Google Scholar. Cite Cite Alice Medalia, Select Format Select format. Permissions Icon Permissions. Abstract Studies of schizophrenia have traditionally focused on deficits in higher-order cognitive processes such as memory and executive function, but there is an increasing realization that deficits can also be found at the level of early sensory processing.
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Am J Clin Nutr. Grazing, cognitive performance and mood. This conclusion is in line with recent cognitive, genetic, neuroimaging and biomarker findings 46 , 47 , 48 but importantly, using a different battery of tasks, extends these transdiagnostic findings into the domain of perception and therefore represents a new and independent finding.
Concordantly, the identification of a subset of psychotic patients characterized by high levels of conceptual disorganization and severely impaired visual integration using a dynamic display, is consistent with an earlier finding of an association between conceptual disorganization and impaired perceptual organization using static visual stimuli. This transdiagnostic finding also accords with the concept that psychosis is syndromal and its sensory integration pathology is not contingent on psychiatric diagnosis.
Accordingly, the current findings are consistent with the effects of the psychotomimetic hallucinogen psilocybin, which was similarly found to selectively impair visual integration but not sensory detection in population of healthy participants. Although we were successful in assessing a range of different measures across a large participant group, we were constrained by time demands on participants.
As a consequence, because we posited that disrupted sensory integration may contribute to positive symptoms, we restricted our patient assessments to focus on this symptom cluster. It therefore remains possible that a similar relationship exists between integrative deficits and other negative and cognitive symptoms that are also exhibited across a range of psychotic disorders.
As previous studies suggest that sensory integration impairments may be related to core dimensions of functioning that are potentially distinct from psychosis but covary with it, 51 future research should interrogate specific temporal relationships between symptomatology and integration deficits in more detail. Finally, it is important to note that a history of substance abuse was an exclusion criteria for our controls, but not the patient samples given the very high rates of substance abuse in acute adult inpatient cohorts.
Therefore, although patients were only tested after any intoxication or withdrawal had resolved and those with a primary substance use diagnosis were excluded, substance-related effects remain a possible confound. In the future, the impact of external factors including individual differences in tobacco and caffeine consumption should be considered in studies investigating the relationship between symptom profiles and sensory integration performance.
Together, these findings are consistent with a dimensional, rather than categorical, view of psychotic illnesses. Moreover, these data suggest that psychosis as a syndrome may share a similar disruption of sensory integration across disorders and as such does not provide diagnostic specificity. Future assessment of sensory abnormalities in this field ought to include participants with a range of psychiatric diagnoses to more finely delineate whether differences in sensory impairment exist between different disorders or whether they reflect symptom specific features that span a range of psychotic illnesses.
The remaining authors declare no conflict of interest. National Center for Biotechnology Information , U. Journal List Transl Psychiatry v. Transl Psychiatry. Published online May 9. Author information Article notes Copyright and License information Disclaimer. E-mail: ua. This work is licensed under a Creative Commons Attribution 4.
This article has been cited by other articles in PMC. Abstract Visual dysfunction is commonplace in schizophrenia and occurs alongside cognitive, psychotic and affective symptoms of the disorder. Introduction The discourse on the discreteness of psychotic disorders remains as contentious as when first proposed over years ago. Materials and methods Participants One-hundred and ninety-five adults 18—55 years with a range of psychiatric disorders were recruited from an acute psychiatry inpatient unit in Melbourne, VIC, Australia.
Table 1 Overall demographic and clinical characteristics. Mean s. Age years Open in a separate window. In addition, 2 healthy control participants did not complete the NART.
Participant information Handedness was assessed using the Edinburgh Handedness Inventory 25 and sociodemographic, family history and clinical—including medication where relevant data were collected.
Visual detection task Local motion detection was assessed by measuring contrast sensitivity to detect the direction of motion of a cloud of dots. Figure 1. Auditory integration task The participants determined whether a set of concurrent, coherently modulated tones, in a background of incoherently modulated tones, was modulated upward or downward. Simple response task The continuous performance task consisted of 2.
Positive symptom analysis We next tested the link between motion integration deficits and positive symptoms across diagnostic categories participant details in Supplementary Table 1. Table 2 Correlations between visual impairments and positive symptom. Psychotic versus nonpsychotic analysis To further explore whether deficits in motion integration were related to psychosis, rather than diagnosis, we categorized patients as either psychotic or nonpsychotic according to criteria above participant details in Supplementary Table 2.
Figure 2. Auditory detection and integration Diagnostic group analyses Two separate ANCOVAs were conducted to analyze the effect of diagnostic group SSD, bipolar, depression, other psychiatric diagnosis, healthy control on auditory detection and integration performance participant details in Supplementary Table 1.
Psychotic versus nonpsychotic analysis As similar deficits were seen across schizophrenia and bipolar disorder, the data were examined using the psychotic or nonpsychotic grouping used in the visual analysis participant details in Supplementary Table 2.
Control experiments and analysis Visual processing speed To determine whether impaired performance in visual integration reflected a deficit in processing speed, a subset of participants was tested at multiple stimulus durations for both motion detection and motion integration participant details in Supplementary Table 4. Figure 3. Visual sustained attention To assess whether the observed motion integration impairments were due to impaired sustained attention in the psychotic patients, a subset of 40 participants who completed visual motion tasks completed a simple response task designed to replicate the cognitive and attentional demands of our visual task participant details in Supplementary Table 4.
Medication In some circumstances, antipsychotic or benzodiazepine medication were found to impair visual sensitivity. Discussion The present study assessed sensory detection and integration in a heterogeneous sample of psychiatric patients and healthy controls.
Supplementary Material Supplementary Information Click here for additional data file. References Adams D. On the spectrum. Nature ; : — Weakened center-surround interactions in visual motion processing in schizophrenia.
J Neurosci ; 26 : — Weak suppression of visual context in chronic schizophrenia. Curr Biol ; 15 : R—R Visual masking by object substitution in schizophrenia. Psychol Med ; 41 : — Dysfunction of early-stage visual processing in schizophrenia. Am J Psychiatry ; : — Altered contextual modulation of primary visual cortex responses in schizophrenia. Neuropsychopharmacology ; 38 : — Windows to the soul: vision science as a tool for studying biological mechanisms of information processing deficits in schizophrenia.
Front Psychol ; 4 : Visual perception and its impairment in schizophrenia. Written consent was obtained from the participant during the first session of treatment, during which the purpose of evaluation and treatment was explained. The patient met the assessment criteria of positive and negative symptoms of schizophrenia and defined form of the occupational therapy department of Semnan University of Medical Sciences, Iran and from social relationships; from this information, his symptoms were evaluated before and after the intervention.
The patient received a full briefing before and after treatment and the social skills questionnaire for Iranian schizophrenic patients was administered. After a comprehensive evaluation, the treatment approach was designed reference circuit. For this schizophrenic patient, sensory integration therapy focused on vestibular and proprioceptive senses, exercises to improve walking in a spiral pattern, walking on a treadmill and correction pattern and physical condition, roping, and jumping over obstacles.
Shoulder and neck exercises to improve the range of motion included darts, ping-pong, and catching and throwing a ball at different angles and distances.
Writing activities were aimed at stimulating the sense of touch, hand coordination, and fine motor skills. Intellectual games were used to turn attention of psychotic symptoms, as well as to increase the accuracy and rapid processing of cognitive information. Along with sensory integration therapy, social skills were targeted through participation in group therapy sessions, membership in sports, and teaching body.
Intervention to enhance independence in activities of daily living was carried out; these activities included education, grooming and hygiene, independence in food preparation, grocery shopping, money management, identifying interests, keeping track of leisure activities, vocational training and basic job skills identification, and holding a job.
Family therapy and support was fostered to create a sense of belonging and friendship between the members of the community 9 , Molavi et al. Goldstein, Krasner and Garfild developed a program that enhances interactive skills.
Meanwhile, Ackley developed the Beck depression inventory. This questionnaire comprises 14 questions that can be scored from 0 to 3. Values for solidarity and test-retest reliability have been reported as 0. He lived in a family of four with his parents and sister. His father worked, his mother was a housewife, and his sister was an art student.
In the hours that my father is not at home, I take care of my mother and sister. This makes me sad and angry. I also cover their weakness through aggression. When I was growing up, because I had nystagmus, I was exempt from military service. I was interested in the field of electronics. However, after four semesters, an inner sense of reluctance and failure stopped me from pursuing my goal.
I had to leave school for a little rest. During this time, in my electronic repair shop students remains. This led to isolation and a lack of desire to go to work. I became aggressive because I did not know the cause of these behaviors. Because I felt frustrated with life, my futile aggressive behavior to those around me was aggravated. As a result of this, my mother went to a psychiatrist and was ordered to stay in the psychiatric ward.
The software used to analyze the data was SPSS, and the mean and standard deviation SD were employed to express the results. After eight sessions of therapy, the patient showed increased awareness of the environment, improved posture and gait patterns, improve motivation and enjoyment, improved patience at work, improved appearance and hygiene, reduction in the targeted behavior, realistic planning of daily activities, improved attention span, improved decision making, and enhanced community participation and interpersonal skills.
The authors were satisfied with the treatment results, as the patient achieved a higher level of awareness of his abilities and disabilities. Table 1 shows the raw scores percent and social skills evaluation for the individual with schizophrenia participating in the study.
Weaknesses in the processing of sensory information, cognitive functions, and diversion remains a sense in person.
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