parameters. Our findings are consistent with the known neurophysiology of the retina and visual pathways, and with the effects of dopamine blocking medications, but the results should be carefully interpreted. [ABSTRACT FROM AUTHOR]

Highlights • Overall findings reported small effects of smoking on visual processing. • For the first time, a replication of these previous studies was performed. • We found that visual processing impairments were pronounced in tobacco addiction disorder. • These differences may explain the extended effects of tobacco constituents. Abstract Prior studies found small effects of chronic smoking on spatial and color vision, but they were inconclusive. This study tries to: (1) replicate and extend these previous findings, and (2) rule in that this relationship is pronounced by tobacco addiction. Data were recorded in 71 healthy controls (M = 33.5 years; SD = 5.4 years) and 63 individuals with tobacco addiction (M = 34.7 years; SD = 4.8 years). Visual processing was assessed in the forms of contrast sensitivity for linear sine-wave gratings (spatial frequencies ranging between 0.2 and 16 cycles per degree) and color discrimination (using the Ellipse and Trivector subtests). The groups were matched for age, gender and level of education. The group with heavy smokers had reduced sensitivity for all spatial frequencies (p <.001), and impairments in color discrimination for both Trivector (all p -values <.001 for Protan, Deutan and Tritan) and Ellipse (all p -values <.001). This study consistently replicates and extended previous findings, and showed that visual processing can be strongly associated with tobacco addiction. These results indicate that excessive use of cigarettes, or chronic exposure to their compounds, affects visual discrimination, supporting the existence of overall deficits in visual processing in tobacco addiction. [ABSTRACT FROM AUTHOR]

Purpose To determine the effect of phenylephrine 1.0%–ketorolac 0.3% injection (Omidria) on different components of intraoperative floppy-iris syndrome (IFIS). Setting Silverstein Eye Centers, Kansas City, Missouri, USA. Design Prospective case series. Methods Men treated with tamsulosin having standard cataract extraction surgery were placed in a treatment group that received phenylephrine 1.0%–ketorolac 0.3% injection in the irrigation solution and a control group) that received basic saline solution. Every procedure was video recorded using an endocyclophotocoagulation (ECP) probe and microscopic view. Pupil dilation, iris billowing, and iris prolapse were measured using a micrometer, ECP recording grading scale, and microscopic recordings, respectively. Results Each group (treatment and control) comprised 25 eyes of 25 patients. Although both groups had a decrease in pupil diameter before and after cataract extraction and before cataract extraction and after intraocular lens implantation, the changes were statistically significantly greater in the treatment group. Iris prolapse occurred in 3 patients (12.0%) in the treatment group and 14 patients (56.0%) in the control group ( P < .001). Stage 3 (severe) pupil billowing occurred in 1 eye (4.0%) in the treatment group and 10 eyes (40.0%) in the control group ( P < .001). Conclusions The use of the phenylephrine 1.0%–ketorolac 0.3% injection combination added to the irrigating solution during cataract surgery in patients at risk for IFIS led to significantly better prevention of miosis, less pupil billowing, and a reduced incidence of iris prolapse. A new grading scale for intraoperative iris abnormalities might be used for future evaluation. [ABSTRACT FROM AUTHOR]

Background/Aims: Perception of space and objects is a traditional focus within phenomenology, and disturbances in these aspects of perception among people with schizophrenia have long been discussed within phenomenological psychiatry. Despite this, there has been little empirical work on the causes and effects of most of these perceptual alterations in people with schizophrenia. Progress towards this goal can be accelerated by the use of EAWE (Examination of Anomalous World Experience), an interview-based tool to elicit, categorize, and quantify abnormal perceptual and other experiential phenomena. Methods: In this brief paper, we review the main types of disturbances in space and object perception in schizophrenia -- as described by phenomenologists, clinicians from other theoretical orientations, and experimental psychopathologists -- as a first step in a research agenda to achieve a better integration of the clinical and experimental literatures. Results/Conclusion: This review indicates that in some cases the cognitive and neurobiological mechanisms of altered space and object perception in schizophrenia are relatively well understood, while in other cases there exist only plausible hypotheses. In still other cases, however, almost nothing is known. Moreover, a fundamental hypothesis of phenomenological psychiatry -- that perceptual changes are related to disturbances in the sense of self -- has yet to be investigated actively. From this context, we offer suggestions for future research and suggest general research designs that may be useful for advancing progress in this area. [ABSTRACT FROM AUTHOR]

Schizophrenia patients with more positive symptoms are less susceptible to depth inversion illusions (DIIs) in which concave objects appear as convex. It remains unclear, however, the extent to which this perceptual advantage uniquely characterizes the schizophrenia phenotype. To address the foregoing, we compared 30 bipolar disorder patients to a previously published sample of healthy controls (N=25) and schizophrenia patients (N=30). The task in all cases was to judge the apparent convexity of physically concave faces and scenes. Half of the concave objects were painted with realistic texture to enhance the convexity illusion and the remaining objects were untextured to reduce the illusion. Subjects viewed objects stereoscopically or via monocular motion parallax depth cues. For each group, DIIs were stronger with texture than without, and weaker with stereoscopic information than without, indicating a uniformly normal response to stimulus alterations across groups. Bipolar patients experienced DIIs more frequently than schizophrenia patients but as commonly as controls, irrespective of the face/scene category, texture, or viewing condition (motion/stereo). More severe positive and disorganized symptoms predicted reduced DIIs for schizophrenia patients and across all patients. These results suggest that people with schizophrenia, but not bipolar disorder, more accurately perceive object depth structure. Psychotic symptoms-or their accompanying neural dysfunction-may primarily drive the effect presumably through eroding the visual system's generalized tendency to construe unusual or ambiguous surfaces as convex. Because such symptoms are by definition more common in schizophrenia, DIIs are at once state-sensitive and diagnostically specific, offering a potential biomarker for the presence of acute psychosis. [ABSTRACT FROM AUTHOR]

People with schizophrenia are impaired at organizing potentially ambiguous visual information into well-formed shape and object representations. This perceptual organization (PO) impairment has not been found in other psychiatric disorders. However, recent data on body dysmorphic disorder (BDD), suggest that BDD may also be characterized by reduced PO. Similarities between these groups could have implications for understanding the RDoC dimension of visual perception in psychopathology, and for modeling symptom formation across these two conditions. We compared patients with SCZ ( n =24) to those with BDD ( n =20), as well as control groups of obsessive–compulsive disorder (OCD) patients ( n =20) and healthy controls ( n =20), on two measures of PO that have been reliably associated with schizophrenia-related performance impairment. On both the contour integration and Ebbinghaus illusion tests, only the SCZ group demonstrated abnormal performance relative to controls; the BDD group performed similarly to the OCD and CON groups. In addition, on both tasks, the SCZ group performed more abnormally than the BDD group. Overall, these data suggest that PO reductions observed in SCZ are not present in BDD. Visual processing impairments in BDD may arise instead from other perceptual disturbances or attentional biases related to emotional factors. [ABSTRACT FROM AUTHOR]

Objectives Visual perceptual organization impairments in schizophrenia (SCZ) are well established, but their neurobiological bases are not. The current study used the previously validated Jittered Orientation Visual Integration (JOVI) task, along with fMRI, to examine the neural basis of contour integration (CI), and its impairment in SCZ. CI is an aspect of perceptual organization in which multiple distinct oriented elements are grouped into a single continuous boundary or shape. Methods On the JOVI, five levels of orientational jitter were added to non-contiguous closed contour elements embedded in background noise to progressively increase the difficulty in perceiving contour elements as left- or right-pointing ovals. Multi-site fMRI data were analyzed for 56 healthy control subjects and 47 people with SCZ. Results SCZ patients demonstrated poorer CI, and this was associated with increased activation in regions involved in global shape processing and visual attention, namely the lateral occipital complex and superior parietal lobules. There were no brain regions where controls demonstrated more activation than patients. Conclusions CI impairment in this sample of outpatients with SCZ was related to excessive activation in regions associated with object processing and allocation of visual–spatial attention. There was no evidence for basic impairments in contour element linking in the fMRI data. The latter may be limited to poor outcome patients, where more extensive structural and functional changes in the occipital lobe have been observed. [ABSTRACT FROM AUTHOR]

Low spatial frequency (SF) processing has been shown to be impaired in people with schizophrenia, but it is not clear how this varies with clinical state or illness chronicity. We compared schizophrenia patients (SCZ, n = 34), first episode psychosis patients (FEP, n = 22), and healthy controls (CON, n = 35) on a gender/facial discrimination task. Images were either unaltered (broadband spatial frequency, BSF), or had high or low SF information removed (LSF and HSF conditions, respectively). The task was performed at hospital admission and discharge for patients, and at corresponding time points for controls. Groups were matched on visual acuity. At admission, compared to their BSF performance, each group was significantly worse with low SF stimuli, and most impaired with high SF stimuli. The level of impairment at each SF did not depend on group. At discharge, the SCZ group performed more poorly in the LSF condition than the other groups, and showed the greatest degree of performance decline collapsed over HSF and LSF conditions, although the latter finding was not significant when controlling for visual acuity. Performance did not change significantly over time for any group. HSF processing was strongly related to visual acuity at both time points for all groups. We conclude the following: 1) SF processing abilities in schizophrenia are relatively stable across clinical state; 2) face processing abnormalities in SCZ are not secondary to problems processing specific SFs, but are due to other known difficulties constructing visual representations from degraded information; and 3) the relationship between HSF processing and visual acuity, along with known SCZ- and medication-related acuity reductions, and the elimination of a SCZ-related impairment after controlling for visual acuity in this study, all raise the possibility that some prior findings of impaired perception in SCZ may be secondary to acuity reductions. [ABSTRACT FROM AUTHOR]

Purpose: To evaluate the efficacy of bromfenac ophthalmic solution 0.07% dosed once daily in achieving zero-to-trace (0-5 cells) anterior chamber cells, following cataract surgery with posterior chamber intraocular lens implantation. Methods: The study designed employed two Phase III, double-masked, placebo-controlled, multicenter clinical trials of 440 subjects, randomized to either bromfenac ophthalmic solution 0.07% (n=222) or placebo (n=218). Subjects self-dosed once daily, beginning 1 day before undergoing cataract surgery with intraocular lens implantation (day -1) and again on the day of surgery (day 0) and for 14 days postoperatively. Follow-up was on days 1, 3, 8, and 15. The outcome measures included the percentage of subjects with zero-to-trace anterior chamber cells at each visit, as determined by the percentage of subjects with #5 anterior chamber cells, overall anterior chamber cell grades, and summed ocular inflammation score (SOIS) (combined anterior chamber cell and flare scores). Results: The proportion of subjects with zero-to-trace anterior chamber cells was significantly higher in the bromfenac 0.07% group compared with the placebo group as early as day 3 (P=0.0007), continued at day 8 (P<0.0001), and through day 15 (P<0.0001). At day 15, 80.2% of subjects in the bromfenac 0.07% group achieved zero-to-trace anterior chamber cells compared with 47.2% of subjects who did so in the placebo group. The overall anterior chamber cell scores were significantly lower in the bromfenac 0.07% group compared with the placebo group at days 3, 8, and 15 (P<0.0001 at each visit). The SOIS were also significantly lower in the bromfenac group compared with the placebo group at days 3, 8, and 15 (P<0.0001 at each visit). Conclusion: Bromfenac ophthalmic solution 0.07%, dosed once daily was clinically effective in achieving zero-to-trace anterior chamber cell severity after cataract surgery and was superior to placebo in all anterior chamber cell severity and inflammation outcome measures. [ABSTRACT FROM AUTHOR]

Jung was the first to emphasize the importance of psychological factors in the aetiology and treatment of schizophrenia. Despite this, and other seminal contributions, his work on schizophrenia is almost completely ignored or forgotten today. This paper, a follow-up to one on Jung's theories of aetiology and symptom formation in schizophrenia ( Journal of Analytical Psychology, 59, 1) reviews Jung's views on psychological approaches to research on, and treatment of, the disorder. Five themes are covered: 1) experimental psychopathology; 2) attentional disturbance; 3) psychological treatment; 4) the relationship between the environment (including the psychiatric hospital) and symptom expression; and 5) heterogeneity and the schizophrenia spectrum. Review of these areas reveal that Jung's ideas about the kind of research that can elucidate psychological mechanisms in schizophrenia, and the importance of psychotherapy for people with this condition, are very much in line with contemporary paradigms. Moreover, further exploration of several points of convergence could lead to advances in both of these fields, as well as within analytical psychology. [ABSTRACT FROM AUTHOR]

Jung's writings on schizophrenia are almost completely ignored or forgotten today. The purpose of this paper, along with a follow-up article, is to review the primary themes found in Jung's writings on schizophrenia, and to assess the validity of his theories about the disorder in light of our current knowledge base in the fields of psychopathology, cognitive neuroscience and psychotherapy research. In this article, five themes related to the aetiology and phenomenology of schizophrenia from Jung's writings are discussed:1) abaissement du niveau mental; 2) the complex; 3) mandala imagery; 4) constellation of archetypes and 5) psychological versus toxic aetiology. Reviews of the above areas suggest three conclusions. First, in many ways, Jung's ideas on schizophrenia anticipated much current thinking and data about the disorder. Second, with the recent (re)convergence of psychological and biological approaches to understanding and treating schizophrenia, the pioneering ideas of Jung regarding the importance of both factors and their interaction remain a useful and rich, but still underutilized resource. Finally, a more concerted effort to understand and evaluate the validity of Jung's concepts in terms of evidence from neuroscience could lead both to important advances in analytical psychology and to developments in therapeutic approaches that would extend beyond the treatment of schizophrenia. [ABSTRACT FROM AUTHOR]

Schizophrenia patients are less susceptible to depth inversion illusions (DIIs) in which concave faces appear as convex, but what stimulus attributes generate this effect and how does it vary with clinical state? To address these issues, we had 30 schizophrenia patients and 25 well-matched healthy controls make convexity judgments on physically concave faces and scenes. Patients were selec-tively sampled from three levels of care to ensure symptom heterogeneity. Half of the concave objects were painted with realistic texture to enhance the convexity illusion; the remaining objects were painted uniform beige to reduce the illusion. Subjects viewed the objects with one eye while laterally moving in front of the stimulus (to see depth via motion parallax) or with two eyes while remaining motionless (to see depth stereoscopically). For each group, DIIs were stronger with texture than without, and weaker with stereoscopic information than without, indicating that patients responded normally to stimulus alterations. More importantly, patients experienced fewer illusions than controls irrespective of the face/scene category, texture, or viewing condition (parallax/stereo). Illusions became less frequent as patients experienced more positive symptoms and required more structured treatment. Taken together, these results indicate that people with schizophrenia experi-ence fewer DIIs with a variety of object types and viewing conditions, perhaps because of a lessened tendency to construe any type of object as convex. Moreover, positive symptoms and the need for structured treatment are associated with more accurate 3-D perception, suggesting that DII may serve as a state marker for the illness. [ABSTRACT FROM AUTHOR]

The readership of Psychiatric Rehabilitation Journal is broad and not limited to a single profession; however, in this opinion piece, as the Journal moves under the umbrella of publications operated by the American Psychological Association, we focus on the need to engage one profession, clinical psychology, more fully in working with individuals with a serious mental illness. Many of the arguments provided below also have clear relevance to other professions, and may have implications for increasing their involvement in work with this population. In this opinion piece, we call attention to the insufficient training and lack of investment and involvement in the treatment of serious mental illness of one mental health profession, clinical psychology. [ABSTRACT FROM AUTHOR]

OBJECTIVE: To evaluate the efficacy and ocular safety of bromfenac ophthalmic solution 0.09% dosed once daily for the treatment of ocular inflammation and pain following cataract extraction with posterior chamber intraocular lens implantation. METHODS: A total of 455 subjects (455 study eyes: 230 bromfenac, 225 placebo) were enrolled in two randomized double-masked, placebo-controlled, clinical trials at 64 ophthalmology clinics in the United States. Subjects were randomized to receive either bromfenac 0.09% or placebo dosed once daily. Dosing began 1 day before cataract surgery (Day -1), continued on day of surgery (Day 0), and for 14 days following surgery. Evaluations were completed on Days 1, 3, 8, 15 and 22. The primary efficacy endpoint was cleared summed ocular inflammation score (SOIS) by Day 15. The secondary efficacy endpoint was the number of subjects who were pain-free at Day 1. RESULTS: The bromfenac 0.09% group was significantly higher compared to the placebo group in the primary endpoint of the proportion of subjects who had cleared ocular inflammation by Day 15 (P < 0.0001). The mean SOIS for the bromfenac 0.09% group was lower than the placebo group at Days 3, 8, 15, and 22 (P < 0.0001). More bromfenac 0.09% subjects were pain free at Days 1, 3, 8, and 15 (P < 0.0001). Fewer subjects in the bromfenac 0.09% group withdrew from the clinical trials due to lack of efficacy at Day 15 (P < 0.0001). Fewer adverse events were reported in the bromfenac 0.09% group than the placebo group. Limitations included advanced age, female predominance, and surgical nuances among cataract surgeons, making cross-trial comparisons difficult. CONCLUSIONS: Bromfenac ophthalmic solution 0.09% dosed once daily is clinically safe and effective for the treatment of ocular inflammation and the reduction of ocular pain associated with cataract surgery. [ABSTRACT FROM AUTHOR]

Abstract: Silverstein et al. (2010) reported correlations between scores on the UCSD Performance-Based Skills Assessment (UPSA) and scores on two cognitive test batteries (MATRICS Consensus Cognitive Battery and IntegNeuro) that were lower than those reported in past studies. The large sample size of that 4-site study (155 patients with schizophrenia) allowed for further analyses of the data to explore the reasons for the discrepancy. We examined the data from Silverstein et al. (2010) to determine if the correlation values obtained were affected by UPSA scoring method, site differences, patient level of functioning, range restriction, missing data, and/or whether data from the first or second administration of each cognitive test battery were used. Results indicate that the overall lower cognition–UPSA correlations were a function of a single site with unusually low correlations. However, the low correlations at this site were not a function of any of the potential causes we examined. Correlations at the other sites were close to or within the range reported in past studies. Interestingly, the correlation between IntegNeuro and UPSA composite scores was higher at Time 2, suggesting that cognition–UPSA correlations are affected by familiarity with the computerized test format. [Copyright &y& Elsevier]

Abstract: Background: Past studies of perceptual organization in schizophrenia have demonstrated impairments binding fragmented stimulus components into unified representations. ERP and fMRI data indicate that even under conditions of adequate behavioral task performance, significant and meaningful changes in cortical and subcortical activation are present. Here, we examined, using fMRI, activation differences on a visual task wherein feature grouping was a precursor to the formation of distinct groups in the service of target location and identification. Method: Fourteen schizophrenia patients and 16 healthy controls completed a target detection task with 2 conditions: one in which target–distractor grouping facilitates detection (the Isolated condition) and one in which it hinders detection (the Embedded condition). Stimuli were blocked by condition. Accuracy and RT data were obtained in addition to fMRI data. Results: Patients and controls did not differ significantly in accuracy or RT in either condition. Within this context, controls demonstrated greater recruitment of brain regions involved in visual–spatial processing, and the groups differed in activity in areas known to support visual search, visual analysis, decision making and response generation. Conclusion: These findings are consistent with past data indicating reduced processing of stimulus organization, and the subsequent use of inefficient visual search strategies, even under conditions when behavioral performance is at a high level and matches that of healthy controls. [ABSTRACT FROM AUTHOR]

With growing awareness of the likelihood of recovery from schizophrenia, interest has arisen about the potential role of psychotherapy within emerging treatment regimens. Could psychotherapy uniquely promote recovery by addressing symptoms, the achievement of psychosocial milestones, and/or helping to enhance the extent to which persons diagnosed with schizophrenia experience themselves as meaningful agents in the world? As an introduction to a set of case studies of how psychotherapy can promote recovery this article briefly reviews the history of the psychotherapy of schizophrenia. In particular the appearance and course of psychoanalytically oriented treatments, as well as cognitively and interpersonally based treatments are detailed. Evidence supporting these approaches and remaining questions for research are discussed. [ABSTRACT FROM AUTHOR]

This special issue of Clinical Case Studies focuses on recent developments in the psychotherapy of schizophrenia. Approaches such as these are needed to address the multiple rate-limiting factors for psychotherapy outcome in this population, such as poor insight, comorbid disorders, low motivation, cognitive impairments, and self and interpersonal disturbances. In this introductory article, each of the case studies is briefly reviewed, with the goals of: (a) noting how each therapeutic approach fills a gap in current practice, and (b) placing the focus of treatment within a larger context of relevant research on schizophrenia. Concluding comments note the implications of these multiple therapeutic developments for future psychological treatment of schizophrenia. [ABSTRACT FROM AUTHOR]

Behavioral and electrophysiological studies of schizophrenia have consistently demonstrated impairments in the integration of visual features into unified perceptual representations. Specific brain regions involved in this dysfunction, however, remain to be clarified. This study used functional Magnetic Resonance Imaging (fMRI) to examine the relative involvement of visual cortex areas (involved in form perception) and parietal and frontal regions (involved in attention), in the visual integration impairment in schizophrenia. Fourteen patients with schizophrenia and 14 healthy controls were compared on behavioral performance and data acquired via fMRI while completing a contour integration task that had previously been used to identify a visual integration deficit in schizophrenia. The schizophrenia patients demonstrated poorer visual integration than controls. Analyses of peak signal change indicated that while the groups were equivalent in area V1, the schizophrenia group demonstrated reduced signal in areas V2–V4, which are the earliest regions sensitive to global configurations of stimuli. Moreover, whereas the control group demonstrated greater recruitment of prefrontal and parietal areas during perception of integrated forms compared to random stimuli, the schizophrenia group demonstrated greater recruitment of frontal regions during perception of random stimuli. The two groups differed on brain regions involved in form perception even when they were matched on accuracy levels. The visual integration disturbance in schizophrenia involves both deficient basic visual processes (beginning as early as occipital region V2), as well as reduced feedback from visual attention regions that normally serves to amplify relevant visual representations relative to irrelevant information. [ABSTRACT FROM AUTHOR]

Purpose: To assess the efficacy and safety of difluprednate ophthalmic emulsion 0.05% (Durezol) 2 or 4 times a day compared with those of a placebo in the treatment of inflammation and pain associated with ocular surgery. Setting: Twenty-six clinics in the United States. Methods: One day after unilateral ocular surgery, patients who had an anterior chamber cell grade of 2 or higher (>10 cells) were treated with 1 drop of difluprednate 2 times or 4 times a day or with a placebo (vehicle) 2 times or 4 times a day in the study eye for 14 days. This was followed by a 14-day tapering period and a 7-day safety evaluation. Outcome measures included cleared anterior chamber inflammation (grade 0, ≤1 cell), absence of pain, and analysis of ocular adverse events. Results: Of the 438 patients, 111 received difluprednate 2 times a day, 107 received difluprednate 4 times a day, and 220 received a placebo 2 or 4 times a day. Both difluprednate dosage regimens reduced postoperative ocular inflammation and pain safely and effectively compared with the placebo. A greater proportion of difluprednate-treated patients had a reduction in inflammation and pain at 8 days and 15 days. Three percent of patients in both difluprednate groups had a clinically significant IOP rise (≥10 mm Hg and ≥21 mm Hg from baseline, respectively) versus 1% in the placebo group. Conclusions: Difluprednate given 2 or 4 times a day cleared postoperative inflammation and reduced pain rapidly and effectively. There were no serious ocular adverse events. Fewer adverse events were reported in the difluprednate-treated groups than in the placebo group. [Copyright &y& Elsevier]

Abstract: Recovery is now a widely discussed concept in the field of research, treatment, and public policy regarding schizophrenia. As it has increasingly become a focus in mainstream psychiatry, however, it has also become clear both that the concept is often used in multiple ways, and that it lacks a strong scientific basis. In this review, we argue that such a scientific basis is necessary for the concept of recovery to have a significant long-term impact on the way that schizophrenia is understood and treated. The discussion focuses on key issues necessary to establish this scientific agenda, including: 1) differences in definitions of recovery and their implications for studying recovery processes and outcomes; 2) key research questions; 3) the implications of data from outcome studies for understanding what is possible for people diagnosed with schizophrenia; 4) factors that facilitate recovery processes and outcomes, and methods for studying these issues; and 5) recovery-oriented treatment, including issues raised by peer support. Additional conceptual issues that have not received sufficient attention in the literature are then noted, including the role of evidence-based practices in recovery-oriented care, recovery-oriented care for elderly people with schizophrenia, trauma treatment and trauma-informed care, and the role of hospitals in recovery-oriented treatment. Consideration of these issues may help to organize approaches to the study of recovery, and in doing so, improve the impact of recovery-based initiatives. [Copyright &y& Elsevier]

Abstract: It has been suggested in the research literature that facial affect processing (FAP) and theory of mind (ToM) are both potential mediators of the well-established relationship between cognition and functional outcome among people with schizophrenia. The current project tests the mediating potency of these two domains of social cognition among deaf and hearing people with schizophrenia. Sixty-five people (34 deaf, 31 hearing) were assessed using measures of verbal and visual memory, attention, visual processing, FAP, and ToM. The results suggest that each domain of cognition, save vigilance, exerts an effect on functional outcome indirectly through its influence on social cognition. The patterns of mediation varied when the samples were broken down by hearing status and analyzed separately. Namely, the cognitive tasks directly involving linguistic ability (early visual processing [EVP] and word memory) were best mediated by social cognition for hearing subjects. For deaf subjects, the nonlinguistic cognitive tasks (e.g., visual–spatial memory-recall and copy [VSM-recall and VSM-copy]) were best mediated by social cognition. While FAP and ToM were equally effective as mediators for hearing subjects, FAP was a more potent mediator than ToM for deaf subjects. This study extends prior work in the area of social cognition and schizophrenia and indicates that the development of cognitive rehabilitation strategies should include not only interventions targeting specific cognitive abilities, such as attention and memory, but should include an emphasis on social–cognitive domains, including FAP and ToM. Further, deaf and hearing subjects may benefit from interventions addressing aspects of cognition that support linguistic ability, especially as they relate to social cognition. [Copyright &y& Elsevier]

Much work in the cognitive neuroscience of schizophrenia has focused on attention, memory, and executive functioning. To date, less work has focused on perceptual processing. However, perceptual functions are frequently disrupted in schizophrenia, and thus this domain has been included in the CNTRICS (Cognitive Neuroscience Treatment Research to Improve Cognition in Schizophrenia) project. In this article, we describe the basic science presentation and the breakout group discussion on the topic of perception from the first CNTRICS meeting, held in Bethesda, Maryland on February 26 and 27, 2007. The importance of perceptual dysfunction in schizophrenia, the nature of perceptual abnormalities in this disorder, and the critical need to develop perceptual tests appropriate for future clinical trials were discussed. Although deficits are also seen in auditory, olfactory, and somatosensory processing in schizophrenia, the first CNTRICS meeting focused on visual processing deficits. Key concepts of gain control and integration in visual perception were introduced. Definitions and examples of these concepts are provided in this article. Use of visual gain control and integration fit a number of the criteria suggested by the CNTRICS committee, provide fundamental constructs for understanding the visual system in schizophrenia, and are inclusive of both lower-level and higher-level perceptual deficits. [Copyright &y& Elsevier]

The valence-arousal (W. Heller, 1993) and approach-withdrawal (R. J. Davidson, 1998a) models hypothesize that particular patterns of hemispheric brain activity are associated with specific motivational tendencies and psychopathologies. We tested several of these predictions in two groups—a posttraumatic stress disorder (PTSD) and a “supercontrol” group, selected to be maximally different from those with PTSD. Contrary to almost all hypotheses, individuals with PTSD did not differ from controls on resting electroencephalogram (EEG) asymmetry. Particular aspects of PTSD were also not related to EEG hemisphere differences. Our null findings are consistent with the few studies that have examined resting EEG asymmetries in PTSD and suggest that PTSD may be associated with different processes than psychopathologies previously examined in studies of hemispheric brain activity (e.g., major depressive disorder, panic disorder). [ABSTRACT FROM AUTHOR]

Assessment of neurocognitive functioning is a critical task in many clinical, educational, service, and industrial settings. We report on descriptive and validation data of a new, World-Wide-Web-based, comprehensive battery of neurocognitive functioning, WebNeuro, that can be used in both applied and research contexts. Fifty healthy control participants completed both WebNeuro, and an established non-Internet-based computerized cognitive assessment battery, IntegNeuro, that uses a touchscreen platform. Results indicated comparability across the two batteries, in terms of critical single test scores, factor analysis derived indices, overall performance scores, and sex differences. These results support the validity of WebNeuro as a neurocognitive assessment measure. Advantages of its use in applied and research settings are discussed. [ABSTRACT FROM AUTHOR]

Abstract: Recent research has highlighted the relationships between impairments in cognitive functioning and poorer functional outcomes among people with schizophrenia (PWS). The purpose of this study was to replicate and extend this work by testing the relationships between cognition and functional outcome among deaf adults with schizophrenia. Empirical findings from deafness-oriented research reveals enhanced abilities in certain aspects of visual–spatial processing compared to hearing people. Sixty-five PWS (34 deaf, 31 hearing) were assessed using measures of verbal and visual memory, attention, and visual processing. The first hypothesis tested whether cognition predicted functional outcome in a similar fashion for both deaf and hearing subjects (n =63). For all subjects, higher levels of cognitive ability were associated with higher levels of functional outcome, and the strongest predictors of outcome were verbal memory and visual–spatial memory (recall condition) (VSM recall). However, the deaf and hearing groups did show different patterns of relationships between cognition and functioning when all cognitive variables were examined. The second hypothesis was that deaf subjects would display superior performance in early visual processing, visual–spatial memory (copy condition) (VSM copy), and VSM recall. Deaf subjects displayed superior performance on each task; however, no significant differences emerged. Deaf subjects outperformed hearing subjects in an unexpected domain (word memory/recognition). This study extends prior work in the area of cognition and schizophrenia and indicates that deaf and hearing subjects may benefit from interventions that address different domains of cognition. [Copyright &y& Elsevier]

Although cognitive-behavior therapy (CBT) can be effective in reducing delusional thinking in schizophrenia, many patients are considered poor candidates, typically because of a lack of distress from the delusion and resistance or low motivation to challenge its validity. Recent developments in CBT for schizophrenia, however, stress the need to move from a sole focus on challenging beliefs toward a person-based model in which recognition of the vulnerability of the self guides treatment and the content of therapy is perceived as personally meaningful by the patient. This article demonstrates how the Jungian technique of archetypal amplification was modified and used within the structure of CBT treatment of a young man with schizophrenia with a religious delusion who refused to engage in standard CBT. His case demonstrates that schizophrenia patients who initially refuse to question the validity of their delusional beliefs can nevertheless be successfully engaged in CBT when the focus promotes alternative understandings of the self and preserves self-esteem. [ABSTRACT FROM AUTHOR]

Abstract: Possibilities for dynamic psychophysical experimentation on the World-Wide Web are just beginning to be explored. We sought to develop a Web-based version of a contour integration test that is suitable for clinical studies, and to determine whether the previously described contour integration deficit in schizophrenia could be replicated using the new test. Fields of Gabor patches against a gray background were used as stimuli, and a closed contour had to be located within a noisy background. A two-alternative forced-choice paradigm was developed in which the subject had to identify which direction an egg-shaped contour was pointing. The signal-to-noise ratio of the images, and the spacing between contour elements were kept constant, but the orientation of the contour elements was varied as the critical manipulation. The program to administer the task and record data was implemented within Java. Past results of a contour integration deficit in schizophrenia were replicated. Potential future uses of this test for clinical and research purposes are discussed. [Copyright &y& Elsevier]

The research into perceptual organization in schizophrenia spectrum disorders has found evidence for and against a perceptual organization deficit and has interpreted the data from within several different theoretical frameworks. A synthesis of this evidence, however, reveals that this body of work has produced reliable evidence for deficits in schizophrenia, as well as for the clinical, stimulus, and task parameters associated with normal and abnormal performance. Recent models of cognition have also advanced understanding of the underlying pathophysiological processes of perceptual organization dysfunction in schizophrenia spectrum disorders. These suggest that deficits in perceptual organization may be one manifestation of a wider disturbance in the integration of contextually related information across space and time. [ABSTRACT FROM AUTHOR]

Introduction . In a previous study (Silverstein, Bakshi, Chapman, & Nowlis, 1998a, Cognitive Neuropsychiatry ) we demonstrated that while schizophrenia patients showed similar learning curves as nonpatient controls when determining whether a configural pattern of elements has been seen before or not, they did not demonstrate any learning curve with nonconfigural stimuli (in contrast to controls). Methodological limitations of that study, however, precluded generalisability of those effects. Methods . In the present study, therefore, different groups of schizophrenia patients ( n = 18) and controls ( n = 22) were administered a modified version of the familiarity judgement task used in Silverstein et al. (1998a). In the new version of the task: (1) the patterns that repeated were different for each participant; and (2) half of the nonrepeating patterns were configural and half were nonconfigural. Results . These indicated stronger perceptual learning effects for the configural compared to the nonconfigural patterns, and overall better performance and more pronounced learning effects for the control group. Conclusions . The data provide further evidence for a schizophrenia-related impairment in perceptual organisation and in the ability to develop memory representations for novel stimuli. [ABSTRACT FROM AUTHOR]

Studies of aging and autism as outlined by Bertone, Mottron, lamp; Faubert (Bertone et aL) and by Faubert lamp; Bertone suggest that disorders of cognitive coordination involv- ing impairments of dynamic gestalt grouping and context-sensi- tivity may be common to several different disorders. We agree that such studies may shed light on these processes and their neuronal bases. However, we also emphasize that dynamic grouping and context-sensitivity can fail in various ways, and that, although the underlying pathophysiology may often involve NMDA-receptor malfunction, many different malfunctions are possible, and each of these may result from any one of a number of different etiologies. [ABSTRACT FROM AUTHOR]

After a brief discussion of methods for studying the premorbid period in schizophrenia, the authors review relevant experimental literature to assess the validity of current theories. A critical review is provided that includes representative empirical investigations on premorbid functioning in schizophrenia in the domains of neuromotor, intellectual, academic, cognitive, social, emotional, and behavioral functioning. Limitations of past research, such as lack of specificity to schizophrenia populations, high incidences of false positives, questionable definitions of the premorbid period, inconsistent measures of premorbid functioning, and problems with the current method of DSM classification are discussed. Alternative approaches to studying early functioning in schizophrenia are highlighted. [ABSTRACT FROM AUTHOR]

Visual context processing was examined in relation to schizotypy in a large nonclinical university population. Schizotypal status was assessed with the Schizotypal Personality Questionnaire (SPQ) [Schizophr. Bull. 17 (1991) 555]. Schizotypal (n=32) and non-schizotypal (n=37) subjects were tested on a contour integration task (where context processing is necessary for good performance) and a visual size perception task (where context processing impairs accurate performance). In addition, a short form of the Thought Disorder Index (TDI) [Psychol. Assess. 5 (1993) 75] was administered to 28 schizotypal subjects. Thought disordered schizotypal subjects showed significantly impaired performance on the contour integration task but more accurate performance on the visual size perception task. These results support the hypothesis that deficits in visual context processing are the manifestation of a larger disturbance of cognitive coordination in schizotypy and schizophrenia. [Copyright &y& Elsevier]

Describes a cognitive intervention for a patient whose inability to pay attention was the result of persistent, distracting, and disabling auditory hallucinations. Modification of the dichotic listening paradigm to enable the patient to repeatedly practice attending to a source of relevant information; Use of a graded technique wherein difficulty level was increased only after near perfect performance was achieved on prior trials; Attentional problems in schizophrenia.