The drive to play extraordinary social roles and schizotypy: a two-part study

Schizophrenia is a neuropsychiatric disorder that affects roughly 1% of the general population in Canada, with a yearly financial burden of nearly 2 billion dollars. Debilitating symptoms such as delusions of grandeur are frequently seen in schizophrenia, but exist to a lesser extent in the general population. These grandiose delusions might reveal a drive to play extraordinary roles. The cognitive and behavioral strategies associated with such drives may conflict with those involved in playing ordinary roles, which could contribute to the symptomatology of schizophrenia. Thus, the aim of the first study was to test if the will to play extraordinary roles in healthy participants could predict some schizophrenia-like traits. 209 healthy volunteers between the ages of 18 and 30 were recruited to fill out questionnaires assessing schizotypal traits, including the schizotypal personality questionnaire (SPQ). They were then presented with hundreds of names of social roles and asked to decide, for each role, whether or not they would consider playing it at any moment of their lives (social roles task). Our results indicated that the participants who accepted a greater percentage of the extraordinary roles, regardless of the favorability of these roles, also had higher SPQ scores. This correlation was significantly greater than the correlation between the percentages of ordinary roles accepted and the SPQ scores. Among the three factors of the SPQ, disorganization was the one best predicted. Considering our first study was correlational, we sought to identify the causal effects of two factors: schizotypy and number of extraordinary roles (NSER). Given that antipsychotic medications decrease schizophrenia symptoms, we used them to test whether they also decreased the acceptance of extraordinary roles or whether these medications left acceptances intact. Thus, in the second study, two different antipsychotics (AP) were given at minimal doses to individuals in order to reduce the symptoms of schizotypy. Event-related brain potentials (ERPs) were recorded to verify that this small AP dose had an effect on cognitive processes. A total of 110 participants, between 18 and 30 years old, were recruited to fill out the SPQ. However, only 104 individuals were administered placebo, risperidone, or olanzapine followed by the social roles task with simultaneous EEG recording before and during the effect of the medications. The participants were divided into a low- and high- SPQ scorers and low- and high- acceptors of extraordinary roles group. Our findings demonstrated that risperidone did not significantly reduce the NESR when considering schizotypy groups. Alternatively, in acceptor groups, high-acceptors accepted more extraordinary roles with risperidone, particularly extraordinary favorable roles. Also, risperidone delayed response times of high-acceptors. In the time window of the N400 component, antipsychotics boosted the N400 potential in the low- but not the high- SPQ scorers, and did not significantly affect acceptor groups differentially. In the time window of the P600 component, risperidone drove the P600 to be more positive in both in low- and high- SPQ scorers. In light of our findings, small doses of antipsychotics likely had an impact on the drive to engage in social roles as well as brain functioning. Future studies should examine the propensity to accept extraordinary social roles in medicated psychotic patients, despite the lessening of delusional symptoms. This would confirm that clinical symptoms are not the cause of the propensity. Finally, the effects of antipsychotic pharmacotherapy on schizophrenia patients should be further examined using novel social paradigms that accurately model their symptoms and delusions.

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