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California State University, Northridge an Event CALIFORNIA STATE UNIVERSITY, NORTHRIDGE AN EVENT RELATED POTENTIAL EXAMINATION OF FACIAL AFFECT PROCESSING IN PERSONS WITH SCHIZOTYPY A thesis submitted in partial fulfillment of the requirements For the degree of Master of Arts in Psychology, Clinical Psychology By Jaime Morales August 2016 The thesis of Jaime Morales is approved: ________________________________________ __________________ Jose P. Abara, Ph.D. Date ________________________________________ __________________ Gary S. Katz, Ph.D. Date ________________________________________ __________________ Mark J. Sergi, Ph.D., Chair Date California State University, Northridge ii Dedication For my parents, whose strong work ethic has been a prime example to live by and whose constant support has helped me throughout my life. And for my sister, whose strength and unrelenting perseverance has laid down a path for me to follow. iii Acknowledgement I would like to thank the following people from the Neuroscience Lab for all their hard work and assistance with the process of this project: Sharis Sarkissians and Theresa Trieu for their assistance in all aspects of EEG data analysis, and Solange Petrosspour for testing of participants. I would also like to thank my committee members without whose support this thesis would not be possible. I am honored to know each and every one of them. To my chair, Dr. Mark Sergi, for taking the time to edit my thesis and having the patience to continue supporting my work. Your expertise have helped me in my understanding of all constructs of this thesis. As my mentor and advisor, your expertise in social cognition and schizophrenia have inspired me to follow a similar career path. It has validated my career choices in clinical psychology, research in schizophrenia, and academia. To Dr. Jose Abara, for all the support and guidance in EEG and the statistical analysis of this study. Your unrelenting dedication to your students is inspiring and one day I hope to follow such mentorship. Your expertise have influenced my journey as a graduate student and led me to greatly appreciate the neuroscientific perspectives of mental disorders. To Dr. Gary Katz, for all the expert insight and guidance which have brought up interesting factors associated with this thesis. Through your practicum and classes I have learned a great amount about what it takes to succeed in the field of clinical psychology. Your expertise and passion in the clinical field have set an example for me to follow. iv Table of Contents Signature Page ii Dedication iii Acknowledgement iv List of Tables vii List of Figures viii Abstract ix Introduction 1 Schizophrenia and Schizotypy 1 Social Cognition 3 Social Cognition in Schizophrenia and Schizotypy 5 Facial Affect Recognition in Schizotypy 10 Electroencephalography 12 Facial Affect Recognition and ERPs in Schizophrenia and Schizotypy 15 Research Questions and Expected Findings 18 Methods 20 Participants 20 Procedure 20 EEG Processing and Analysis 22 v Statistical Analysis 23 Results 25 Discussion 31 Summary of Findings 31 Limitations and Future Research 33 References 37 Appendix A: Schizotypal Personality Questionnaire - Brief 51 Appendix B: Examples of Stimuli Images 53 vi List of Tables 1 . Mean N170 amplitudes in microvolts (μV) across Groups, Emotion, and Lead 27 2 . Mean N170 amplitudes in microvolts (μV) across Groups, Emotion, and Lead 27 vii List of Figures 1 . N170 and N250 amplitudes for Schizotypy and Control. 25 2 . Grand average waveforms for Schizotypy and Control. 26 3 . The amplitudes for N170 across Leads. 28 4 . The amplitudes for N250 across Emotions. 29 5 . The amplitudes for N250 across Leads. 30 viii Abstract AN EVENT RELATED POTENTIAL EXAMINATION OF FACIAL AFFECT PROCESSING IN PERSONS WITH SCHIZOTYPY By Jaime Morales Masters of Arts in Psychology, Clinical Psychology Deficits in facial affect recognition have been widely investigated in schizophrenia. Their performance on facial affect recognition tasks have shown an apparent deficit in social cognitive processing, specifically on fear and neutral emotions. It is still unclear if these impairments reflect a trait-like vulnerability for schizophrenia. Investigators hoping to uncover a core deficit of schizophrenia spectrum disorders have highly valued utilization of the schizotypy population. Schizotypy is conceptualized as a subclinical manifestation of the same biological factors that give rise to schizophrenia and other schizophrenia spectrum disorders. Schizotypy provides a useful construct for understanding the development of schizophrenia spectrum disorders as it is dimensional and involves similar but lesser symptoms and dysfunction. Electroencephalography can advance our understanding of the neuronal processes involved in emotion recognition deficits of persons with schizophrenia or schizotypy, as this technology can identify deficits in both early facial structural encoding and the later facial affect decoding. ix The current study examined early structural encoding and facial affect decoding using electroencephalography methods during a continuous performance task (CPT). 20 participants high in schizotypy and 20 participants low in schizotypy were identified from a screening of over 1,200 undergraduate students at California State University, Northridge. Event-related potentials (ERPs) were evaluated during a CPT involving facial affect recognition. Amplitudes for the facial structural encoding N170 and facial affect decoding N250 ERP components were captured and analyzed at the frontal, central, and posterior sites, specifically for fear and neutral facial expressions. There were no significant differences between controls and schizotypes on N170 and N250 ERP amplitudes. N170 amplitudes followed the same topographical distribution for both groups, displaying greater negativity at the central site. Although this finding is unexpected, what is most interesting is that the greatest attenuation was at the parietal site for both groups. Also, N250 amplitudes followed the same topographical distribution for both groups, displaying greater negativity at the frontal and central sites. x Introduction Schizophrenia and Schizotypy Schizophrenia is a debilitating disorder which affects approximately 0.3%-0.7% of the U.S. population (American Psychiatric Association, 2013). Schizophrenia is a severe and chronic mental disorder characterized by dysfunctions in cognition, behavior, and emotion. Disturbances affect work performance, interpersonal relations, and self- care, which tend to be considerably below expected levels of achievement. These impairments often hinder a person’s ability to live independently. Symptomology can be separated into three categories: positive, negative, and cognitive (American Psychiatric Association, 2013; National Institute of Mental Health. 2015). Positive symptoms include delusions, hallucinations, disorganized speech, and grossly disorganized or abnormal motor behavior. Negative symptoms involve diminished emotional expression, avolition (decreased motivation), alogia (diminished speech output), anhedonia (decreased ability to experience pleasure), and asociality (lack of interest in social interactions). Cognitive deficits are common and strongly linked to professional and functional impairment. Deficits in cognition are present in declarative memory, working memory, executive functioning, and attention (American Psychiatric Association, 2013). Persons with schizophrenia will have varied symptomology as this disorder is a heterogeneous clinical syndrome. Variation in the presentation of the disorder has brought upon a consensus that the disorder lies on a spectrum rather than a category of psychopathology (Asai, Yamauchi, Sugimori, Bando, & Tanno, 2010; Claridge, 1997; Johns, & van Os, 2001; van Os, Hanssen, Bijl, & Ravelli, 2000; Verdoux, & van Os, 1 2002). From a dimensional view of schizophrenia, deficits are likely to underlie the various levels of the spectrum and those who are susceptible to developing schizophrenia. Schizotypy is considered a subclinical manifestation of the same etiological factors that give rise to schizophrenia and other schizophrenia spectrum disorders (Barrantes-Vidal, Grant, & Kwapil, 2015; Lenzenweger, 2006a; Lenzenweger, 2011; Meehl, 1962; Meehl, 1990). Schizotypy seems to follow the same three factor model of symptomology that organizes schizophrenia, including positive, negative, and cognitive symptoms (Vollema & Hoijtink, 2000; Vollema & van den Bosch, 1995). Schizotypy was made known to represent the inherited susceptibility to schizophrenia spectrum disorders expressed as a multidimensional personality structure (Barrantes-Vidal, et al., 2015). According to Meehl, four primary symptoms are observed in schizotypy: mild associative loosening or cognitive slippage, interpersonal aversiveness or social fear, anhedonia, and ambivalence (Meehl, 1962; Meehl, 1990). In addition, social withdrawal, flat affect (Chapman, Chapman, Raulin, 1976), unusual sensory experiences, magical ideation, perceptual aberration, and referential thinking (Lenzenweger, 2006b), have been included in the characterization of schizotypy. It is important to note that Meehl's model says that schizotypy, as a personality continuum, can manifest itself behaviorally and psychologically in various degrees of clinical symptomology (Lenzenweger, 1994). In other words, not all schizotypes will develop schizophrenia or schizophrenia spectrum disorders, but all schizotypes will display some evidence of their susceptibility in the form
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