Attribution style in schizophrenia linked to symptom severity

Attribution style in schizophrenia linked to symptom severity


MedWire News: Attribution in schizophrenia patients is linked to overall symptom severity, with an internalizing style associated with higher global psychopathology, say scientists who also found that treatment has little effect on attribution.
Although it has been suggested that patients with persecutory delusions attribute hypothetical positive events to internal causes and hypothetical negative events to external causes, there has been little examination of how attribution is associated with other psychotic symptoms.
Romina Mizrahi, from the University of Toronto in Ontario, Canada, and colleagues therefore assessed a cross section of 86 patients with schizophrenia and related psychotic disorders using the Internal, Personal and Situational Attributions Questionnaire (IPSAQ).
The average age of the patients was 31.9 years, and 78% were receiving antipsychotics.
The average total Positive and Negative Syndrome Scale (PANSS) score was 66.68. The average score on the Positive internal subscale was 9.29, while those on the Positive personal and Positive situational subscales were 2.65 and 4.05, respectively.
Average scores on the Negative internal, Negative personal, and Negative situational subscale scores were 6.55, 3.98, and 5.45, respectively.
The average externalizing bias score was 2.73, and the personalizing bias score was 0.40.
Patients with an internal attribution style had significantly greater total PANSS scores than other patients, and a trend towards greater PANSS-Positive subscale scores. Confirming these findings, externalizing bias scores were negatively associated with PANSS total scores.
In a longitudinal substudy, 17 patients with schizophrenia and related psychotic disorders who were free of antipsychotic drugs at baseline were followed-up for 6 weeks after starting antipsychotic medication.
The average patient age was 31 years. All PANSS scores improved significantly during treatment.
There were no overall changes in attribution on any measure during treatment, although externalizing bias changed significantly during the first 2 weeks and then stabilized.
Patients with an internalizing attribution style showed less improvement in terms of their PANSS-Positive subscale scores at 6 weeks than other patients.
In view of their findings, the researchers call for longer term trials to better understand the role of attribution in psychosis and look at pharmacological and non-pharmacological methods to change attribution style in ways that could improve clinical outcome.