S304 Abstracts of the 4th Biennial Schizophrenia International Research Conference / Schizophrenia Research 153, Supplement 1 (2014) S1–S384

confer vulnerability to addiction. Our objective was to identify a deficit in

schizophrenia patients on response to rewarding stimuli and see whether

this deficit predicts cannabis use.

Methods: 35 schizophrenia patients and 35 non-psychotic controls were

divided into cannabis users and non-users. Response to emotional and

cannabis-associated visual stimuli was assessed using self-report, event-

related potentials (using the late positive potential, LPP), motivated be-

haviour, facial electromyography, and skin-conductance response. Fre-

quency of cannabis self-administration over the prior month was assessed

on the test day and one month later.

Results: Schizophrenia-spectrum patients showed blunted LPP response to

pleasant stimuli compared to controls (p=0.003) and blunted reward seek-

ing of pleasant stimuli (p=0.046). Across measures, cannabis-using controls

showed significantly greater response to pleasant stimuli than to cannabis

stimuli whereas cannabis-using patients showed little bias towards pleasant

stimuli. More frequent subsequent cannabis use was predicted by blunted

LPP response to pleasant stimuli (beta = −0.24, p=0.034) and blunted reward

seeking of pleasant stimuli (beta = −0.34, p=0.006).

Discussion: Reward processing deficits identified in schizophrenia may

promote substance use and explain in part the common comorbidity of

these two disorders. The LPP in particular shows potential as a biomarker

related to schizophrenia which may be able to help identify patients at

risk of heavy cannabis use. Targeting reward processing deficits may be

a promising avenue in the development of interventions for reducing

cannabis use in schizophrenia.

Poster #T42

DURABILITY OF REINFORCEMENT LEARNING CHANGES AFTER COGNITIVE

REMEDIATION

Matteo Cella1,2, Anthony Bishara3, Clare Reeder2, Til Wykes1

1Department of Psychology, Institute of Psychiatry, Kings College London;2King’s College London; 3College of Charleston

Background: Converging evidence suggests that individuals with

schizophrenia show a marked impairment in reinforcement learning. Re-

cent research showed that cognitive remediation (CR) can improve reward

learning by altering sensitivity to reward and punishment. The aim of this

study is to explore whether these gains can be sustained once therapy is

finished and compare them to individuals assessed at the same intervals to

assess whether practice has effects.

Methods: Using computational modelling, two reinforcement learning pa-

rameters based on the Wisconsin Card Sorting Test (WCST) trial-by-trial

performance were estimated: R (reward sensitivity) and P (punishment sen-

sitivity). The durability of the cognitive remediation (CR) improvements on

these parameters was assessed 3-months after the end of therapy in a group

of individuals with schizophrenia who received CR (n=37) and compared to

a group receiving treatment-as-usual (TAU, n=34).Neuropsychological and

symptom assessments were also conducted.

Results: Individuals in the CR group showed a significant reduction in

both P and R gains at follow-up compared to TAU. In the CR group 14

participants maintained or improved in R levels at follow-up while 12

maintained or improved in P levels. Participants who maintain P levels had

higher premorbid and actual IQ at baseline and working memory levels at

follow-up compared to those who did not. The R retention sub-group was

not associated with any variable measured. Most individuals in the TAU

still failed to improve on both parameters at follow-up despite practice.

Discussion: Retaining reward learning gains after CR may be difficult if

patients are not provided with additional support. Despite overall group

worsening in the CR group about a third of the participants maintained R

and P gains without additional interventions. Punishment sensitivity gains

retention seems to be affected by IQ levels and working memory.

Poster #T43

AUTOMATIC SELF-STIGMA-RELEVANT ASSOCIATIONS IN PEOPLE WITH

SCHIZOPHRENIA EXPERIENCING HABITUAL SELF-STIGMA: EVIDENCE

FROM THE BRIEF IMPLICIT ASSOCIATION TESTS

Kevin K.S. Chan1, Winnie W.S. Mak2

1The Hong Kong Institute of Education; 2The Chinese University of Hong Kong,

Hong Kong

Background: While self-stigmatizing thoughts constitute a cognitive vul-

nerability factor for poor mental health, dysfunctional coping (i.e., expe-

riential avoidance and lack of mindfulness) with self-stigma may pose an

additional risk factor for this propensity by leading to frequent activation

of self-stigmatization, which may then make self-stigmatizing thinking

habitual and automatic (namely, a mental habit). This concept of habit-

ual self-stigma points to the importance of understanding the automatic,

implicit aspects of self-stigma. The present study aims to investigate the

possibility of a pattern of more automatic self-stigma-relevant associations

among people with schizophrenia having habitual self-stigma.

Methods: A community sample of 62 people with schizophrenia spectrum

or other psychotic disorder was recruited in Hong Kong. Habitual self-

stigma was assessed with the Self-stigmatizing Thinking’s Automaticity and

Repetition (STAR) scale. Considering that self-stigma refers to internalizing

the negative attributes associated with the mental illness (MI) identity for

the self, three different Brief Implicit Association Tests (BIATs) were used

to assess the automatic processing of the “self-MI” association (i.e., high

centrality of the MI identity to the self), the “MI-negative” association (i.e.,

negative attitudes toward MI), and the “self–negative” association (i.e., low

self-esteem).

Results: The automatic “self-MI” association (r=0.342, p=0.006), but not the

“MI-negative” association (r=0.196; p=0.126) and the “self-negative” asso-

ciation (r=−0.079; p=0.544), was correlated with stronger self-stigmatizing

thinking habit. Repetitive self-stigma (r=0.341, p=0.007) and automatic

self-stigma (r=0.324, p=0.01) were also correlated with more automatic

processing of the “self-MI” association.

Discussion: While there has been extensive research on the demographic,

clinical, and psychosocial correlates of self-stigma, there has been little

research on its cognitive or information-processing profile. This study pro-

vides a direct test of the relevance of automatic evaluation in understanding

the nature of automatic cognitive processing in habitual self-stigma. Our

findings suggest that the mental illness identity may be more central to

the self-definition of participants with stronger self-stigmatizing thinking

habit. The significant correlation between the STAR scale and the automatic

quality of response latencies in the BIAT strengthens the assumption that

the scale does have validity in reflecting cognitive processes that take place

automatically.

Poster #T44

THREE-YEAR OUTCOME COMPARISON BETWEEN PATIENTS PRESENTING

WITH FIRST-EPISODE PSYCHOTIC MANIA AND SCHIZOPHRENIA TO EASY

PROGRAM IN HONG KONG

Chung W. Chang1, Emily S.K. Lau2, L.M. Hui3, K.W. Chan3, H.M. Lee3, Eric

Y.H. Chen3

1Department of Psychiatry, The University of Hong Kong; 2Queen Mary

Hospital; 3The University of Hong Kong

Background: Early intervention for first-episode psychosis has been the fo-

cus of mental health care development worldwide in the past two decades.

A majority of previous research focused mainly either on outcomes of

a cohort of broad-spectrum psychotic disorders (first-episode psychosis)

or patients with a more specific diagnostic entity, mostly schizophrenia.

Despite the fact that bipolar affective disorder frequently occurs in late

adolescence or early adulthood, and is associated with poor long-term func-

tional impairment, relatively few studies have been conducted to examine

the early course of the illness. In this study, we aimed to compare the

3-year clinical and functional outcomes between first-episode psychotic

mania (FEPM) and first-episode schizophrenia (FES) in the context of early

intervention program in Hong Kong.

Methods: Four hundred-twenty patients aged 15 to 25 years presenting

with first-episode ICD-10 psychotic mania or schizophrenia to a territory-

wide early intervention service in Hong Kong, namely Early Assessment

Service for Young people with psychosis (EASY) between July 2001 and

August 2003 and completed 3-year follow-up were included in the study.

Socio-demographics, baseline and follow-up variables were obtained via

systematic retrospective medical record review following standardized pro-

tocol. Symptom (CGI-S) and functional outcome (SOFAS) measures were