Concurrent and predictive electrodermal correlates of symptomatology in recent-onset schizophrenic patients.

Abstract

Electrodermal activity and symptomatology were interrelated in a group of 56 male and 13 female recent-onset schizophrenic patients. Electrodermal activity was indexed by the frequency of nonspecific skin conductances responses and the number of trials to habituation of the skin conductance orienting response. Symptomatology was assessed by the Brief Psychiatric Rating Scale (BPRS) on two separate test occasions. The first test occasion was during the inpatient period when psychotic symptoms were prevalent and medications were variable. The second test occasion was several months later during an outpatient period when symptoms were stabilized and medications held constant. Electrodermal activity was positively and significantly related to a number of symptoms in male patients, most reliably the BPRS factors Activation and Hostility/Suspiciousness. These relationships were most consistent during the outpatient period. Of particular theoretical interest, greater electrodermal activity during the inpatient period was associated with greater outpatient psychopathology. The results suggest that heightened inpatient electrodermal activity is predictive of poor short-term symptomatic recovery in recent-onset, acute, male schizophrenic patients.

A Systems Approach to Prefrontal-Limbic Dysregulation in Schizophrenia

“…Emphasis has been placed on the relationship between chronic stress, the deleterious effects of cortisol on the hippocampus and prefrontal cortex, and their implications for understanding 'allostatic load' in mental illness [32] . However, recent results favor the idea that the cognitive impairment is the effect of the emotional arousal dysregulation, rather then its cause, as initially hypothesized by Nuechterlein [26][27][28] . Indeed, many cognitive abnormalities associated with schizophrenia [33] -impaired memory [34,35] , lowered sensory gating [36] , selective attention [37] , 'jumping to conclusions' [33] , as well as delusions and hallucinations [38] -are also induced in healthy adults under acute emotional stress [39][40][41] .…”

“…We hypothesize that symptoms may constitute an end-stage of a cyclic and neurodegenerative process [45] , in which limbic dysregulation (caused by compromised inhibition of the amygdala) leads to hyperarousal [26,46] , leading to hypercortisolemia [47] , leading to neurotoxicity [48] and further degeneration of the inhibitory limbic areas [35] , and thus to further limbic dysregulation ( fig. 1 ).…”

“…Almost 20 years after the theory of Gruzelier [24,25] , relating schizophrenia to limbic abnormalities in the regulation of arousal, Nuechterlein and colleagues [26][27][28] posited a 'vulnerability/stress' hypothesis: a vulnerability to stress (assumed to be due to cognitive deficits), combined with stressful 'life events,' leads to first-break schizophrenia or a relapse [see also : 9, 29 ]. The stress/vulnerability theory has been supported by newer models, which use pathologies of the amygdala to account for the deficit syndrome of schizophrenia [30] and link prenatal damage to the limbic system with later development of the disease [31] .…”

The temporal stability of electrodermal variables over a one‐year period in patients with recent‐onset schizophrenia and in normal subjects

“…For variables such as NS-SCRs and SCL, it may be the state aspects that are of greatest interest for schizophrenia, because~at least in this young, recent-onset population! they may predict short-term outcome in an already symptomatic group~Dawson, Nuechterlein, Schell, & Mintz, 1992! and possibly impending relapse or exacerbation in remitted patients One aspect of the present data of particular interest is the relative stability of different measures of EDA responsiveness to stimuli.…”

Schizophrenia—a parameters’ game?

“…A sympathetic upturn-such as elevated autonomic activation (Dawson et al, 1994), or electrodermal activity levels (Hazlett et al, 1997;Dawson et al, 1992b)-seems to be present pre-symptomatically in as high as 60% of patients. Also, it has been observed that stressful life events and highly critical attitudes toward the patient in the social environment predict relapse , while antipsychotic medication reduces relapse rates.…”