title: Self-monitoring as a familial vulnerability marker for psychosis: an analysis of patients, unaffected siblings and healthy controls.
abstract: BACKGROUND
  Alterations in self-monitoring have been reported in patients with psychotic disorders, but it remains unclear to what degree they represent true indicators of familial vulnerability for psychosis.
  
  
  METHODS
  An error-correction action-monitoring task was used to examine self-monitoring in 42 patients with schizophrenia, 32 of their unaffected siblings and 41 healthy controls.
  
  
  RESULTS
  Significant between-group differences in self-monitoring accuracy were found (χ2=29.3, p<0.0001), patients performing worst and unaffected siblings performing at an intermediate level compared to controls (all between-group differences p<0.05). In the combined group of healthy controls and unaffected siblings, detection accuracy was associated with positive schizotypy as measured by the Structured Interview for Schizotypy - Revised (SIS-R) (β=-0.16, s.e.=0.07, p=0.026), but not with negative schizotypy (β=-0.05, s.e.=0.12, p=0.694). In patients, psychotic symptoms were not robustly associated with detection accuracy (β=-0.01, s.e.=0.01, p=0.094), although stratified analysis revealed suggestive evidence for association in patients not currently using antipsychotic medication (β=-0.03, s.e.=0.01, p=0.052), whereas no association was found in patients on antipsychotic medication (β=-0.01, s.e.=0.01, p=0.426). A similar pattern of associations was found for negative symptoms.
  
  
  CONCLUSIONS
  Alterations in self-monitoring may be associated with familial risk and expression of psychosis. The association between psychotic symptoms and self-monitoring in patients may be affected by antipsychotic medication, which may explain previous inconsistencies in the literature.
authors: Department of Psychiatry and Psychology, School of Mental Health and Neuroscience, Maastricht University Medical Centre, The Netherlands.
authors: J
authors: J
authors: Hommes
authors: Department of Psychology and Education, VU University of Amsterdam, The Netherlands.
authors: L
authors: L
authors: Krabbendam
authors: Foundation for Equal Opportunities, University of Antwerp, Belgium.
authors: D
authors: D
authors: Versmissen
authors: Department of Psychiatry and Psychotherapy, University of Marburg, Germany.
authors: T
authors: T
authors: Kircher
authors: Department of Psychiatry and Psychology, School of Mental Health and Neuroscience, Maastricht University Medical Centre, The Netherlands.
authors: J
authors: J
authors: van Os
authors: Department of Psychiatry and Psychology, School of Mental Health and Neuroscience, Maastricht University Medical Centre, The Netherlands.
authors: R
authors: R
authors: van Winkel
mesh_terms: D000328:Adult; D015415:Biomarkers; D056344:Executive Function / Q000502:physiology*; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D008297:Male; D011597:Psychomotor Performance / Q000502:physiology*; D011618:Psychotic Disorders / Q000235:genetics / Q000503:physiopathology*; D012569:Schizotypal Personality Disorder / Q000235:genetics / Q000503:physiopathology; D035781:Siblings
chemical_list: D015415:Biomarkers