Hostname: page-component-586b7cd67f-vdxz6 Total loading time: 0 Render date: 2024-11-28T17:15:06.721Z Has data issue: false hasContentIssue false
  • English
  • Français

Reflection impulsivity and response inhibition in first-episode psychosis: relationship to cannabis use

Published online by Cambridge University Press:  23 January 2013

V. C. Huddy ,
L. Clark ,
I. Harrison ,
M. A. Ron ,
M. Moutoussis ,
T. R. E. Barnes  and
E. M. Joyce
V. C. Huddy
Affiliation:
Department of Psychosis Studies, Institute of Psychiatry, King's College London, UK
L. Clark
Affiliation:
Department of Psychology, University of Cambridge, UK
I. Harrison
Affiliation:
Mental Health Sciences Unit, University College London, UK
M. A. Ron
Affiliation:
Institute of Neurology, University College London, UK
M. Moutoussis
Affiliation:
Institute of Neurology, University College London, UK
T. R. E. Barnes
Affiliation:
Centre for Mental Health, Imperial College, Charing Cross Campus, London, UK
E. M. Joyce*
Affiliation:
Institute of Neurology, University College London, UK
*
*Address for correspondence: Professor E. M. Joyce, Box 19, The National Hospital for Neurology and Neurosurgery, Queen Square, London WC1N 3BG, UK. (Email: [email protected])
Get access Rights & Permissions [Opens in a new window]

Abstract

Background

People with psychosis demonstrate impaired response inhibition on the Stop Signal Task (SST). It is less clear if this impairment extends to reflection impulsivity, a form of impulsivity that has been linked to substance use in non-psychotic samples.

Method

We compared 49 patients with first-episode psychosis (FEP) and 30 healthy control participants on two forms of impulsivity measured using the Information Sampling Test (IST) and the SST, along with clinical and IQ assessments. We also compared those patients who used cannabis with those who had either given up or never used.

Results

Patients with FEP had significantly greater impairment in response inhibition but not in reflection impulsivity compared with healthy controls. By contrast, patients who reported current cannabis use demonstrated greater reflection impulsivity than those that had either given up or never used, whereas there were no differences in response inhibition.

Conclusions

These data suggest that abnormal reflection impulsivity is associated with substance use in psychosis but not psychosis itself; the opposite relationship may hold for response inhibition.

Keywords

Cannabisimpulsivityinhibitionpsychosisschizophreniasubstance use
Type
Original Articles
Information
Psychological Medicine , Volume 43 , Issue 10 , October 2013 , pp. 2097 - 2107
Copyright
Copyright © Cambridge University Press 2013 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Andreasen, N (1990). Methods for assessing positive and negative symptoms. In Schizophrenia: Positive and Negative Symptoms and Syndromes. Modern Problems in Pharmacopsychiatry (ed. Andreasen, N.), pp. 73–85. Karger: Basel.Google Scholar
Badcock, JC, Michie, PT, Johnson, L, Combrinck, J (2002). Acts of control in schizophrenia: dissociating the components of inhibition. Psychological Medicine 32, 287–297.CrossRefGoogle ScholarPubMed
Barch, DM, Berman, MG, Engle, R, Jones, JH, Jonides, J, MacDonald, A 3rd, Nee, DE, Redick, TS, Sponheim, SR (2009). CNTRICS final task selection: working memory. Schizophrenia Bulletin 35, 136–152.CrossRefGoogle ScholarPubMed
Barnett, JH, Werners, U, Secher, SM, Hill, KE, Brazil, R, Masson, K, Pernet, DE, Kirkbride, JB, Murray, GK, Bullmore, E, Jones, PB (2007). Substance use in a population-based clinic sample of people with first-episode psychosis. British Journal of Psychiatry 190, 515–520.CrossRefGoogle Scholar
Barrowclough, C, Haddock, G, Wykes, T, Beardmore, R, Conrod, P, Craig, T, Davies, L, Dunn, G, Eisner, E, Lewis, S, Moring, J, Steel, C, Tarrier, N (2010). Integrated motivational interviewing and cognitive behavioural therapy for people with psychosis and comorbid substance misuse: randomised controlled trial. British Medical Journal 341, c6325.CrossRefGoogle ScholarPubMed
Bellgrove, MA, Chambers, CD, Vance, A, Hall, N, Karamitsios, M, Bradshaw, JL (2006). Lateralized deficit of response inhibition in early-onset schizophrenia. Psychological Medicine 36, 495–505.CrossRefGoogle ScholarPubMed
Blanchard, JJ, Brown, SA, Horan, WP, Sherwood, AR (2000). Substance use disorders in schizophrenia: review, integration, and a proposed model. Clinical Psychology Review 20, 207–234.CrossRefGoogle Scholar
Blanchard, JJ, Squires, D, Henry, T, Horan, WP, Bogenschutz, M, Lauriello, J, Bustillo, J (1999). Examining an affect regulation model of substance abuse in schizophrenia. Journal of Nervous and Mental Disease 187, 72–79.CrossRefGoogle ScholarPubMed
Blyler, CR, Gold, JM, Iannone, VN, Buchanan, RW (2000). Short form of the WAIS-III for use with patients with schizophrenia. Schizophrenia Research 46, 209–215.CrossRefGoogle ScholarPubMed
Clark, L, Robbins, TW, Ersche, KD, Sahakian, BJ (2006). Reflection impulsivity in current and former substance users. Biological Psychiatry 60, 515–522.CrossRefGoogle ScholarPubMed
Clark, L, Roiser, JP, Robbins, TW, Sahakian, BJ (2009). Disrupted ‘reflection’ impulsivity in cannabis users but not current or former ecstasy users. Journal of Psychopharmacology 23, 14–22.CrossRefGoogle ScholarPubMed
Dervaux, A, Bayle, FJ, Laqueille, X, Bourdel, MC, Le Borgne, MH, Olie, JP, Krebs, MO (2001). Is substance abuse in schizophrenia related to impulsivity, sensation seeking, or anhedonia? American Journal of Psychiatry 158, 492–494.CrossRefGoogle ScholarPubMed
Dudley, REJ, Over, DE (2003). People with delusions jump to conclusions: a theoretical account of research findings on the reasoning of people with delusions. Clinical Psychology and Psychotherapy 10, 263–274.CrossRefGoogle Scholar
Dumais, A, Potvin, S, Joyal, C, Allaire, J-F, Stip, E, Lesage, A, Gobbi, G, Cote, G (2011). Schizophrenia and serious violence: a clinical-profile analysis incorporating impulsivity and substance-use disorders. Schizophrenia Research 130, 234–237.CrossRefGoogle ScholarPubMed
Duva, SM, Silverstein, SM, Spiga, R (2011). Impulsivity and risk-taking in co-occurring psychotic disorders and substance abuse. Psychiatry Research 186, 351–355.CrossRefGoogle ScholarPubMed
Enticott, PG, Ogloff, JRP, Bradshaw, JL (2008). Response inhibition and impulsivity in schizophrenia. Psychiatry Research 157, 251–254.CrossRefGoogle ScholarPubMed
Evenden, JL (1999). Varieties of impulsivity. Psychopharmacology 146, 348–361.CrossRefGoogle ScholarPubMed
Fine, C, Gardner, M, Craigie, J, Gold, I (2007). Hopping, skipping or jumping to conclusions? Clarifying the role of the JTC bias in delusions. Cognitive Neuropsychiatry 12, 46–77.CrossRefGoogle ScholarPubMed
Garety, PA, Freeman, D (1999). Cognitive approaches to delusions: a critical review of theories and evidence. British Journal of Clinical Psychology 38, 113–154.CrossRefGoogle ScholarPubMed
Goldberg, TE, Weinberger, DR (1994). Schizophrenia, training paradigms, and the Wisconsin Card Sorting Test redux. Schizophrenia Research 11, 291–296.CrossRefGoogle ScholarPubMed
Grech, A, van Os, J, Jones, PB, Lewis, SW, Murray, RM (2005). Cannabis use and outcome of recent onset psychosis. European Psychiatry 20, 349–353.CrossRefGoogle ScholarPubMed
Green, B, Young, R, Kavanagh, D (2005). Cannabis use and misuse prevalence among people with psychosis. British Journal of Psychiatry 187, 306–313.CrossRefGoogle ScholarPubMed
Gut-Fayand, A, Dervaux, A, Olie, JP, Loo, H, Poirier, MF, Krebs, MO (2001). Substance abuse and suicidality in schizophrenia: a common risk factor linked to impulsivity. Psychiatry Research 102, 65–72.CrossRefGoogle ScholarPubMed
Huddy, VC, Aron, AR, Harrison, M, Barnes, TRE, Robbins, TW, Joyce, EM (2009). Impaired conscious and preserved unconscious inhibitory processing in recent onset schizophrenia. Psychological Medicine 39, 907–916.CrossRefGoogle ScholarPubMed
Hutton, SB, Murphy, FC, Joyce, EM, Rogers, RD, Cuthbert, I, Barnes, TRE, McKenna, PJ, Sahakian, BJ, Robbins, TW (2002). Decision making deficits in patients with first-episode and chronic schizophrenia. Schizophrenia Research 55, 249–257.CrossRefGoogle ScholarPubMed
Jablensky, A, McGrath, J, Herrman, H, Castle, D, Gureje, O, Evans, M, Carr, V, Morgan, V, Korten, A, Harvey, C (2000). Psychotic disorders in urban areas: an overview of the Study on Low Prevalence Disorders. Australian and New Zealand Journal of Psychiatry 34, 221–236.CrossRefGoogle Scholar
Jablensky, A, Sartorius, N, Ernberg, G, Anker, M, Korten, A, Cooper, JE, Day, R, Bertelsen, A (1992). Schizophrenia: manifestations, incidence and course in different cultures. A World Health Organization ten-country study. Psychological Medicine. Monograph Supplement 20, 1–97.CrossRefGoogle ScholarPubMed
Kagan, J (1966). Reflection–impulsivity: the generality and dynamics of conceptual tempo. Journal of Abnormal Psychology 71, 17–24.CrossRefGoogle ScholarPubMed
Kaladjian, A, Jeanningros, R, Azorin, JM, Anton, JL, Mazzola-Pomietto, P (2011). Impulsivity and neural correlates of response inhibition in schizophrenia. Psychological Medicine 41, 291–299.CrossRefGoogle ScholarPubMed
Kaladjian, A, Jeanningros, R, Azorin, JM, Grimault, S, Anton, JL, Mazzola-Pomietto, P (2007). Blunted activation in right ventrolateral prefrontal cortex during motor response inhibition in schizophrenia. Schizophrenia Research 97, 184–193.CrossRefGoogle ScholarPubMed
Kolliakou, A, Joseph, C, Ismail, K, Atakan, Z, Murray, RM (2011). Why do patients with psychosis use cannabis and are they ready to change their use? International Journal of Developmental Neuroscience 29, 335–346.CrossRefGoogle ScholarPubMed
Lawrence, AJ, Luty, J, Bogdan, NA, Sahakian, BJ, Clark, L (2009). Impulsivity and response inhibition in alcohol dependence and problem gambling. Psychopharmacology 207, 163–172.CrossRefGoogle ScholarPubMed
Leeson, VC, Harrison, I, Ron, MA, Barnes, TRE, Joyce, EM (2012). The effect of cannabis use and cognitive reserve on age at onset and psychosis outcomes in first-episode schizophrenia. Schizophrenia Bulletin 38, 873–880.CrossRefGoogle ScholarPubMed
Leeson, VC, Robbins, TW, Matheson, E, Hutton, SB, Ron, MA, Barnes, TRE, Joyce, EM (2009). Discrimination learning, reversal, and set-shifting in first-episode schizophrenia: stability over six years and specific associations with medication type and disorganization syndrome. Biological Psychiatry 66, 586–593.CrossRefGoogle ScholarPubMed
Li, C-SR, Milivojevic, V, Kemp, K, Hong, K, Sinha, R (2006). Performance monitoring and stop signal inhibition in abstinent patients with cocaine dependence. Drug and Alcohol Dependence 85, 205–212.CrossRefGoogle ScholarPubMed
Liddle, PF, Barnes, TRE (1990). Syndromes of chronic schizophrenia. British Journal of Psychiatry 157, 558–561.CrossRefGoogle ScholarPubMed
Lincoln, TM, Ziegler, M, Mehl, S, Rief, W (2010). The jumping to conclusions bias in delusions: specificity and changeability. Journal of Abnormal Psychology 119, 40–49.CrossRefGoogle ScholarPubMed
McGuffin, P, Farmer, A, Harvey, I (1991). A polydiagnostic application of operational criteria in studies of psychotic illness. Development and reliability of the OPCRIT system. Archives of General Psychiatry 48, 764–770.CrossRefGoogle ScholarPubMed
Meiran, N, Levine, J, Henik, A (2000). Task set switching in schizophrenia. Neuropsychology 14, 471–482.CrossRefGoogle ScholarPubMed
Menon, M, Pomarol-Clotet, E, McKenna, PJ, McCarthy, RA (2006). Probabilistic reasoning in schizophrenia: a comparison of the performance of deluded and nondeluded schizophrenic patients and exploration of possible cognitive underpinnings. Cognitive Neuropsychiatry 11, 521–536.CrossRefGoogle ScholarPubMed
Mesholam-Gately, RI, Giuliano, AJ, Goff, KP, Faraone, SV, Seidman, LJ (2009). Neurocognition in first-episode schizophrenia: a meta-analytic review. Neuropsychology 23, 315–336.CrossRefGoogle ScholarPubMed
Moritz, S, Woodward, TS (2005). Jumping to conclusions in delusional and non-delusional schizophrenic patients. British Journal of Clinical Psychology 44, 193–207.CrossRefGoogle ScholarPubMed
Moritz, S, Woodward, TS (2007). Metacognitive training in schizophrenia: from basic research to knowledge translation and intervention. Current Opinion in Psychiatry 20, 619–625.CrossRefGoogle ScholarPubMed
Nolan, KA, D'Angelo, D, Hoptman, MJ (2010). Self-report and laboratory measures of impulsivity in patients with schizophrenia or schizoaffective disorder and healthy controls. Psychiatry Research 187, 301–303.CrossRefGoogle ScholarPubMed
Park, S, Holzman, PS (1992). Schizophrenics show spatial working memory deficits. Archives of General Psychiatry 49, 975–982.CrossRefGoogle ScholarPubMed
Ramaekers, JG, Kauert, G, van Ruitenbeek, P, Theunissen, EL, Schneider, E, Moeller, MR (2006). High-potency marijuana impairs executive function and inhibitory motor control. Neuropsychopharmacology 31, 2296–2303.CrossRefGoogle ScholarPubMed
Rubia, K, Russell, T, Bullmore, ET, Soni, W, Brammer, MJ, Simmons, A, Taylor, E, Andrew, C, Giampietro, V, Sharma, T (2001). An fMRI study of reduced left prefrontal activation in schizophrenia during normal inhibitory function. Schizophrenia Research 52, 47–55.CrossRefGoogle ScholarPubMed
Schofield, D, Tennant, C, Nash, L, Degenhardt, L, Cornish, A, Hobbs, C, Brennan, G (2006). Reasons for cannabis use in psychosis. Australian and New Zealand Journal of Psychiatry 40, 570–574.CrossRefGoogle ScholarPubMed
Solowij, N, Jones, KA, Rozman, ME, Davis, SM, Ciarrochi, J, Heaven, PCL, Pesa, N, Lubman, DI, Yuecel, M (2012). Reflection impulsivity in adolescent cannabis users: a comparison with alcohol-using and non-substance-using adolescents. Psychopharmacology 219, 575–586.CrossRefGoogle ScholarPubMed
Spencer, C, Castle, D, Michie, PT (2002). Motivations that maintain substance use among individuals with psychotic disorders. Schizophrenia Bulletin 28, 233–247.CrossRefGoogle ScholarPubMed
Van Dael, F, Versmissen, D, Janssen, I, Myin-Germeys, I, van Os, J, Krabbendam, L (2006). Data gathering: biased in psychosis? Schizophrenia Bulletin 32, 341–351.CrossRefGoogle ScholarPubMed
Wechsler, D (1999). Wechsler Adult Intelligence Scale – Third Edition. Psychological Corporation: London.Google Scholar
Wechsler, D (2001). Wechsler Test of Adult Reading. Psychological Corporation: London.Google Scholar
Wing, JK, Babor, T, Brugha, T, Burke, J, Cooper, JE, Giel, R, Jablenski, A, Regier, D, Sartorius, N (1990). SCAN. Schedules for Clinical Assessment in Neuropsychiatry. Archives of General Psychiatry 47, 589–593.CrossRefGoogle ScholarPubMed
Zammit, S, Moore, THM, Lingford-Hughes, A, Barnes, TRE, Jones, PB, Burke, M, Lewis, G (2008). Effects of cannabis use on outcomes of psychotic disorders: systematic review. British Journal of Psychiatry 193, 357–363.CrossRefGoogle ScholarPubMed