Lynn Alden

No abstract available.

Social cognitive functioning has been shown to be impaired in patients with schizophrenia (SZ), and these impairments are associated with functional outcomes. To better understand these deficits this dissertation investigated the neurocognitive processes associated with several social cognitive tasks. A novel irony comprehension paradigm was developed for use with electroencephalogram (EEG). The N400, a negative event related potential (ERP) that occurs 300-500 ms after the onset of a semantically incongruent word, and the P600, a positive ERP that occurs around 500-800 ms, were used to index irony comprehension. Study 1 revealed that SZ performed worse than healthy controls (HC) across three measures of social cognition – emotion perception, Theory of Mind (ToM), and irony comprehension. Furthermore, negative symptoms of SZ were associated with poor ToM performance. ERP findings showed that HC exhibited hemispheric differences in N400 amplitude in response to ironic sentences, with the left hemisphere showing smaller amplitudes to ironic compared to literal statements, whereas SZ did not show this differentiation. Although HC processed ironic statements differently compared to SZ, the direction of the effect was opposite of what was hypothesized. Study 2 examined the durability of this unanticipated finding in a larger group of HC. The N400 effect from Study 1was not replicated – there were no differences in N400 amplitude for ironic and literal statements. A difference in P600 was found whereby the P600 amplitude for literal was greater than for ironic. Self-reported schizotypal traits were associated with poor ToM performance. Study 3 examined whether computerized cognitive remediation (CCR), which has been shown to improve neurocognition, would generalize to social cognition, and whether these changes could be detected at a neural level using EEG. The CCR program implemented in this study produced no improvement in neurocognition or social cognition. Taken together, these results suggest that several aspects of social cognition are impaired in patients with schizophrenia, on a behavioural and possibly a neural level. Future studies are necessary to determine the most effective framework for CCR to minimize the deficits in interpersonal skills that are linked to both general cognitive abilities and social cognition in those with schizophrenia.

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Anxiety disorders are the most common mental health problem, affect individuals across the lifespan, and cause significant impairment and distress in a variety of life domains. Safety behaviour use has been identified as contributing to the maintenance of anxiety. The reduction of safety behaviours is a component of several adult-focused Cognitive Behavioural Therapies for anxiety. Safety behaviour use is discussed in the literature specific to individual anxiety disorders. Currently, there are few psychometrically sound measures of safety behaviours available to researchers and clinicians. The few available safety behaviour measures are associated with Social Phobia (SoP) and Panic Disorder. Few studies have examined safety behaviours associated with Generalized Anxiety Disorder (GAD). This study is composed of two separate studies : Study 1 evaluated the psychometric properties of a measure of GAD-associated safety behaviours, the Generalized Safety Behaviour Scale (GSBS), in an adult sample diagnosed with Generalized Anxiety Disorder (GAD; n = 36) compared with adults with Social Phobia (SoP; n = 34) and with non-anxious controls (n = 38). The GSBS demonstrated strong internal consistency and displayed convergent validity with measures of worry and intolerance of uncertainty. Two underlying factors were identified. Construct validity of the GSBS was further assessed through one-way ANOVAs revealing that participants with GAD engaged in more frequent GAD-associated safety behaviour use than those with SoP or no anxiety. Study 2 contributed to further psychometric investigation of the GSBS and explored safety behaviour use by youth in a community sample (N = 175). The GSBS demonstrated strong internal consistency, and good convergent validity. Two underlying factors were identified. Linear regression analysis revealed that youth with high levels of anxiety engaged in more frequent use of safety behaviours. A MANOVA analysis, grouping youth into low/moderate and at-risk/clinical levels of anxiety, revealed that the at-risk/clinical group endorsed more frequent use of safety behaviours. Implications include a discussion of the benefits of using safety behaviours to help inform treatment sessions, the importance of developing psychometrically sound measures of safety behaviours, and the need to examine safety behaviour use in youth.

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Cognitive models of Social Anxiety Disorder (SAD) emphasize the role of safety behaviours in maintaining the negative sense of self hypothesized to be at the core of SAD. The social psychology literature contains theories regarding the self that might enrich clinical cognitive models by addressing the interplay between aspects of self and social functioning. The first theory pertains to authenticity: being able to engage in self-congruent behaviours is associated with better social functioning and self-esteem. The second pertains to the contribution of social belonging to self-esteem. My goal in this dissertation was to examine the links between safety-seeking, authenticity, relatedness, and self-esteem suggested by an integration of these theories. In Study 1, individuals seeking treatment for SAD participated in an experiment designed to manipulate use of safety behaviours in laboratory-based social interactions (N = 93). Consistent with study predictions, reduction in safety behaviours was related to increase in self-authenticity. Additionally, increased authenticity mediated the relationship between condition and enhanced interpersonal functioning (i.e., prosocial behaviour and perceived partner reaction). In Study 2, structural equation modeling was used to evaluate two potential models of the interrelationships between safety behaviours, authenticity, relatedness, and self-esteem in a nonclinical sample (N = 279): (a) a “self-protection model,” based on the hypothesis that less reliance on safety behaviours would be linked to greater self-authenticity, which, in turn, would be linked to stronger relatedness and self-esteem, or (b) a “relatedness model” in which relatedness was hypothesized to be linked to higher self-esteem, which was linked to less safety-seeking behaviour and, thereby, greater authenticity. Results found preliminary support for both models. Study 3 extended the investigation to a clinical sample (N = 49) to examine temporal relationship between these variables during the course of interpersonal cognitive-behavioural treatment (ICBT) for SAD. Multilevel mediational modeling was used to test whether change in mediators predicted subsequent change in outcome variables. Greater support was found for the “relatedness” model from Study 2. Implications of the present findings for understanding the role of safety behaviours in maintaining the negative self-system and how clinical and social models might be usefully integrated are discussed.

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A diagnosis of posttraumatic stress disorder (PTSD) requires meeting Criterion A, whichstates that the individual must: 1) experience, witness, or be confronted with an event thatinvolved actual or threatened death, serious injury, or threat to one’s physical integrity (CriterionA1); and 2) experience intense fear, helplessness, or horror during or shortly after the event(Criterion A2). Despite various attempts to define Criterion A, a strong etiological link betweenthe event and resulting PTSD has remained elusive. The overarching purpose of the current studywas to examine characteristics of traumatic stressors beyond Criterion A. A cross-sectional,repeated-measures design was used to examine Criterion A1 events under two conditions: whenan event was associated with lasting distress (i.e., distressing event) and when an event was notassociated with lasting distress (i.e., control event). This research addressed four objectives.First, it identified characteristics of Criterion A1 events that evoked extreme amounts of distress(i.e., PTSD symptoms). Second, it examined whether these characteristics were more relevant fordistressing events compared to control events. Third, it tested whether event characteristicsadded incremental value in predicting PTSD symptoms above meeting Criterion A. Finally, ittested hypothesized relationships between event characteristics and processes implicated incognitive models, namely peritraumatic dissociation and posttrauma cognitions.The present study surveyed 181 first responders from northern British Columbia. Firstresponders repeatedly experience Criterion A1 events, which allowed them to rate the relevanceof event characteristics for both types of events. A principal component analysis of diverse eventcharacteristics revealed that distressing events were characterized by chaos and resourcelimitations, which were both rated as significantly more descriptive of distressing eventscompared to control events. As hypothesized, both event characteristics predicted PTSDsymptoms above meeting Criterion A, which was not associated with PTSD symptoms.Consistent with cognitive models, the event characteristics influenced peritraumatic dissociationand posttrauma cognitions, which in turn predicted PTSD symptoms. Moreover, the affect of theevent on PTSD symptoms was partially mediated by these cognitive variables. Overall, theresults of this study are novel because they underscore the importance of examining eventcharacteristics beyond Criterion A.

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