2024-03-29T13:28:41Zhttps://www.tdx.cat/oai/requestoai:www.tdx.cat:10803/5863522018-07-16T11:13:01Zcom_10803_1col_10803_20
nam a 5i 4500
Esquizofrènia
Esquizofrenia
Schizophrenia
Psicosi
Psicosis
Psychoses
Raonament (Psicologia)
Razonamiento (Psicología)
Reasoning (Psychology)
Cognició
Cognición
Cognition
Characterization of Counterfactual Reasoning Deficits in Schizophrenia Patients and Non-Psychotic First-Degree Relatives in Comparison with Healthy Control Subjects
[Barcelona] :
Universitat de Barcelona,
2018
Accés lliure
http://hdl.handle.net/10803/586352
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Albacete Belzunces, Àuria,
autor
1 recurs en línia (238 pàgines)
Tesi
Doctorat
Universitat de Barcelona. Departament de Ciències Clíniques
2017
Universitat de Barcelona. Departament de Ciències Clíniques
Tesis i dissertacions electròniques
Menchón Magriñá, José Manuel,
supervisor acadèmic
Contreras, Fernando,
supervisor acadèmic
TDX
Schizophrenia is one of the most serious and complex psychiatric illnesses supposing a great negative impact on the life of the individuals who suffer from it. Cognitive impairment is a core feature of the illness and is characterized by the presence of deficits in almost all neurocognitive and social cognition domains. As a strong correlate of these patients’ real-world functioning, such deficiencies are observable in individuals who share unexpressed genetic components of vulnerability to schizophrenia, including the unaffected first-degree relatives of these patients. Therefore, it is a high priority to identify the biological underpinnings of cognitive deficits in schizophrenia to develop effective treatments promoting the functional recovery of these patients. One way to do so is through the identification and further characterization of novel cognitive deficits specific for the disorder. Pervasive in everyday life, CFT involves mental representations of alternatives to past situations that were once factual possibilities but which never occurred. Counterfactual thoughts are mainly activated by negative outcomes in the form of “if only” conditional prepositions. Furthermore, counterfactual reasoning refers to the remarkable ability to make inferences through the generation of counterfactual thoughts. Overall, prefrontal cortex (PFC) regions seem to be the primary regions activated in people engaged in CFT tasks. Therefore, given that schizophrenia seems to be related, at least in part, to PFC dysfunction and that patients suffering from it show impoverished decision-making and problem-solving skills, studies centered on the evaluation of counterfactual reasoning in schizophrenia should be expected; especially for the impact that these deficits might have on these patients’ personal and social functioning. Unfortunately, despite preliminary findings seeming to suggest CFT disruption in this disorder, research on this matter is still scarce. Further research is needed to properly characterize counterfactual reasoning impairment in schizophrenia since it might lead to the identification of a new primary cognitive deficit of the illness susceptible to becoming a target for treatment in the future. The overall aim of the present thesis is to provide new insights into neurocognitive impairment in schizophrenia by further characterizing counterfactual reasoning impairment in this disorder. Using different neuropsychological methodologies, we sought to better describe these deficits and its relationship with cognitive functioning and clinical status by assessing adult schizophrenia patients and non-psychotic first-degree relatives in comparison with healthy control subjects. In a compendium of four studies, different counterfactual measures were explored: (1) activation of counterfactual thoughts, (2) generation of counterfactual-derived inferences, and (3) activation of behavioural intentions through counterfactual inference generation. In Study 1, 40 patients and 40 controls were examined. The analyses evidenced the abilities to activate counterfactual thoughts and counterfactual inferences to be globally altered in the group of patients. In Study 2, the same counterfactual measures were evaluated but in 78 patients meeting criteria for symptomatic remission (Andreasen et al., 2005) in comparison with 84 healthy controls. The results not only evidenced the same difficulties among the patients, but also significant negative associations between less number of counterfactual thoughts activated and: (i) symptom severity and (ii) more than ten years of illness duration. In Study 3, the same counterfactual measures were evaluated in 43 non-psychotic first-degree relatives, 54 patients and 44 controls. Results evidenced the relatives to present a subtle counterfactual deficit compared with the controls. Finally, in Study 4, the ability to generate behavioural intentions through the activation of CFT was explored in 37 patients and 37 controls. Results evidenced a similar facilitator effect of CFT between groups. Findings from the current thesis further characterize counterfactual reasoning impairment in schizophrenia by improving and extending existing preliminary studies on this field. Overall, whereas the abilities to activate counterfactual thoughts and to construct counterfactual inference seem to be altered in this disorder, the ability to activate behavioural intentions through counterfactual reasoning has been found to be preserved. Further, the present thesis provides basis for the study of counterfactual hypoactivation as a new putative cognitive endophenotype for schizophrenia.
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