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2021 Congress Recordings

Plenary Sessions

How to Translate Scientific Findings on Emotional Information Processing to Psychological Interventions for People with Psychotic Disorders

Presenter
Tania Lincoln | Germany

How to Translate Scientific Findings on Emotional Processing to Psychological Interventions for Delusions

Abstract

The last decades of research have revolutionized the understanding of psychosis. We now have an increasingly clearer picture of the psychological mechanisms that drive the formation and maintenance of psychotic symptoms and are beginning to translate this knowledge into targeted interventions. Within this broader context, this talk will spotlight the link between emotion processing and delusions and its implications for psychological interventions. The first part of the talk will cover research on the link between negative affect and delusions. Using a variety of designs, including longitudinal surveys, experimental and experience-sampling methods this research clearly demonstrates that negative affect precedes, accompanies and follows delusions. It has also shown that interventions that are successful in reducing negative affect tend to attenuate delusions as well. Taken together, this research renders support to the notion of a causal role of negative affect for delusion formation and maintenance. The second part will introduce two lines of research that are exploring the exact mechanisms that link negative affect to delusions. One possibility is that delusions arise from a failure to downregulate negative affect. Indeed, patients with delusions report to use fewer ‘functional’ affect regulation strategies (e.g., reappraisal). They also show a lower heart rate variability, a physiological indicator of affect regulation difficulties. Another possibility is that delusions stem from difficulties in emotional learning. This view is indirectly supported by experimental studies showing heightened fear responses to neutral faces in patients with delusions, indicating a tendency to overgeneralize and by self-reported safety behaviour, pointing to a maintaining role of avoidance.

Although these lines of research are still in their early stages, they already promise novel opportunities for intervention. These will be discussed in the last part of the talk. They include training of specific affect regulation strategies or enabling corrective social experiences. Novel technology could be used to enhance the effectiveness of this approaches, for example by prompting 35 2021 Congress of the Schizophrenia International Research Society the use of emotion regulation strategies in daily life or by creating virtual social learning environments to promote emotional learning.

The Identification of Cross-Cultural Causes of Mental Illness and How to Address This in Mental Health Care with Focus on Psychosis

Presenter
Kwame McKenzie | Canada

The Identification of Cross-Cultural Causes of Mental Illness and How to Address this in Mental Health Care with Focus on Psychosis

Abstract

The literature has detailed differences in the rate of psychosis for racial and cultural groups in high income countries. For instance; in the UK, some racialized groups including people of African and Caribbean heritage and those with South Asian origins have been shown to be at higher risk of psychosis than the White British population.

There has been significant investigation of the possible causes for these increased incidence rates. This work has contributed to the renaissance in research into how social factors may influence psychosis risk. Complex and intriguing multi-level and life course perspectives on causation have led to integrative theories. These have included, but are not limited to concepts such as gene environment interaction, neurogenesis and inflammation as pathways through which social inequities, adverse childhood experiences, stress and perceived racism get under the skin. There has also been consideration of the role of possible psychosis risk indicators such as stress reactivity among other concepts.

There has, however, been less consideration about what can be done to decrease disparities in incidence of psychosis.

In both wave 1 and wave 2 of the covid-19 pandemic, high income countries have reported higher rates of infection, hospitalizations and death for racialized groups. Black populations and those of South Asian origin have again been among the groups reported at higher risk. Similar to the psychosis literature, there has been significant discussion and investigation of possible causes of the disparities. Again, the role of social factors has been considered. The literature suggests that increased covid-19 risks for certain racialised populations may be because of at least four reasons:

1) increased risk of exposure to covid-19 because they are more likely to be essential workers and are more likely to be mobile; 2) decreased ability to protect themselves from covid-19 because they are less able to follow public health guidelines; for instance people who are lower income and live in over crowded homes are 43 2021 Congress of the Schizophrenia International Research Society less able to physically distance; 3) increased risk of serious impacts of infection because of existing higher rates of chronic illnesses such as diabetes (which are in part linked to social factors) and poorer access to healthcare during a pandemic; and, 4) risks linked to the disproportionate impacts of the pandemic-related economic downturn. But one difference in the covid-19 pandemic has been the number of places where the evidence of disparities has been used to develop multi-level interventions to both decrease disparities in illness rates and improve outcomes.

This presentation will explore how the identification of racial disparities in covid-19 infection in Toronto, Ontario led to a complex policy and practice intervention to promote equity and will discuss what we can learn from this about how to address the cross cultural causes of psychosis.

Early Life Stress – Implications for Risk Trajectories in Psychiatry

Presenter
Elisabeth Binder | Germany

The Role of Genetics in Clinical Practice for Treatment of Schizophrenia

Abstract

The literature has detailed differences in the rate of psychosis for racial and cultural groups in high income countries. For instance; in the UK, some racialized groups including people of African and Caribbean heritage and those with South Asian origins have been shown to be at higher risk of psychosis than the White British population.

There has been significant investigation of the possible causes for these increased incidence rates. This work has contributed to the renaissance in research into how social factors may influence psychosis risk. Complex and intriguing multi-level and life course perspectives on causation have led to integrative theories. These have included, but are not limited to concepts such as gene environment interaction, neurogenesis and inflammation as pathways through which social inequities, adverse childhood experiences, stress and perceived racism get under the skin. There has also been consideration of the role of possible psychosis risk indicators such as stress reactivity among other concepts.

There has, however, been less consideration about what can be done to decrease disparities in incidence of psychosis.

In both wave 1 and wave 2 of the covid-19 pandemic, high income countries have reported higher rates of infection, hospitalizations and death for racialized groups. Black populations and those of South Asian origin have again been among the groups reported at higher risk. Similar to the psychosis literature, there has been significant discussion and investigation of possible causes of the disparities. Again, the role of social factors has been considered. The literature suggests that increased covid-19 risks for certain racialised populations may be because of at least four reasons:

1) increased risk of exposure to covid-19 because they are more likely to be essential workers and are more likely to be mobile; 2) decreased ability to protect themselves from covid-19 because they are less able to follow public health guidelines; for instance people who are lower income and live in over crowded homes are 43 2021 Congress of the Schizophrenia International Research Society less able to physically distance; 3) increased risk of serious impacts of infection because of existing higher rates of chronic illnesses such as diabetes (which are in part linked to social factors) and poorer access to healthcare during a pandemic; and, 4) risks linked to the disproportionate impacts of the pandemic-related economic downturn. But one difference in the covid-19 pandemic has been the number of places where the evidence of disparities has been used to develop multi-level interventions to both decrease disparities in illness rates and improve outcomes.

This presentation will explore how the identification of racial disparities in covid-19 infection in Toronto, Ontario led to a complex policy and practice intervention to promote equity and will discuss what we can learn from this about how to address the cross cultural causes of psychosis.

Removing the Reliability Bottleneck in Functional Magnetic Resonance Imaging Research to Achieve Clinical Utility

Presenter
Michael Milham | United States

The Reliability and Reproducibility of Scientific Findings as New Guidelines are based on These Findings

Abstract

Functional MRI (fMRI) investigators have long sought to inform psychiatric research and practice. First, through developing a better scientific understanding of normative human brain development, the perturbations that lead to mental illness, and the impact of therapeutic interventions. Such knowledge can inform clinical nosology and decision making, as well as help identify critical periods for intervention and prevention. Secondly, by developing clinical applications of fMRI that can guide individual-specific decisions (e.g., diagnosis, prognosis, treatment selection) and interventions (e.g., imaging-guided brain stimulation). While these goals once seemed unattainable, the maturation of fMRI techniques has brought the measurement of individual-level differences – a critical prerequisite – within reach. This plenary will identify and discuss four critical gaps in efforts to achieve clinical utility, which if not corrected, can jeopardize the progress of psychiatric fMRI research.

Typical Brain Development during Prenatal and Early Life and Pathways to Psychotic Disorders: A Population-Based Perspective

Presenter
Tonya White | Netherlands

The Relevance of Normal Brain Development in Children and Adolescence for Schizophrenia in Adulthood and its Relationship to Psychotic Experiences

Abstract

The core symptoms of schizophrenia typically emerge during late adolescence and early adulthood and there is considerable evidence that the emerging symptoms are nested within neurodevelopment processes that take place earlier in development. However, many questions remain regarding at what stage during typical brain development do the deviations take place in those who begin showing prodromal or more severe symptoms of schizophrenia. Large population-based studies provide the opportunity to study trajectories of brain development, including premorbid and early prodromal measures of brain structure and function. The goal of this presentation is to provide an overview of the neuroimaging and behavioral component of the Generation R Study, which is a large epidemiological study of child development. The role of population-based neuroimaging studies in better understanding emerging psychopathology will be discussed. In addition, there will be a focus on typical development during fetal and early life and one potential pathway to the development of psychotic disorders that could potentially be translated into primary prevention. Put on your seat belt for this talk, it’ll be fun.

Bridging Implementation Science and Learning Healthcare in Early Psychosis Treatment Systems

Presenters
Lisa Dixon | United States
Moving Early Psychosis Intervention from Research to On-The-Ground Community Practice

Robert K. Heinssen | United States
Cultivating a National Learning Healthcare Network in Early Psychosis Intervention

Abstract

This session truly aligns with the theme of this year’s meeting “Bringing Precision Medicine to Mental Health Services”. Both presentation focus on how evidence based research findings can find their way to outside of the academic research clinics, to reach surrounding communities. Dr. Dixon will discuss successful strategies and pitfalls of how implementation science can help a statewide adoption of an evidence based early psychosis program in New York State. Dr. Heinssen will introduce the concept of learning healthcare and the Early Psychosis Intervention Network (EPINET). These initiatives show the power of working together – researchers, clinicians, service users and their families – and standardization to improve health care and stimulate research.

Workshops

Diversity and SIRS: Future Directions and the Hills to Climb

Chair
Sohee Park | United States

Moderator
Kim Do | Switzerland

Presenters
Regional Diversity Survey: How Well is SIRS Known to Outside the Western Developed World?
Jun Miyata | Japan
Nicolas Crossley | Chile

Behind the Veil of Schizophrenia Research in Asia
Sara-Ann Lee | Singapore
Eric Tan | Australia

Women in Academic Psychiatry: Breaking Through Barriers and Implicit Systemic Bias
Lynn DeLisi | United States

Racial Disparities in Clinical Trials
Kia Crittenden-Ward | United States
Margaret Niznikiewicz | United States

An Update on Progress in Schizophrenia Research in Africa
Lebogang Phahladira | South Africa

Abstract

The Diversity Task Force (DTF) aims to prioritize diversity and inclusivity as essential core values of SIRS and to support multicultural perspectives. In this second DTF workshop, we highlight diverse and innovative approaches to achieving progress in global mental health research and addressing ethnic and gender disparities on multiple levels.

  1. Drs. Jun Miyata and Nicolas Crossley will describe their efforts to implement large international research networks and offer insight gained from multinational collaborations.
  2. Drs. Eric Tan and Sara Ann Lee will depict the state of the psychosis research in Asia and draw attention to the challenges facing Asian scientists and clinicians.
  3. Dr. Lebogang Phahladira will provide an overview of the current state of psychosis research in the sub-Saharan Africa, with a specific focus on South Africa.
  4. Dr. Lynn DeLisi will highlight the prevalence of gender bias in science and barriers that prevent women from breaking the glass ceiling.
  5. Drs. Kia Crittenden and Margaret Niznikiewicz will discuss the importance of engaging women and minorities in clinical trials and evaluate potential strategies to improve inclusivity.

After these presentations, we will invite the audience for discussions moderated by Drs Mary Cannon and Kim Do. We have much to learn and benefit from the work conducted around the world by all stakeholders including researchers, clinicians, educators, as well as persons with lived experiences. Enhanced diversity of ideas, expertise and resources through open dialogues, exchanges and collaborations at SIRS will facilitate progress in the field.

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