title: Behavioral response inhibition in psychotic disorders: diagnostic specificity, familiality and relation to generalized cognitive deficit.
abstract: Difficulty inhibiting context-inappropriate behavior is a common deficit in psychotic disorders. The diagnostic specificity of this impairment, its familiality, and its degree of independence from the generalized cognitive deficit associated with psychotic disorders remain to be clarified. Schizophrenia, schizoaffective and bipolar patients with history of psychosis (n=523), their available first-degree biological relatives (n=656), and healthy participants (n=223) from the multi-site B-SNIP study completed a manual Stop Signal task. A nonlinear mixed model was used to fit logistic curves to success rates on Stop trials as a function of parametrically varied Stop Signal Delay. While schizophrenia patients had greater generalized cognitive deficit than bipolar patients, their deficits were similar on the Stop Signal task. Further, only bipolar patients showed impaired inhibitory control relative to healthy individuals after controlling for generalized cognitive deficit. Deficits accounted for by the generalized deficit were seen in relatives of schizophrenia and schizoaffective patients, but not in relatives of bipolar patients. In clinically stable patients with psychotic bipolar disorder, impaired inhibitory behavioral control was a specific cognitive impairment, distinct from the generalized neuropsychological impairment associated with psychotic disorders. Thus, in bipolar disorder with psychosis, a deficit in inhibitory control may contribute to risk for impulsive behavior. Because the deficit was not familial in bipolar families and showed a lack of independence from the generalized cognitive deficit in schizophrenia spectrum disorders, it appears to be a trait related to illness processes rather than one tracking familial risk factors.
authors.affiliation: Department of Psychiatry, UT Southwestern Medical Center, Dallas, TX, United States.
authors.forename: Lauren E
authors.initials: LE
authors.lastname: Ethridge
authors.affiliation: Department of Psychiatry, UT Southwestern Medical Center, Dallas, TX, United States.
authors.forename: Melanie
authors.initials: M
authors.lastname: Soilleux
authors.affiliation: Department of Psychiatry, UT Southwestern Medical Center, Dallas, TX, United States; Department of Clinical Sciences, Division of Biostatistics, UT Southwestern Medical Center, Dallas, TX, United States.
authors.forename: Paul A
authors.initials: PA
authors.lastname: Nakonezny
authors.affiliation: Department of Psychiatry, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States; Department of Behavioral Sciences, Feinberg School of Medicine, Northwestern University, Chicago, IL, United States.
authors.forename: James L
authors.initials: JL
authors.lastname: Reilly
authors.affiliation: Department of Psychology, Rosalind Franklin University, North Chicago, IL, United States.
authors.forename: S Kristian
authors.initials: SK
authors.lastname: Hill
authors.affiliation: Department of Psychiatry, Duke University Medical Center, Durham, NC, United States; Department of Behavioral Sciences, Duke University Medical Center, Durham, NC, United States.
authors.forename: Richard S E
authors.initials: RS
authors.lastname: Keefe
authors.affiliation: Department of Psychiatry, University of Chicago, Chicago, IL, United States.
authors.forename: Elliot S
authors.initials: ES
authors.lastname: Gershon
authors.affiliation: Olin Neuropsychiatry Research Center, Institute of Living, Hartford, CT, United States; Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States; Department of Neurobiology, Yale University School of Medicine, New Haven, CT, United States.
authors.forename: Godfrey D
authors.initials: GD
authors.lastname: Pearlson
authors.affiliation: Department of Psychiatry, UT Southwestern Medical Center, Dallas, TX, United States.
authors.forename: Carol A
authors.initials: CA
authors.lastname: Tamminga
authors.affiliation: Department of Psychiatry, Beth Israel Deaconness Medical Center, Harvard University, Boston, MA, United States.
authors.forename: Matcheri S
authors.initials: MS
authors.lastname: Keshavan
authors.affiliation: Department of Psychiatry, UT Southwestern Medical Center, Dallas, TX, United States; Department of Pediatrics, UT Southwestern Medical Center, Dallas, TX, United States. Electronic address: John.Sweeney@UTSouthwestern.edu.
authors.forename: John A
authors.initials: JA
authors.lastname: Sweeney
mesh_terms: D000328:Adult; D001714:Bipolar Disorder / Q000150:complications / Q000175:diagnosis / Q000235:genetics / Q000503:physiopathology*; D003072:Cognition Disorders / Q000175:diagnosis / Q000209:etiology / Q000235:genetics / Q000503:physiopathology*; D005190:Family; D005260:Female; D020022:Genetic Predisposition to Disease; D006801:Humans; D007266:Inhibition, Psychological; D008297:Male; D008875:Middle Aged; D011618:Psychotic Disorders / Q000150:complications / Q000175:diagnosis / Q000235:genetics / Q000503:physiopathology*; D012559:Schizophrenia / Q000150:complications / Q000175:diagnosis / Q000235:genetics / Q000503:physiopathology*
keywords: Family study; Psychotic bipolar disorder; Response inhibition; Schizophrenia; Stop signal