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Golembiewski J.A.,MAAP | Golembiewski J.A.,Schizophrenia Research Institute SRI
Archives of Psychiatry and Psychotherapy

It is commonly assumed that psychiatric violence is motivated by delusions, but here the concept of a reversed impetus is explored, to understand whether delusions are formed as ad-hoc or post-hoc rationalizations of behaviour or in advance of the actus reus. The reflexive violence model proposes that perceptual stimuli has motivational power and this may trigger unwanted actions and hallucinations. The model is based on the theory of ecological perception, where opportunities enabled by an object are cues to act. As an apple triggers a desire to eat, a gun triggers a desire to shoot. These affordances (as they are called) are part of the perceptual apparatus, they allow the direct recognition of objects - And in emergencies they enable the fastest possible reactions. Even under normal circumstances, the presence of a weapon will trigger inhibited violent impulses. The presence of a victim will also, but under normal circumstances, these affordances don't become violent because negative action impulses are totally inhibited, whereas in psychotic illness, negative action impulses are treated as emergencies and bypass frontal inhibitory circuits. What would have been object recognition becomes a blind automatic action. A range of mental illnesses can cause inhibition to be bypassed. At its most innocuous, this causes both simple hallucinations (where the motivational power of an object is misattributed). But ecological perception may have the power to trigger serious violence also -a kind that's devoid of motives or planning and is often shrouded in amnesia or post-rational delusions. Source

Outram S.,University of Newcastle | Harris G.,University of Newcastle | Kelly B.,University of Newcastle | Bylund C.L.,Hamad Medical Corporation | And 7 more authors.
International Journal of Social Psychiatry

Background: Despite widespread acceptance of the principle that patients should be informed about their diagnosis, many clinicians are reluctant to provide a diagnosis of schizophrenia. This study examines family caregivers experiences of the communication of a schizophrenia diagnosis and related information. Methods: A generic qualitative methodological approach was used. In all, 13 family caregivers were recruited in regional New South Wales, Australia. Semi-structured interviews were used to explore their experiences and perceptions of discussing the diagnosis, prognosis and treatment of schizophrenia with mental health professionals. Interviews were recorded, transcribed, codes generated and thematic analysis undertaken. Results: Family caregivers described long and difficult pathways to being given a diagnosis, haphazard means of finding out the diagnosis, high unmet needs for information, exclusion from the medical care process and problematic communication and general interactions with mental health clinicians. Caregivers were unanimous about the importance of receiving a timely diagnosis, for them and their relative with schizophrenia. Conclusion: Family caregivers are an integral part of the mental health-care system, and they should be included early in discussions of diagnosis and treatment of a person with schizophrenia. Their perspectives on communicating a diagnosis of schizophrenia provide important information for communication skills training of psychiatrists and other mental health professionals. © 2014 The Author(s). Source

Marsh P.J.,Macquarie University | Green M.J.,Schizophrenia Research Institute SRI | Green M.J.,University of New South Wales | Green M.J.,National Alliance for Research on Schizophrenia and Depression NARSAD | And 5 more authors.
American Journal of Psychiatric Rehabilitation

Impaired recognition of facial emotion in schizophrenia is associated with poor social functioning. Evidence shows that targeted emotion recognition training (ERT) can improve perception of facial emotions in schizophrenia for up to 1 week after training. This study investigated whether (a) improved recognition generalizes to novel faces, (b) training effects are durable over 1 month, and (c) baseline functioning levels predict the extent of improvement. Thirty-nine participants with schizophrenia received ERT using Ekman's Micro-Expression Training Tool (METT; 2003). Emotion recognition was assessed using METT face stimuli and other face stimuli not used in training (static faces shown at 100% and 50% intensity and dynamic stimuli). Baseline ratings of interpersonal and cognitive functioning were collected; a subgroup of 10 participants was followed up at 1 month posttraining. Post-METT training, participants showed improved perception of METT faces and novel faces. The subgroup followed over 1 month showed improved recognition of novel faces and dynamic stimuli 1 month after training, but not immediately after training. Baseline measures of interpersonal and social functioning and general face processing and working memory abilities (50% intensity expressions only) predicted improvement in facial affect recognition immediately after METT training. These findings suggest that the effectiveness of ERT in schizophrenia is influenced by pretraining levels of social functioning and that general face processing abilities and working memory may affect the ability to accurately process subtle facial expressions. Furthermore, improved recognition generalizes to novel faces but only over time, which might indicate an increasing awareness of facial emotion after ERT, at least in people with better baseline social functioning. Copyright © Taylor & Francis Group, LLC. Source

Cheng L.,University of Wollongong | Yu Y.,University of Wollongong | Yu Y.,Schizophrenia Research Institute SRI | Szabo A.,University of Wollongong | And 6 more authors.
Journal of Nutritional Biochemistry

The consumption of diets rich in saturated fat largely contributes to the development of obesity in modern societies. A diet high in saturated fats can induce inflammation and impair leptin signaling in the hypothalamus. However, the role of saturated fatty acids on hypothalamic leptin signaling, and hepatic glucose and lipid metabolism remains largely undiscovered. In this study, we investigated the effects of intracerebroventricular (icv) administration of a saturated fatty acid, palmitic acid (PA, C16:0), on central leptin sensitivity, hypothalamic leptin signaling, inflammatory molecules and hepatic energy metabolism in C57BL/6. J male mice. We found that the icv administration of PA led to central leptin resistance, evidenced by the inhibition of central leptin's suppression of food intake. Central leptin resistance was concomitant with impaired hypothalamic leptin signaling (JAK2-STAT3, PKB/Akt-FOXO1) and a pro-inflammatory response (TNF-α, IL1-β, IL-6 and pIκBa) in the mediobasal hypothalamus and paraventricular hypothalamic nuclei. Furthermore, the pre-administration of icv PA blunted the effect of leptin-induced decreases in mRNA expression related to gluconeogenesis (G6Pase and PEPCK), glucose transportation (GLUT2) and lipogenesis (FAS and SCD1) in the liver of mice. Therefore, elevated central PA concentrations can induce pro-inflammatory responses and leptin resistance, which are associated with disorders of energy homeostasis in the liver as a result of diet-induced obesity. © 2015 Elsevier Inc. Source

Bucci S.,University of Manchester | Baker A.,University of Newcastle | Halpin S.A.,Psychological Assistance Service PAS | Hides L.,University of Melbourne | And 4 more authors.
Mental Health and Substance Use: Dual Diagnosis

Background: The aims of this service evaluation were to determine if an early intervention for cannabis use is feasible and effective in reducing cannabis use and improving functional outcomes among young people at ultra high risk (UHR) for psychosis or with early psychosis. Method: This was a naturalistic evaluation that included 58 people attending a clinical service for young people at UHR for psychosis or in the early stages of a psychotic disorder. Young people were offered a tiered intervention consisting of motivational interviewing (MI) and cognitive behaviour therapy (CBT) for cannabis use according to the severity of their use. Non-users were provided with brief advice; infrequent cannabis users were offered a four-session brief intervention and regular users were offered an eight-session intervention. Cannabis use was assessed using the Drug Use Scale of the Opiate Treatment Index (OTI) and functioning was assessed using the Global Assessment of Functioning (GAF) at initial assessment and 12 months follow-up. Results: Intervention for cannabis use was associated with a significant reduction in the average number of cannabis use occasions per day at follow-up. Only one non-cannabis user had commenced using at follow up after brief advice. Baseline cannabis users had lower GAF scores at 12-months in comparison to non-users. Conclusion: A tiered intervention for cannabis use appears to be feasible and effective for reducing cannabis use among UHR and early psychosis groups, and it is recommended to be tested in a randomised controlled trial. Source

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