Religious beliefs and practices are an important source of symptom relief for individuals with schizophrenia; however, it can also be a debilitating source of symptom exacerbation. This quantitative study examined the cognitions and religious life orientations of Christian individuals both with and without a diagnosis of schizophrenia, as measured by the Rust Inventory of Schizotypal Cognitions (RISC) and the Religious Life Inventory (RLI) to examine a baseline for healthy religious cognitions. The aberrant-salience and attribution theories were used to explore the relationship between psychotic stimuli and religious attributions. One hundred and thirty Christian individuals from an outpatient mental health facility, both with and without a diagnosis of schizophrenia completed the RISC and the RLI. A t-test showed that individuals with schizophrenia scored higher on average on the schizotypal cognitions continuum than individuals without a diagnosis. The results of an ANOVA indicated that individuals with a Quest religious life orientation rendered higher scores on the schizotypal cognitions scale. This research study showed that higher levels of schizotypal cognitions were associated with low religiosity. Overall, individuals with schizophrenia showed no difference in religiosity compared to individuals without schizophrenia. This study addressed the stigma of religious practice among individuals with schizophrenia. Results of this study have positive social implications for individuals with schizophrenia and their practitioners/clergy who incorporate religion as a coping method for symptom relief.

Résumé : Depuis la caractérisation de la schizophrénie, les cliniciens ont noté une sensibilité anormale à la douleur chez leurs patients. D’un autre côté, la littérature publiée sur le sujet est plutôt inconsistante concernant la nature du changement de douleur rapportée. Dans un effort pour mieux caractériser le profil de réponse à la douleur dans la schizophrénie, nous avons donné des stimulations nociceptives aiguës et prolongées (à répétition rapide; sommation temporelle) à des patients souffrant de schizophrénie et à des sujets sains. En mesurant le score de douleur subjective et la réponse du réflexe de flexion nociceptif en réponse à des stimulations électriques transcutanées, il a été possible d’évaluer la contribution des circuits spinaux à la douleur chez les patients et les sujets sains. Les résultats révèlent une sensibilité augmentée à la douleur aiguë chez les patients atteints de schizophrénie (i.e., un seuil de détection de la douleur plus bas que les sujets sains) mais aussi une diminution de la sommation temporelle de la douleur quand les stimuli se répètent fréquemment. Les différences intergroupes dans l’expérience subjective à la douleur n’étaient pas accompagnées d’une différence dans l’amplitude du réflexe nociceptif, suggérant ainsi une origine supra-spinale du phénomène observé. Il est intéressant de noter que les symptômes positifs de la schizophrénie étaient corrélés négativement avec les scores de seuil de douleur chez les patients atteints de schizophrénie, suggérant que les distorsions de la pensée et des fonctions peuvent être reliées à une augmentation de la sensibilité à la douleur aiguë dans la schizophrénie. Ces résultats suggèrent la présence d’un profil de sensibilité à la douleur unique chez les patients atteints de schizophrénie ayant des répercussions importantes pour les pratiques cliniques. // Abstract : Ever since the characterization of schizophrenia, clinicians have noted abnormal pain sensitivity in their patients. The published literature, however, is inconsistent concerning the nature of the change reported. In an effort to better characterize the pain response profile of schizophrenia patients, we provided both acute and prolonged (i.e., rapidly-repeating: temporal summation) painful stimuli to schizophrenia patients and healthy controls. By measuring subjective pain ratings and nociceptive flexion reflexes in response to transcutaneous electrical stimulations of the sural nerve, it was possible to evaluate the contribution of spinal circuits to pain in patients and controls. Results revealed increased sensitivity to acute pain in schizophrenia patients (i.e., lower pain detection thresholds for schizophrenia patients than for controls), but decreased temporal summation of pain when painful stimuli repeated frquently. Group differences in subjective experience were not accompanied by group differences in nociceptive flexion reflex activity, suggesting supra-spinal origins to the change in pain experienced by patients. Interestingly, positive symptoms correlated negatively with pain threshold values among patients, suggesting that distortions of thought and function relate to pain sensitivity in schizophrenia. These results indicate the presence of a unique pain response profile for schizophrenia patients which have important implications for clinical practice.

Due to abnormal functioning of the brain’s reward and prediction system patients with schizophrenia spectrum disorders are thought to assign salience to non-relevant objects and events and to form context-inappropriate associations. The brain’s ventral striatum is critical in the formation of associations, and aberrant associations are believed to create delusional content during psychosis. The study wanted to examine the neural response, particularly in the ventral striatum, combined with subjective reports as patients learn associations in an aversive Pavlovian conditioning paradigm. The stimuli were randomized and involved circles of different colors. The conditioned stimuli (CS+) was followed by an unconditioned stimuli (US), consisting of an unpleasant sound, in 50% of events. The unconditioned (CS-) stimuli was followed by a low, not unpleasant sound in 50% of events. The degree of striatal activation was thought to be associated with the severity of patient’s illness. Functional magnetic resonance imaging (fMRI) blood-oxygen-level dependent (BOLD) responses were examined in eleven unmedicated non-institutionalized patients with schizophrenia spectrum disorders and 15 matched healthy controls. No significant within group differences in neural or subjective response to the [CS+ > CS-] contrast were found. No significant associations between severity of illness and degree of striatal activation in response to CS+ or CS- were found. Significant differences in neural activation for the [CS+ > CS-] contrast were found in the ventral striatum, the right inferor frontal gyrus, and the right angular gyrus, with patients exhibiting stronger activation compared to controls. The results and implications are discussed along with suggestions for future research.

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