Estilo atribucional en esquizofrenia

Attributional style in schizophrenia


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Definition of Attributional Style in Schizophrenia

The attributional style is one of the areas that integrate the social cognition construct in the field of schizophrenia. It refers to how individuals come to infer the possible causes of both positive and negative personal events (Green and Horan, 2010).

As referred by Penn, Sanna and Roberts (2008), most of the research that has focused on the study of the attributional style in the case of schizophrenia has tried to investigate the genesis and maintenance of the paranoid symptomatology that some of these people sometimes present.

Attributional style assessment in schizophrenia

The following tests are commonly used for the assessment of attributional style in schizophrenia::

Attributional Style Questionnaire (ASQ) (Peterson et al, 1982)

This test evaluates the three basic dimensions of attributional style which are called: place (internal-external), stability (stable-stable) and globality (globality-specificity). The instrument is composed of 36 items corresponding to 12 situations (six positive and six negative). Once the subjects are exposed to these scenarios, they are asked to evaluate them in relation to each of the three dimensions of attribution.

Internal, Personal and Situational Attribution Questionnaire (IPAQ) (Kinderman and Bentall, 1996)

The aim of this test is to observe the ability of the subject being assessed to discriminate between personal external attributes (causes attributed to other people), situational external attributes (causes attributed to situational factors) and internal attributes (causes that are due to oneself) in a total of 32 hypothetical situations, half of which are positive and half negative.

The Ambiguous Intentions Hostility Questionnaire (AIHQ) (Combs, Penn, Wicher y Waldheter, 2007)

This instrument measures attributional style by analyzing the subject’s potential tendency to overattribute negative intentions to others and to respond to those intentions in a hostile manner. During the test, a series of vignettes describing different social situations are shown, and then the subject is asked about the intentions of the characters and the response they would give to these situations if they were presented to them

Deficits in schizophrenia

Individuals diagnosed with schizophrenia who have paranoid symptoms often tend to blame others for the negative events that happen to them. This attributional style is known as “personalization bias” (Bentall, Corcoran, Howard, Blackwood, & Kinderman, 2001; Garety & Freeman, 1999).

Factors

According to Bentall et al (2001) there would be two factors that would negatively influence whether a person diagnosed with schizophrenia with paranoid symptoms would be able to correct their “personalization biases”.

  1. The first one would be marked by a strong tendency to “close” before the options that discredit the guilt of the other, aspect that would be expressed in behaviors marked by intolerance or ambiguity.
  2. The second would have to do with the presence of deficits in the theory of mind, understood as the individual’s ability to infer mental states from others such as intentions, dispositions and beliefs (Green and Horan, 2010).

It has also been found that people who suffer from paranoid symptoms show, apart from the mentioned “personalization bias”, other cognitive biases such as the tendency to “jump quickly to conclusions” and to “demonstrate the reality of their biases” (Freeman, 2007).

The attributional style of paranoid symptomatology is characterized by a tendency to exaggerate, distort or focus selectively on the hostile or threatening aspects of others (Fenigstein, 1997), with anger, disgust and contempt being the emotions usually associated with hostility (Barefoot, 1992; Brummett et al.) It should be remembered that, specifically in these emotions, it has been found to be more difficult for people diagnosed with schizophrenia to interpret them correctly (Kohler et al, 2003).

Neurological level

At the neurological level, different neuroimaging studies have shown that the hyperactivity found in the amygdala contributes to the deficits that these subjects show when judging the intentions of others (Marwick and Hall, 2008).

References

  • Barefoot, J. (1992). Development in the measurement of hostility. En H. Friedman (Ed), Hostility, coping and health (pp. 13-31). Washington, DC: American Psychological Association.
  • Bentall, R. P., Corcoran, R., Howard, R., Blackwood, N., y Kinderman, P. (2001). Persecutory delusions: a review and theoretical integration. Clinical Psychology Review, 21(8), 1143-1192
  • Brummett, B. H., Maynard, K. E, Babyak, M. A., Haney, T. L., Siegler, I. C., Helms, M. J., y Barefoot, J. C. (1998). Measures of hostility as predictor of facial affect during social interaction: evidence for construct validity. Annals of Behavioral Medicine, 20(3), 168-173.
  • Combs, D. R., Penn, D. L., Wicher, M., y Waldheter, E. (2007). The Ambiguous Intentions Hostility Questionnaire (AIHQ): a new measure for evaluating hostile social-cognitive biases in paranoia. Cognitive Neuropsychiatry, 12(2), 128-143.
  • Fenigstein, A. (1997). Paranoid thought and schematic processing. Journal of Social and Clinical Psychology, 16(1), 77-94
  • Freeman, D. (2007). Suspicious minds: the psychology of persecutory delusions. Clinical Psychological Review, 27(4), 425-467.
  • Garety, P. A., y Freeman, D. (1999). Cognitive approaches to delusions: a critical review of theories and evidence. British Journal of Clinical Psychology, 38(2), 113-154.
  • Green, M. F., y Horan, W. P. (2010). Social cognition in schizophrenia. Current Directions in Psychological Science, 19(4), 243-248.
  • Izard, C. (1994). Innate and universal facial expressions: evidence for development and cross-cultural research. Psychological Bulletin, 115(2), 288-299
  • Kinderman, P., y Bentall, R. P. (1996). A new measure of causal locus: the internal, personal and situational attributions questionnaire. Personality and Individual Differences, 20(2), 261-264.
  • Kohler, C. G., Turner, T. H., Bilker, W. B., Brensinger, C., Siegel, S. J., Kanes, S. J.,… y Gur, R. C. (2003). Facial emotion recognition in schizophrenia: intensity effects and error pattern. American Journal of Psychiatry, 160(10), 1768-1774.
  • Marwick, K., y Hall, J. (2008). Social cognition in schizophrenia: a review of face processing. British Medical Bulletin, 88(1), 43-58.
  • Penn, D. L., Sanna, L. J., y Roberts, D. L. (2008). Social Cognition in schizophrenia: an overview. Schizophrenia Bulletin, 34(3), 408-411
  • Peterson, C., Semmel, A., Von Baeyer, C., Abramsom, L. Y., Metalsky, G. I., y Seligman, M. E. P. (1982). The attributional style questionnaire. Cognitive Therapy and Research, 6(3), 287-299

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