Cognition and violent behavior in psychotic disorders: A nationwide case-control study

J. Lamsma; W. Cahn; S. Fazel; Genetic Risk and Outcome of Psychosis (GROUP) investigators

doi:10.1016/j.scog.2019.100166

Cognition and violent behavior in psychotic disorders: A nationwide case-control study

J. Lamsma
, W. Cahn
, S. Fazel
, Genetic Risk and Outcome of Psychosis (GROUP) investigators

Research output: Contribution to Journal › Article › Academic › peer-review

Abstract

Background: The excess risk of violence in psychotic disorders may partly be explained by impairments in executive functions (EFs) and theory of mind (ToM). However, previous studies have been limited by composite measures of EFs and small samples of inpatients.
Methods: Data were collected for the research project Genetic Risk and Outcome of Psychosis (GROUP). Patients with psychotic disorders (N = 891) were recruited from various care settings in the Netherlands. The following neuropsychological tests were administered (targeted cognitive function in parentheses): (i) Continuous Performance Test-HQ (inhibition); (ii) Response Shifting Task (cognitive flexibility); (iii) Wechsler Adult Intelligence Scale, Third Edition (WAIS-III) Block Design subtest (fluid intelligence); (iv) Neuropsychological Assessment Battery (NAB) Mazes Test (planning); (v) Degraded Facial Affect Recognition Task (affective ToM); and (vi) Hinting Task (cognitive ToM). Lifetime violence was ascertained from medical records and patient interviews. We used analysis of covariance to compare the mean scores of violent and nonviolent patients on each test, adjusting for age and sex.
Results: Violent patients performed significantly worse than nonviolent patients on the WAIS-III Block Design subtest (F [1, 847] = 5.12, p = .024), NAB Mazes Test (F [1, 499] = 5.32, p = .022) and Hinting Task (F [1, 839] = 9.38, p = .002). For the other tests, the between-group differences were nonsignificant. Violent behavior explained no more than 1% of the variance in performance on each test.
Conclusion: Impairments in EFs and ToM are unlikely to provide useful targets for risk assessment and interventions.

Original language	English
Article number	100166
Pages (from-to)	1-6
Number of pages	6
Journal	Schizophrenia Research: Cognition
Volume	19
Early online date	31 Oct 2019
DOIs	https://doi.org/10.1016/j.scog.2019.100166
Publication status	Published - Mar 2020
Externally published	Yes

Funding

The GROUP project was supported by the Geestkracht program of The Netherlands Organization for Health Research and Development (grant number 10-000-1001 ) and matching funds from the coordinating university medical centers (i.e. Academic Medical Center, Maastricht University Medical Center+, University Medical Center Groningen and University Medical Center Utrecht), their affiliated mental health care institutions (i.e. Altrecht, Arkin, Delta, Dimence, Dijk en Duin, Erasmus University Medical Center, GGNet, GGZ Breburg, GGZ Centraal, GGZ Drenthe, GGZ Eindhoven en De Kempen, GGZ Friesland, GGZ inGeest, Mondriaan, GGZ Noord-Holland-Noord, GGZ Oost-Brabant, GGZ Overpelt, GGZ Rivierduinen, Lentis, Mediant GGZ, Met GGZ, Parnassia Psycho-Medical Center, Psychiatric Center Ziekeren, Psychiatric Hospital Sancta Maria, Public Center for Mental Health Rekem, The Collaborative Antwerp Psychiatric Research Institute, Vincent van Gogh voor Geestelijke Gezondheid, Virenze riagg, University Psychiatric Center Sint Jozef, Yulius, and Zuyderland GGZ) and participating pharmaceutical companies (i.e. Lundbeck, AstraZeneca, Eli Lilly and Janssen Cilag). JL received funding from the Prins Bernhard Cultuurfonds and Dr. Hendrik Muller Fonds . SF was funded by a Wellcome Trust Senior Research Fellowship in Clinical Science ( 202836/Z/16/Z ). The funders had no role in study design, data collection and analysis, decision to publish or preparation of the manuscript.

Funders	Funder number
Geestkracht program of The Netherlands Organization for Health Research and Development
Universiteit Maastricht
Geestkracht program
H. Lundbeck A/S
Prins Bernhard Cultuurfonds
GGZ Friesland
GGZ InGeest
Academisch Medisch Centrum
Eli Lilly and Janssen Cilag
Metropolitan Museum of Art
Universitair Medisch Centrum Groningen
Rivierduinen
Gogh voor Geestelijke Gezondheid
Aids Fonds
Zuyderland GGZ
Public Center for Mental Health Rekem
Senior Research Fellowship in Clinical Science
Erasmus Universitair Medisch Centrum Rotterdam
AstraZeneca
Delta
Wellcome Trust	202836/Z/16/Z, 202836
The Netherlands Organization for Health Research and Development	10-000-1001

UN SDGs

This output contributes to the following UN Sustainable Development Goals (SDGs)

SDG 5 Gender Equality
SDG 16 Peace, Justice and Strong Institutions

Access to Document

10.1016/j.scog.2019.100166

Persistent URL (handle)

Persistent link

Cite this

@article{f3116ed762a44189ae99aee2f442fc17,

title = "Cognition and violent behavior in psychotic disorders: A nationwide case-control study",

abstract = "Background: The excess risk of violence in psychotic disorders may partly be explained by impairments in executive functions (EFs) and theory of mind (ToM). However, previous studies have been limited by composite measures of EFs and small samples of inpatients. Methods: Data were collected for the research project Genetic Risk and Outcome of Psychosis (GROUP). Patients with psychotic disorders (N = 891) were recruited from various care settings in the Netherlands. The following neuropsychological tests were administered (targeted cognitive function in parentheses): (i) Continuous Performance Test-HQ (inhibition); (ii) Response Shifting Task (cognitive flexibility); (iii) Wechsler Adult Intelligence Scale, Third Edition (WAIS-III) Block Design subtest (fluid intelligence); (iv) Neuropsychological Assessment Battery (NAB) Mazes Test (planning); (v) Degraded Facial Affect Recognition Task (affective ToM); and (vi) Hinting Task (cognitive ToM). Lifetime violence was ascertained from medical records and patient interviews. We used analysis of covariance to compare the mean scores of violent and nonviolent patients on each test, adjusting for age and sex. Results: Violent patients performed significantly worse than nonviolent patients on the WAIS-III Block Design subtest (F [1, 847] = 5.12, p = .024), NAB Mazes Test (F [1, 499] = 5.32, p = .022) and Hinting Task (F [1, 839] = 9.38, p = .002). For the other tests, the between-group differences were nonsignificant. Violent behavior explained no more than 1\% of the variance in performance on each test. Conclusion: Impairments in EFs and ToM are unlikely to provide useful targets for risk assessment and interventions.",

author = "J. Lamsma and W. Cahn and S. Fazel and \{Genetic Risk and Outcome of Psychosis (GROUP) investigators\}",

year = "2020",

month = mar,

doi = "10.1016/j.scog.2019.100166",

language = "English",

volume = "19",

pages = "1--6",

journal = "Schizophrenia Research: Cognition",

issn = "2215-0013",

publisher = "Elsevier Inc.",

}

TY - JOUR

T1 - Cognition and violent behavior in psychotic disorders

T2 - A nationwide case-control study

AU - Lamsma, J.

AU - Cahn, W.

AU - Fazel, S.

AU - Genetic Risk and Outcome of Psychosis (GROUP) investigators

PY - 2020/3

Y1 - 2020/3

N2 - Background: The excess risk of violence in psychotic disorders may partly be explained by impairments in executive functions (EFs) and theory of mind (ToM). However, previous studies have been limited by composite measures of EFs and small samples of inpatients. Methods: Data were collected for the research project Genetic Risk and Outcome of Psychosis (GROUP). Patients with psychotic disorders (N = 891) were recruited from various care settings in the Netherlands. The following neuropsychological tests were administered (targeted cognitive function in parentheses): (i) Continuous Performance Test-HQ (inhibition); (ii) Response Shifting Task (cognitive flexibility); (iii) Wechsler Adult Intelligence Scale, Third Edition (WAIS-III) Block Design subtest (fluid intelligence); (iv) Neuropsychological Assessment Battery (NAB) Mazes Test (planning); (v) Degraded Facial Affect Recognition Task (affective ToM); and (vi) Hinting Task (cognitive ToM). Lifetime violence was ascertained from medical records and patient interviews. We used analysis of covariance to compare the mean scores of violent and nonviolent patients on each test, adjusting for age and sex. Results: Violent patients performed significantly worse than nonviolent patients on the WAIS-III Block Design subtest (F [1, 847] = 5.12, p = .024), NAB Mazes Test (F [1, 499] = 5.32, p = .022) and Hinting Task (F [1, 839] = 9.38, p = .002). For the other tests, the between-group differences were nonsignificant. Violent behavior explained no more than 1% of the variance in performance on each test. Conclusion: Impairments in EFs and ToM are unlikely to provide useful targets for risk assessment and interventions.

AB - Background: The excess risk of violence in psychotic disorders may partly be explained by impairments in executive functions (EFs) and theory of mind (ToM). However, previous studies have been limited by composite measures of EFs and small samples of inpatients. Methods: Data were collected for the research project Genetic Risk and Outcome of Psychosis (GROUP). Patients with psychotic disorders (N = 891) were recruited from various care settings in the Netherlands. The following neuropsychological tests were administered (targeted cognitive function in parentheses): (i) Continuous Performance Test-HQ (inhibition); (ii) Response Shifting Task (cognitive flexibility); (iii) Wechsler Adult Intelligence Scale, Third Edition (WAIS-III) Block Design subtest (fluid intelligence); (iv) Neuropsychological Assessment Battery (NAB) Mazes Test (planning); (v) Degraded Facial Affect Recognition Task (affective ToM); and (vi) Hinting Task (cognitive ToM). Lifetime violence was ascertained from medical records and patient interviews. We used analysis of covariance to compare the mean scores of violent and nonviolent patients on each test, adjusting for age and sex. Results: Violent patients performed significantly worse than nonviolent patients on the WAIS-III Block Design subtest (F [1, 847] = 5.12, p = .024), NAB Mazes Test (F [1, 499] = 5.32, p = .022) and Hinting Task (F [1, 839] = 9.38, p = .002). For the other tests, the between-group differences were nonsignificant. Violent behavior explained no more than 1% of the variance in performance on each test. Conclusion: Impairments in EFs and ToM are unlikely to provide useful targets for risk assessment and interventions.

UR - https://www.scopus.com/pages/publications/85074506044

UR - https://www.scopus.com/pages/publications/85074506044#tab=citedBy

U2 - 10.1016/j.scog.2019.100166

DO - 10.1016/j.scog.2019.100166

M3 - Article

SN - 2215-0013

VL - 19

SP - 1

EP - 6

JO - Schizophrenia Research: Cognition

JF - Schizophrenia Research: Cognition

M1 - 100166

ER -

Cognition and violent behavior in psychotic disorders: A nationwide case-control study

Abstract

Funding

UN SDGs

Access to Document

Persistent URL (handle)

Other files and links

Fingerprint

Cite this