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Drugs, Schizotypy and Cognition: Cognitive Attenuations Seem More Consistently Associated with Substance Use Than Schizotypal Symptoms

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Drugs, Schizotypy and Cognition: Cognitive Attenuations Seem More Consistently Associated with Substance Use Than Schizotypal Symptoms Unicentre CH-1015 Lausanne http://serval.unil.ch Year : 2012 Drugs, schizotypy and cognition: Cognitive attenuations seem more consistently associated with substance use than schizotypal symptoms HERZIG DANIELA HERZIG DANIELA, 2012, Drugs, schizotypy and cognition: Cognitive attenuations seem more consistently associated with substance use than schizotypal symptoms Originally published at : Thesis, University of Lausanne Posted at the University of Lausanne Open Archive. http://serval.unil.ch Droits d’auteur L'Université de Lausanne attire expressément l'attention des utilisateurs sur le fait que tous les documents publiés dans l'Archive SERVAL sont protégés par le droit d'auteur, conformément à la loi fédérale sur le droit d'auteur et les droits voisins (LDA). A ce titre, il est indispensable d'obtenir le consentement préalable de l'auteur et/ou de l’éditeur avant toute utilisation d'une oeuvre ou d'une partie d'une oeuvre ne relevant pas d'une utilisation à des fins personnelles au sens de la LDA (art. 19, al. 1 lettre a). A défaut, tout contrevenant s'expose aux sanctions prévues par cette loi. Nous déclinons toute responsabilité en la matière. Copyright The University of Lausanne expressly draws the attention of users to the fact that all documents published in the SERVAL Archive are protected by copyright in accordance with federal law on copyright and similar rights (LDA). Accordingly it is indispensable to obtain prior consent from the author and/or publisher before any use of a work or part of a work for purposes other than personal use within the meaning of LDA (art. 19, para. 1 letter a). Failure to do so will expose offenders to the sanctions laid down by this law. We accept no liability in this respect. Institut de Psychologie Drugs, schizotypy and cognition: Cognitive attenuations seem more consistently associated with substance use than schizotypal symptoms THÈSE DE DOCTORAT Présentée à la Faculté de Sciences Sociales et Politiques, Institut de Psychologie, de l’Université de Lausanne pour l’obtention du grade de Docteur (PhD) en Psychologie par: DANIELA HERZIG Directrice de these: CHRISTINE MOHR Jury: Prof. Christine Mohr (Université de Lausanne, CH) ; Prof. Grégoire Zimmermann (Université de Lausanne, CH), Dr. Martin Debbané (Université de Genève, CH) and Dr. Elias Tsakanikos (Roehampton University, London, UK) Nombre de mots (compris les références et le contenu): 74419 LAUSANNE, 2012 1 2 Résumé La psychose est une maladie invalidant, préjudiciable à l'individu et à la société. Depuis que la détection précoce de la maladie est associée à une évolution plus bénigne, les facteurs de détection précoce de la psychose font l'objet l'investigation. Dans la présente thèse, nous nous concentrerons sur deux facteurs de risque potentiels, à savoir la schizotypie et l'usage de drogue. Le concept de schizotypie, initialement développé par Meehl (1962), comprend le fait que les symptômes de la schizophrénie se trouvent sur un spectre, et que leur sévérité va croissante de l'individu le moins touché de la population générale jusque aux patients schizophrènes les plus atteints. Sur ce spectre des troubles schizophréniques, on trouve souvent des troubles cognitifs, par exemple la diminution de l'asymétrie hémisphérique ou des fonctions du lobe frontal. Le deuxième facteur de risque (usage de drogues), affecte les mêmes fonctions cognitives. En outre, la consommation de drogues est élevée dans la schizophrénie et chez les individus ayant des scores élevés sur les échelles mesurant la schizotypie. Par conséquent, nous avons décidé d'investiguer si des atténuations cognitives, précédemment attribuées à des symptômes schizotypiques, pourraient avoir été associées à un usage de substances élevé dans cette population. Pour tester cette idée, nous avons évalué l'usage de différentes drogues (nicotine, cannabis, méphédrone, dépendance à une substance en général), mesuré des symptômes de schizotypie (O-LIFE), et mesuré soit l'asymétrie hémisphérique de la fonction (dominance de l'hémisphère gauche pour le langage, et la domination du droit pour le traitement des informations faciales ), soit le fonctionnement du lobe frontal (tels que la flexibilité cognitive, la mémoire de travail, la mémoire verbale à court terme, l'apprentissage verbal et de la fluidité verbale). Les résultats de toutes ces études suggèrent que c'est surtout l'usage de drogues et non la schizotypie qui prédit le fonctionnement cognitif. Ainsi, les atténuations cognitives précédemment attribuées aux dimensions de schizotypie sont susceptibles d'être associées à une utilisation accrue de drogues. Les études futures devraient étendre la liste des facteurs de risque potentiels (par exemple la dépression et le QI) et obtenir un aperçu plus général des prédicteurs les plus fiables des profils désavantageux. i Abstract Psychosis is a debilitating disease, causing harm to the individual and society. Since early detection of the disease is associated with a more benign course, factors are warranted that enable the early detection of psychosis. In the present thesis we will be focusing on two potential risk factors, namely schizotypy and drug use. The schizotypy concept, originally developed by Meehl (1962), states that schizophrenia symptoms exist on a spectrum, with symptoms ranging from the most severe in patients with schizophrenia to the least affected individual in the general population. Along the schizophrenia spectrum cognitive impairments are commonly found, for instance reduced hemispheric asymmetry or frontal lobe functions. The second risk factor (drug use), affects similar cognitive functions as those attenuated along the schizophrenia spectrum, and drug use is elevated in schizophrenia and people scoring high on schizotypy. Therefore, we set out to investigate whether cognitive attenuations formerly allocated to schizotypal symptoms could have been influenced by elevated substance use in this population. To test this idea, we assessed various drugs (nicotine, cannabis, mephedrone, general substance dependence) and schizotypy symptoms (O-LIFE), and measured either hemispheric asymmetry of function (left hemisphere dominance for language, and right hemisphere dominance for facial processing) or functions largely relying on the frontal lobes (such as cognitive flexibility, working memory, verbal short-term memory, verbal learning and verbal fluency). Results of all studies suggest that it is mostly drugs, and not schizotypy in general that predict cognitive functioning. Therefore, cognitive attenuations subscribed to schizotypy dimensions are likely to have been affected by enhanced drug use. Future studies should extend the list of potential risk factors (e.g. depression and IQ) to acquire a comprehensive overview of the most reliable predictors of disadvantageous cognitive profiles. ii Acknowledgements The author would like to especially thank her supervisor, Prof. Christine Mohr, for continued support, patience and advice. She is and always will remain a great source of inspiration to me. Additionally, the author is grateful to the following colleagues for statistical, financial, and general support: Michael Wilson, Guillaume Sierro, Nele Dael, Yann Schraeg, Nevena Dimitrova, Patricia Kanngiesser, Dr. Angeliki Theodoridou, Dr. Abigail Millings, Dr. Angela Rowe, Prof. Gordon Claridge, Prof. David Nutt, and Sarah Sullivan. Furthermore, the author would like to thank the individual co-authors of the papers presented in this dissertation for their input (Prof. Christine Mohr, Rowan Brooks, Julia Tracy, Prof. David Nutt, Prof. Marcus Munafo), the participants who agreed to participate in my study, as well as the jury members who agreed to evaluate my work. A very special thanks goes out to all my family members and friends who have supported me throughout this endeavor, especially those who helped by `not being there´. This particularly concerns my parents Werner and Ingeborg Herzig, as well as some of my best friends, e.g. Dr. Angeliki Theodoridou, Regina Löhndorf, Kim Dauber, Sanja Koletic and many others (unfortunately I do not have the space to thank all of them individually here). Not insisting on taking up someone´s time at peak-times of their dissertation is very difficult if that person is missed very much. The fact that they never made me feel guilty for abandoning them for long periods of time –yet always answered when I called for help- just shows how great and amazing these people truly are, and how lucky I am to have them in my life. To conclude: Without all of the above mentioned people this work would have not been possible, and therefore this dissertation is theirs just as much as it is mine. iii Declaration I declare that the work in this dissertation was carried out in accordance with the requirements of the University’s Regulations and Code of Practice for Research Degree Programs and that it has not been submitted for any other academic award. Except where indicated by specific reference in the text, the work is the candidates own work. Work done in collaboration with, or with the assistance of, others, is indicated as such. Any views expressed in the dissertation are those of the author. 02/07/2012 Signature Date iv Table of contents I. GENERAL INTRODUCTION ........................................................................................................ 1 A. SYNOPSIS ........................................................................................................................................ 1 1. Categorical model ....................................................................................................................
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