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Self-monitoring as a familial vulnerability marker for psychosis: an analysis of patients, unaffected siblings and healthy controls

Published online by Cambridge University Press:  07 July 2011

J. Hommes ,
L. Krabbendam ,
D. Versmissen ,
T. Kircher ,
J. van Os  and
R. van Winkel
J. Hommes
Affiliation:
Department of Psychiatry and Psychology, School of Mental Health and Neuroscience, Maastricht University Medical Centre, The Netherlands
L. Krabbendam
Affiliation:
Department of Psychology and Education, VU University of Amsterdam, The Netherlands
D. Versmissen
Affiliation:
Foundation for Equal Opportunities, University of Antwerp, Belgium
T. Kircher
Affiliation:
Department of Psychiatry and Psychotherapy, University of Marburg, Germany
J. van Os
Affiliation:
Department of Psychiatry and Psychology, School of Mental Health and Neuroscience, Maastricht University Medical Centre, The Netherlands King's College London, King's Health Partners, Department of Psychosis Studies, Institute of Psychiatry, London, UK
R. van Winkel*
Affiliation:
Department of Psychiatry and Psychology, School of Mental Health and Neuroscience, Maastricht University Medical Centre, The Netherlands University Psychiatric Centre Catholic University Leuven, Campus Kortenberg, Belgium
*
*Address for correspondence: Dr R. van Winkel, M.D., Ph.D., School of Mental Health and Neuroscience (MHeNS), Maastricht University Medical Centre, Vijverdalseweg 1, Concorde Building (SN2), 6200 MD Maastricht, The Netherlands. (Email: [email protected])
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Abstract

Background

Alterations in self-monitoring have been reported in patients with psychotic disorders, but it remains unclear to what degree they represent true indicators of familial vulnerability for psychosis.

Method

An error-correction action-monitoring task was used to examine self-monitoring in 42 patients with schizophrenia, 32 of their unaffected siblings and 41 healthy controls.

Results

Significant between-group differences in self-monitoring accuracy were found (χ2=29.3, p<0.0001), patients performing worst and unaffected siblings performing at an intermediate level compared to controls (all between-group differences p<0.05). In the combined group of healthy controls and unaffected siblings, detection accuracy was associated with positive schizotypy as measured by the Structured Interview for Schizotypy – Revised (SIS-R) (β=−0.16, s.e.=0.07, p=0.026), but not with negative schizotypy (β=−0.05, s.e.=0.12, p=0.694). In patients, psychotic symptoms were not robustly associated with detection accuracy (β=−0.01, s.e.=0.01, p=0.094), although stratified analysis revealed suggestive evidence for association in patients not currently using antipsychotic medication (β=−0.03, s.e.=0.01, p=0.052), whereas no association was found in patients on antipsychotic medication (β=−0.01, s.e.=0.01, p=0.426). A similar pattern of associations was found for negative symptoms.

Conclusions

Alterations in self-monitoring may be associated with familial risk and expression of psychosis. The association between psychotic symptoms and self-monitoring in patients may be affected by antipsychotic medication, which may explain previous inconsistencies in the literature.

Keywords

Psychosisschizophreniaself-monitoring
Type
Original Articles
Information
Psychological Medicine , Volume 42 , Issue 2 , February 2012 , pp. 235 - 245
Copyright
Copyright © Cambridge University Press 2011

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