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Feller C, Ilen L, Eliez S, Schneider M. Social skills in neurodevelopmental disorders: a study using role-plays to assess adolescents and young adults with 22q11.2 deletion syndrome and autism spectrum disorders. J Neurodev Disord 2024; 16:11. [PMID: 38500028 PMCID: PMC11064408 DOI: 10.1186/s11689-024-09527-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2022] [Accepted: 03/08/2024] [Indexed: 03/20/2024] Open
Abstract
BACKGROUNDS Social skills are frequently impaired in neurodevelopmental disorders and genetic conditions, including 22q11.2 deletion syndrome (22q11DS) and autism spectrum disorders (ASD). Although often assessed with questionnaires, direct assessment provides a more valid estimate of the constructs. Role-plays (i.e., simulates situational settings) therefore appear to be an appropriate indicator of social skills in daily life. METHODS This co-registered study involved 53 individuals with 22q11DS, 34 individuals with ASD, and 64 typically developing (TD) peers aged 12-30 years. All participants were assessed with role-plays as well as parent-reported questionnaires and clinical interviews focusing on social skills, functioning and anxiety. RESULTS Both clinical groups showed impaired social skills compared to TD, but distinct social profiles emerged between the groups. Individuals with 22q11DS displayed higher social appropriateness and clarity of speech but weaker general argumentation and negotiation skills, with the opposite pattern observed in participants with ASD. No association was found between social skills measured by direct observation and caregiver reports. Social anxiety, although higher in clinical groups than in TD, was not associated with role-plays. CONCLUSIONS This study highlights the need to train social skills through tailored interventions to target the specific difficulties of each clinical population. It also highlights the importance of combining measures as they do not necessarily provide the same outcome.
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Affiliation(s)
- Clémence Feller
- Department of Psychology and Educational Sciences, Clinical Psychology Unit for Intellectual and Developmental Disabilities, Faculty of Psychology and Educational Sciences, University of Geneva, 40, Boulevard du Pont-d'Arve, 1205, Geneva, Switzerland.
| | - Laura Ilen
- Department of Psychology and Educational Sciences, Clinical Psychology Unit for Intellectual and Developmental Disabilities, Faculty of Psychology and Educational Sciences, University of Geneva, 40, Boulevard du Pont-d'Arve, 1205, Geneva, Switzerland
| | - Stephan Eliez
- Developmental Imaging and Psychopathology Lab Research Unit, Faculty of Medicine, University of Geneva, Geneva, Switzerland
- Department of Genetic Medicine and Development, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Maude Schneider
- Department of Psychology and Educational Sciences, Clinical Psychology Unit for Intellectual and Developmental Disabilities, Faculty of Psychology and Educational Sciences, University of Geneva, 40, Boulevard du Pont-d'Arve, 1205, Geneva, Switzerland
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Okruszek Ł, Jarkiewicz M, Piejka A, Chrustowicz M, Krawczyk M, Schudy A, Harvey PD, Penn DL, Ludwig K, Green MF, Pinkham AE. Loneliness is associated with mentalizing and emotion recognition abilities in schizophrenia, but only in a cluster of patients with social cognitive deficits. J Int Neuropsychol Soc 2024; 30:27-34. [PMID: 37154103 DOI: 10.1017/s1355617723000206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/10/2023]
Abstract
OBJECTIVE Loneliness is a concern for patients with schizophrenia. However, the correlates of loneliness in patients with schizophrenia are unclear; thus, the aim of the study is to investigate neuro- and social cognitive mechanisms associated with loneliness in individuals with schizophrenia. METHOD Data from clinical, neurocognitive, and social cognitive assessments were pooled from two cross-national samples (Poland/USA) to examine potential predictors of loneliness in 147 patients with schizophrenia and 103 healthy controls overall. Furthermore, the relationship between social cognition and loneliness was explored in clusters of patients with schizophrenia differing in social cognitive capacity. RESULTS Patients reported higher levels of loneliness than healthy controls. Loneliness was linked to increased negative and affective symptoms in patients. A negative association between loneliness and mentalizing and emotion recognition abilities was found in the patients with social-cognitive impairments, but not in those who performed at normative levels. CONCLUSIONS We have elucidated a novel mechanism which may explain previous inconsistent findings regarding the correlates of loneliness in individuals with schizophrenia.
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Affiliation(s)
- Ł Okruszek
- Social Neuroscience Lab, Institute of Psychology, Polish Academy of Sciences, Warsaw, Poland
| | - M Jarkiewicz
- Third Department of Psychiatry, Institute of Psychiatry and Neurology, Warsaw, Poland
| | - A Piejka
- Social Neuroscience Lab, Institute of Psychology, Polish Academy of Sciences, Warsaw, Poland
| | - M Chrustowicz
- Social Neuroscience Lab, Institute of Psychology, Polish Academy of Sciences, Warsaw, Poland
| | - M Krawczyk
- Social Neuroscience Lab, Institute of Psychology, Polish Academy of Sciences, Warsaw, Poland
| | - A Schudy
- Faculty of Psychology, University of Warsaw, Warsaw, Poland
| | - P D Harvey
- University of Miami Miller School of Medicine, Miami VA Healthcare System, Miami, FL, USA
| | - D L Penn
- Department of Psychology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- School of Psychology, Australian Catholic University, Melbourne, Victoria, Australia
| | - K Ludwig
- Department of Psychology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - M F Green
- Desert Pacific Mental Illness Research, Education, and Clinical Center, VA Greater Los Angeles, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - A E Pinkham
- Department of Psychology, University of Texas at Dallas, Richardson, TX, USA
- Department of Psychiatry, UT Southwestern Medical Center, Dallas, TX, USA
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Iyer SN, Rangaswamy T, Mustafa S, Pawliuk N, Mohan G, Joober R, Schmitz N, Margolese H, Padmavati R, Malla A. Context and Expectations Matter: Social, Recreational, and Independent Functioning among Youth with Psychosis in Chennai, India and Montreal, Canada. CANADIAN JOURNAL OF PSYCHIATRY. REVUE CANADIENNE DE PSYCHIATRIE 2023; 68:766-779. [PMID: 36744381 PMCID: PMC10517650 DOI: 10.1177/07067437231153796] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVES Most cross-cultural psychosis research has focused on a limited number of outcomes (generally symptom-related) and perspectives (often clinician-/observer-rated). It is unknown if the purported superior outcomes for psychosis in some low- and middle-income countries extend to patient-reported measures of social, recreational, and independent functioning. Addressing this gap, this study aimed to compare these outcomes in first-episode psychosis at a high-income site and a lower middle-income site. METHODS Patients receiving similarly designed early intervention for psychosis in Chennai, India (N = 164) and Montreal, Canada (N = 140) completed the self-reported Social Functioning Scale-Early Intervention, which measures prosocial, recreation, and independence-performance functioning. Their case managers rated expected independence-performance functioning. Both sets of assessments were done at entry and Months 6, 18, and 24. Linear mixed model analyses of differences between sites and over time were conducted, accounting for other pertinent variables, especially negative symptoms. RESULTS Linear mixed models showed that prosocial, recreation, and independence-performance functioning scores were significantly higher in Montreal than Chennai and did not change over time. Expected independence-performance was also higher in Montreal and increased over time. Negative symptoms and education independently predicted prosocial, recreation, and expected independence-performance functioning. When added to the model, expected independence-performance predicted actual independence-performance and site was no longer significant. At both sites, prosocial and recreation scores were consistently lower (<40%) than independence-performance (40-65%). CONCLUSION This is the first cross-cultural investigation of prosocial, recreation, and independent functioning in early psychosis. It demonstrates that these outcomes differ by socio-cultural context. Differing levels of expectations about patients, themselves shaped by cultural, illness, and social determinants, may contribute to cross-cultural variations in functional outcomes. At both sites, social, recreational, and independent functioning were in the low-to-moderate range and there was no improvement over time, underscoring the need for effective interventions specifically designed to impact these outcomes.
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Affiliation(s)
- Srividya N. Iyer
- Department of Psychiatry, McGill University, Montreal, Canada
- Prevention and Early Intervention Program for Psychosis (PEPP-Montreal), Douglas Mental Health University Institute, Montreal, Canada
| | | | - Sally Mustafa
- Prevention and Early Intervention Program for Psychosis (PEPP-Montreal), Douglas Mental Health University Institute, Montreal, Canada
| | - Nicole Pawliuk
- Prevention and Early Intervention Program for Psychosis (PEPP-Montreal), Douglas Mental Health University Institute, Montreal, Canada
| | - Greeshma Mohan
- Schizophrenia Research Foundation (SCARF), Chennai, India
| | - Ridha Joober
- Department of Psychiatry, McGill University, Montreal, Canada
- Prevention and Early Intervention Program for Psychosis (PEPP-Montreal), Douglas Mental Health University Institute, Montreal, Canada
| | - Norbert Schmitz
- Department of Psychiatry, McGill University, Montreal, Canada
- Department of Population-Based Medicine, Institute of Health Sciences, University Hospital Tübingen, Tübingen, Germany
| | | | | | - Ashok Malla
- Department of Psychiatry, McGill University, Montreal, Canada
- Prevention and Early Intervention Program for Psychosis (PEPP-Montreal), Douglas Mental Health University Institute, Montreal, Canada
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Abel DB, Minor KS. Social pleasure in daily life: A meta-analysis of experience sampling studies in schizophrenia. Schizophr Res 2023; 260:56-64. [PMID: 37625224 DOI: 10.1016/j.schres.2023.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Revised: 06/19/2023] [Accepted: 08/13/2023] [Indexed: 08/27/2023]
Abstract
Social anhedonia is considered a key feature of schizophrenia that leads to impaired social functioning. Although traditional laboratory measures assess non-current social pleasure, researchers have begun using experience sampling methods (ESM) to measure current, or consummatory, experiences of social pleasure in daily life. A recent meta-analysis examined deficits in consummatory social pleasure in schizophrenia and found vast heterogeneity in effect sizes across ESM studies. Thus, this meta-analysis aimed to extend those results by testing moderators of this effect. Meta-analysis of 14 ESM studies suggests those with psychotic disorders exhibit a moderate deficit in consummatory social pleasure compared to healthy controls. Yet, this effect was significantly moderated by the type of measure used to assess social pleasure. Measures that directly assessed positive emotional experience during socialization yielded small effects that failed to reach significance; indirect measures of other social factors related to pleasure yielded large, significant effects. This suggests daily social anhedonia observed in psychotic disorders is not due to reduced experience of positive emotion. Instead, social anhedonia may be driven by other elements of social functioning. Most clinical variables did not influence effects, but there was a trend such that patient groups with lower cognitive functioning exhibited greater pleasure deficits. Inconsistent reporting across studies limited our ability to examine other real-world variables that may contribute to deficits in social pleasure. Yet, results show different ESM items used to measure social pleasure do not assess the same construct. Future research is needed to validate ESM measures and standardize protocols across studies.
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Affiliation(s)
- Danielle B Abel
- Indiana University-Purdue University Indianapolis, 402 N Blackford St, Indianapolis, IN 46202, United States.
| | - Kyle S Minor
- Indiana University-Purdue University Indianapolis, 402 N Blackford St, Indianapolis, IN 46202, United States
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Strauss GP, Raugh IM, Luther L, Walker EF, Mittal VA. Temporal Interactions Between Social Motivation and Behavior In Daily Life Among Individuals at Clinical High-Risk for Psychosis. Schizophr Bull 2023; 49:1150-1160. [PMID: 37467481 PMCID: PMC10483454 DOI: 10.1093/schbul/sbad096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/21/2023]
Abstract
BACKGROUND AND HYPOTHESES Poor social functioning is common among individuals at clinical high-risk (CHR) for psychosis and is associated with greater likelihood of conversion. Unfortunately, processes contributing to social impairment are unclear, making social functioning difficult to improve via treatment. The current study examined whether abnormalities in social functioning result from aberrant temporal interactions between social motivation and behavior. STUDY DESIGN Participants included 105 individuals at CHR and 62 healthy controls (CN) who completed 6 days of ecological momentary assessment. Multilevel models examined time-lagged interactions between social behavior and motivation. STUDY RESULTS CHR and CN did not differ in social motivation; however, CHR were less likely to interact with family and coworkers and more likely to engage in interactions via phone and text/social media. Autocorrelations indicated that social behavior and motivation were generally consistent across time in CHR and CN groups. Time-lagged analyses indicated that both groups had an increase in social motivation across time when they were alone and a decrease in social motivation across time when they were with others. However, the relative decrease when with others and increase when alone were less robust in CHR than CN, particularly for in-person interactions. Social motivation at time t did not differentially impact social partner or modality at time t+1 in the groups. CONCLUSIONS Findings suggest that social behavior and motivation have different temporal interactions in CHR and CN. Psychosocial interventions may benefit from targeting the frequency of social behavior with specific partners and modalities to change social motivation.
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Affiliation(s)
| | - Ian M Raugh
- Department of Psychology, University of Georgia, Athens, GA, USA
| | - Lauren Luther
- Department of Psychology, University of Georgia, Athens, GA, USA
| | - Elaine F Walker
- Department of Psychology, Emory University, Atlanta, GA, USA
| | - Vijay A Mittal
- Department of Psychology, Northwestern University, Evanston, IL, USA
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Bell V, Velthorst E, Almansa J, Myin-Germeys I, Shergill S, Fett AK. Do loneliness and social exclusion breed paranoia? An experience sampling investigation across the psychosis continuum. Schizophr Res Cogn 2023; 33:100282. [PMID: 37006705 PMCID: PMC10064439 DOI: 10.1016/j.scog.2023.100282] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 03/16/2023] [Accepted: 03/17/2023] [Indexed: 03/28/2023] Open
Abstract
Background The role of loneliness and social exclusion in the development of paranoia is largely unexplored. Negative affect may mediate potential associations between these factors. We investigated the temporal relationships of daily-life loneliness, felt social exclusion, negative affect, and paranoia across the psychosis continuum. Method Seventy-five participants, including 29 individuals with a diagnosis of non-affective psychosis, 20 first-degree relatives, and 26 controls used an Experience Sampling Method (ESM) app to capture the fluctuations in loneliness, feelings of social exclusion, paranoia, and negative affect across a 1-week period. Data were analysed with multilevel regression analyses. Results In all groups, loneliness and feelings of social exclusion were independent predictors of paranoia over time (b = 0.05, p < .001 and b = 0.04, p < .05, respectively). Negative affect predicted paranoia (b = 0.17, p < .001) and partially mediated the associations between loneliness, social exclusion, and paranoia. It also predicted loneliness (b = 0.15, p < .0001), but not social exclusion (b = 0.04, p = .21) over time. Paranoia predicted social exclusion over time, with more pronounced effects in controls (b = 0.43) than patients (b = 0.19; relatives: b = 0.17); but not loneliness (b = 0.08, p = .16). Conclusion Paranoia and negative affect worsen in all groups following feelings of loneliness and social exclusion. This highlights the importance of a sense of belonging and being included for mental well-being. Loneliness, feeling socially excluded, and negative affect were independent predictors of paranoid thinking, suggesting they represent useful targets in its treatment.
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Núñez D, Villacura-Herrera C, Gaete J, Meza D, Andaur J, Wigman JTW, Robinson J. Initial validation of the Multidimensional Adolescent Functioning Scale (MAFS) in Spanish-speaking students from Chilean secondary schools. Health Qual Life Outcomes 2023; 21:78. [PMID: 37488538 PMCID: PMC10367328 DOI: 10.1186/s12955-023-02163-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 07/12/2023] [Indexed: 07/26/2023] Open
Abstract
INTRODUCTION Psychosocial functioning is closely associated with psychopathology and wellbeing in different populations, particularly adolescents. Despite its relevance, measures assessing psychosocial functioning in healthy adolescents are scant as most focus on adults or clinical populations. We evaluated the psychometric properties of the Multidimensional Adolescent Functioning Scale (MAFS), a self-report questionnaire created to assess three dimensions of psychosocial functioning ('general functioning', 'family-related functioning', and 'peer-related functioning') in adolescents from the general population. METHODS After translation and cultural adaptation, we administered the Spanish MAFS to 619 adolescents aged 14 to 19. We assessed the factor structure, internal consistency, and associations with depressive symptoms, suicidal ideation, cognitive-behavioral skills, cognitive reappraisal (CR), and expressive suppression (ES). We additionally tested for measurement invariance based on biological sex. RESULTS The original three-factor structure showed the best fit. Internal consistency was good for the total scale (ω = 0.874; α = 0.869; GLB = 0.939, rM=0.216) and for all subscales (ω = 0.806-0.839; α = 0.769 to 0.812; GLB = 0.861-0.873). Correlations between all three MAFS subscales were significant, ranging between 0.291 and 0.554. All MAFS subscales correlated positively and significantly with cognitive-behavioral skills and adaptive regulatory strategies and negatively with depressive symptoms and suicidal ideation. CONCLUSION The Spanish MAFS translation is a valid and reliable self-report measure to assess three domains of psychosocial functioning in adolescents aged 14-19 from the general population.
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Affiliation(s)
- Daniel Núñez
- Centro de Investigación en Ciencias Cognitivas, Faculty of Psychology, Universidad de Talca, Talca, Chile.
- Millennium Science Initiative Program, ANID, Millennium Nucleus to Improve the Mental Health of Adolescents and Youths, Santiago, Chile.
| | - César Villacura-Herrera
- Centro de Investigación en Ciencias Cognitivas, Faculty of Psychology, Universidad de Talca, Talca, Chile
| | - Jorge Gaete
- Millennium Science Initiative Program, ANID, Millennium Nucleus to Improve the Mental Health of Adolescents and Youths, Santiago, Chile
- Facultad de Educación, Universidad de Los Andes, Las Condes, Chile
| | - Daniela Meza
- Centro de Investigación en Ciencias Cognitivas, Faculty of Psychology, Universidad de Talca, Talca, Chile
- Millennium Science Initiative Program, ANID, Millennium Nucleus to Improve the Mental Health of Adolescents and Youths, Santiago, Chile
| | - Javiera Andaur
- Centro de Investigación en Ciencias Cognitivas, Faculty of Psychology, Universidad de Talca, Talca, Chile
| | - Johanna T W Wigman
- Department of Psychiatry, Interdisciplinary Centre for Psychopathology and Emotion regulation (ICPE), University Medical Center Groningen, Groningen, the Netherlands
| | - Jo Robinson
- Orygen, Parkville, VIC, 3052, Australia
- Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, 3010, Australia
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Maechling C, Yrondi A, Cambon A. Mobile health in the specific management of first-episode psychosis: a systematic literature review. Front Psychiatry 2023; 14:1137644. [PMID: 37377474 PMCID: PMC10291100 DOI: 10.3389/fpsyt.2023.1137644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Accepted: 05/23/2023] [Indexed: 06/29/2023] Open
Abstract
Purpose The purpose of this systematic literature review is to assess the therapeutic efficacy of mobile health methods in the management of patients with first-episode psychosis (FEP). Method The participants are patients with FEP. The interventions are smartphone applications. The studies assess the preliminary efficacy of various types of application. Results One study found that monitoring symptoms minimized relapses, visits to A&E and hospital admissions, while one study showed a decrease in positive psychotic symptoms. One study found an improvement in anxiety symptoms and two studies noted an improvement in psychotic symptoms. One study demonstrated its efficacy in helping participants return to studying and employment and one study reported improved motivation. Conclusion The studies suggest that mobile applications have potential value in the management of young patients with FEP through the use of various assessment and intervention tools. This systematic review has several limitations due to the lack of randomized controlled studies available in the literature.
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Affiliation(s)
- Claire Maechling
- Pôle de Psychiatrie, Centre Hospitalier Universitaire de Toulouse, Toulouse, France
| | - Antoine Yrondi
- Service de Psychiatrie et de Psychologie Médicale, Centre Expert Dépression Résistante Fonda Mental, CHU de Toulouse, Hôpital Purpan, ToNIC Toulouse NeuroImaging Centre, Université de Toulouse, INSERM, UPS, Toulouse, France
| | - Amandine Cambon
- Programme d'intervention précoce RePeps, réseau Transition, Clinique Aufrery, Toulouse, France
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Hermans KSFM, Kirtley OJ, Kasanova Z, Achterhof R, Hagemann N, Hiekkaranta AP, Lecei A, Zapata-Fonseca L, Lafit G, Fossion R, Froese T, Myin-Germeys I. Ecological and Convergent Validity of Experimentally and Dynamically Assessed Capacity for Social Contingency Detection Using the Perceptual Crossing Experiment in Adolescence. Assessment 2023; 30:1109-1124. [PMID: 35373600 DOI: 10.1177/10731911221083613] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The Perceptual Crossing Experiment (PCE) captures the capacity for social contingency detection using real-time social interaction dynamics but has not been externally validated. We tested ecological and convergent validity of the PCE in a sample of 208 adolescents from the general population, aged 11 to 19 years. We expected associations between PCE performance and (a) quantity and quality of social interaction in daily life, using Experience Sampling Methodology (ESM; ecological validity) and (b) self-reported social skills using a questionnaire (convergent validity). We also expected PCE performance to better explain variance in ESM social measures than self-reported social skills. Multilevel analyses showed that only self-reported social skills were positively associated with social experience of company in daily life. These initial results do not support ecological and convergent validity of the PCE. However, fueled by novel insights regarding the complexity of capturing social dynamics, we identified promising methodological advances for future validation efforts.
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Affiliation(s)
- Karlijn S F M Hermans
- KU Leuven, Belgium
- Karlijn S. F. M. Hermans now affiliated to: Developmental and Educational Psychology, Faculty of Behavioral and Social Sciences, Leiden University, Leiden, The Netherlands; Department of Psychology, Education and Child studies, Erasmus School of Social and Behavioral Sciences, Erasmus University Rotterdam, Rotterdam, The Netherlands
| | | | | | | | | | | | | | | | | | - Ruben Fossion
- National Autonomous University of Mexico, Mexico City
| | - Tom Froese
- Okinawa Institute of Science and Technology Graduate University, Japan
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Abel DB, Rand KL, Salyers MP, Myers EJ, Mickens JL, Minor KS. Do People With Schizophrenia Enjoy Social Activities as Much as Everyone Else? A Meta-analysis of Consummatory Social Pleasure. Schizophr Bull 2023; 49:809-822. [PMID: 36820515 PMCID: PMC10154728 DOI: 10.1093/schbul/sbac199] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
BACKGROUND The "emotion paradox" of schizophrenia suggests people with schizophrenia demonstrate deficits when reporting anticipated and retrospective pleasure; yet, in-the-moment, consummatory pleasure is largely intact. It is uncertain how these findings extend to social situations. This meta-analysis aimed to (1) determine the mean difference in consummatory social pleasure between people with schizophrenia and healthy controls, and (2) examine moderators of this effect, including study design and clinical characteristics of participants. DESIGN A literature search using PsycINFO, Web of Science, Pubmed, and EMBASE databases was conducted. Studies measuring consummatory social pleasure using experience sampling methods and laboratory social simulations were included. Random effects meta-analyses were conducted using Hedge's g. RESULTS Meta-analysis of 26 studies suggests people with schizophrenia exhibited a small, significant deficit in consummatory social pleasure (g = -0.38, 90% CI [-0.53, -0.22]). There was significant heterogeneity in effect sizes; magnitude was moderated by study design and type of measure used to assess social pleasure. CONCLUSIONS Overall, people with schizophrenia seem to exhibit less consummatory social pleasure than controls. However, this deficit is smaller than in studies of anticipated and retrospective pleasure. Thus, consummatory social pleasure may not be quite as impaired in people with schizophrenia as traditional anhedonia research suggests. Moreover, pleasure deficits observed in people with schizophrenia may result from differences in the quality of their daily social experiences rather than differences in their capacity for social pleasure. Results have important implications for clinical interventions that address barriers to social engagement, low-pleasure beliefs, and cognitive remediation to treat schizophrenia.
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Affiliation(s)
- Danielle B Abel
- Department of Psychology, Indiana University-Purdue University, Indianapolis, IN, USA
| | - Kevin L Rand
- Department of Psychology, Indiana University-Purdue University, Indianapolis, IN, USA
| | - Michelle P Salyers
- Department of Psychology, Indiana University-Purdue University, Indianapolis, IN, USA
| | - Evan J Myers
- Department of Psychology, Indiana University-Purdue University, Indianapolis, IN, USA
| | - Jessica L Mickens
- Department of Psychology, Indiana University-Purdue University, Indianapolis, IN, USA
| | - Kyle S Minor
- Department of Psychology, Indiana University-Purdue University, Indianapolis, IN, USA
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Fung VSC, Chan JCY, Wong SCY, Wong CSM, Kirtley O, Myin-Germeys I, Strauss GP, Chang WC. Investigation of momentary negative symptoms in patients with early psychosis in daily life: An experience sampling study. Psychiatry Res 2023; 325:115234. [PMID: 37146460 DOI: 10.1016/j.psychres.2023.115234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 04/27/2023] [Accepted: 04/29/2023] [Indexed: 05/07/2023]
Abstract
Negative symptoms are a key therapeutic target in promoting functional recovery in early psychosis intervention, but momentary negative symptom manifestations remain understudied in the early stage of illness. We employed an experience-sampling methodology (ESM) to evaluate momentary affective experiences, hedonic capacity for an event recalled, current activities and social interactions, and associated appraisals for 6 consecutive days in 33 clinically-stable early psychosis patients (within 3 years of treatment for first-episode psychosis) and 35 demographically-matched healthy controls. Adjusted multilevel linear-mixed models revealed higher intensity and variability of negative affect in patients than controls, but no group difference in affect instability as well as positive affect intensity and variability. Patients demonstrated no significantly greater anhedonia for event, activity or social interactions relative to controls. Higher preference for company (when alone) and to be alone (when in company) was observed in patients than controls. No significant group difference in pleasantness to be alone or proportion of time being alone. Our results indicate no evidence for blunting of affective experiences, anhedonia (social and non-social) and asociality in early psychosis. Future research complementing ESM with multiple digital phenotyping measures will facilitate more refined negative symptom assessment in the daily life of patients with early psychosis.
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Affiliation(s)
- Vivian Shi Cheng Fung
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, University of Hong Kong, Hong Kong
| | - Joseph Ching Yui Chan
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, University of Hong Kong, Hong Kong
| | - Sandra Chi Yiu Wong
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, University of Hong Kong, Hong Kong
| | - Corine Sau Man Wong
- School of Public Health, LKS Faculty of Medicine, University of Hong Kong, Hong Kong
| | - Olivia Kirtley
- Center of Contextual Psychiatry, Department of Neurosciences, KU Leuven, Belgium
| | - Inez Myin-Germeys
- Center of Contextual Psychiatry, Department of Neurosciences, KU Leuven, Belgium
| | | | - Wing Chung Chang
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, University of Hong Kong, Hong Kong; State Key Laboratory of Brain and Cognitive Sciences, University of Hong Kong, Hong Kong.
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Langener AM, Stulp G, Kas MJ, Bringmann LF. Capturing the Dynamics of the Social Environment Through Experience Sampling Methods, Passive Sensing, and Egocentric Networks: Scoping Review. JMIR Ment Health 2023; 10:e42646. [PMID: 36930210 PMCID: PMC10132048 DOI: 10.2196/42646] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2022] [Revised: 12/21/2022] [Accepted: 01/02/2023] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Social interactions are important for well-being, and therefore, researchers are increasingly attempting to capture people's social environment. Many different disciplines have developed tools to measure the social environment, which can be highly variable over time. The experience sampling method (ESM) is often used in psychology to study the dynamics within a person and the social environment. In addition, passive sensing is often used to capture social behavior via sensors from smartphones or other wearable devices. Furthermore, sociologists use egocentric networks to track how social relationships are changing. Each of these methods is likely to tap into different but important parts of people's social environment. Thus far, the development and implementation of these methods have occurred mostly separately from each other. OBJECTIVE Our aim was to synthesize the literature on how these methods are currently used to capture the changing social environment in relation to well-being and assess how to best combine these methods to study well-being. METHODS We conducted a scoping review according to the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines. RESULTS We included 275 studies. In total, 3 important points follow from our review. First, each method captures a different but important part of the social environment at a different temporal resolution. Second, measures are rarely validated (>70% of ESM studies and 50% of passive sensing studies were not validated), which undermines the robustness of the conclusions drawn. Third, a combination of methods is currently lacking (only 15/275, 5.5% of the studies combined ESM and passive sensing, and no studies combined all 3 methods) but is essential in understanding well-being. CONCLUSIONS We highlight that the practice of using poorly validated measures hampers progress in understanding the relationship between the changing social environment and well-being. We conclude that different methods should be combined more often to reduce the participants' burden and form a holistic perspective on the social environment.
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Affiliation(s)
- Anna M Langener
- Groningen Institute for Evolutionary Life Sciences, Groningen, Netherlands.,Department of Sociology, Faculty of Behavioural and Social Sciences, University of Groningen & Inter-University Center for Social Science Theory and Methodology, Groningen, Netherlands.,Department of Psychometrics and Statistics, Faculty of Behavioural and Social Sciences, University of Groningen, Groningen, Netherlands
| | - Gert Stulp
- Department of Sociology, Faculty of Behavioural and Social Sciences, University of Groningen & Inter-University Center for Social Science Theory and Methodology, Groningen, Netherlands
| | - Martien J Kas
- Groningen Institute for Evolutionary Life Sciences, Groningen, Netherlands
| | - Laura F Bringmann
- Department of Psychometrics and Statistics, Faculty of Behavioural and Social Sciences, University of Groningen, Groningen, Netherlands.,Interdisciplinary Center Psychopathology and Emotion Regulation, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
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13
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Initial response to the COVID-19 pandemic on real-life well-being, social contact and roaming behavior in patients with schizophrenia, major depression and healthy controls: A longitudinal ecological momentary assessment study. Eur Neuropsychopharmacol 2023; 69:79-83. [PMID: 36791492 PMCID: PMC9892325 DOI: 10.1016/j.euroneuro.2023.01.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 01/17/2023] [Accepted: 01/25/2023] [Indexed: 02/05/2023]
Abstract
The COVID-19 pandemic strongly impacted people's daily lives. However, it remains unknown how the pandemic situation affects daily-life experiences of individuals with preexisting severe mental illnesses (SMI). In this real-life longitudinal study, the acute onset of the COVID-19 pandemic in Germany did not cause the already low everyday well-being of patients with schizophrenia (SZ) or major depression (MDD) to decrease further. On the contrary, healthy participants' well-being, anxiety, social isolation, and mobility worsened, especially in healthy individuals at risk for mental disorder, but remained above the levels seen in patients. Despite being stressful for healthy individuals at risk for mental disorder, the COVID-19 pandemic had little additional influence on daily-life well-being in psychiatric patients with SMI. This highlights the need for preventive action and targeted support of this vulnerable population.
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14
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de With J, Korver-Nieberg N, de Haan L, Schirmbeck F. The association between attachment style and social functioning in patients with non-affective psychotic disorders, unaffected siblings and healthy controls. Schizophr Res 2023; 252:96-102. [PMID: 36638690 DOI: 10.1016/j.schres.2022.12.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 09/12/2022] [Accepted: 12/28/2022] [Indexed: 01/13/2023]
Abstract
OBJECTIVE In patients with psychotic disorders, insecure attachment styles and impaired social functioning are highly prevalent. Our aim was to explore the multi-cross-sectional and longitudinal associations between attachment style and social functioning. METHODS This study was performed in a subsample of 119 patients with non-affective psychotic disorders, 128 unaffected siblings and 66 healthy controls within the Genetic Risk and Outcome of Psychosis (GROUP) Study. Attachment style (using the Psychosis Attachment Measure) and three social functioning domains, namely withdrawal, interpersonal behaviour and pro-social activities as measured with the Social Functioning Scale (SFS) were assessed on two moments in time. Generalized linear mixed models and linear regression models were used. Bonferroni correction for multiple testing was applied. RESULTS In the patient group, a significant negative association was found between avoidant attachment and pro-social functioning. In the sibling and control group, we found significant negative associations between avoidant attachment and the social functioning domains withdrawal and interpersonal behaviour. We also found a significant negative association between anxious attachment and the social functioning domain withdrawal in siblings. Higher levels of insecure anxious attachment at baseline predicted a reduction of the social functioning domain interpersonal behaviour in siblings over a period of three years on a trend level. CONCLUSIONS Findings indicate that levels of insecure attachment are elevated in patients with psychotic disorders and have a negative association with social functioning in both patients, siblings and controls. These findings warrant specific attention for attachment style in the treatment of patients with psychotic disorders and individuals with an increased vulnerability for developing psychosis.
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Affiliation(s)
- Justine de With
- Early Psychosis Department, Amsterdam UMC (location AMC), Department of Psychiatry, Amsterdam, the Netherlands.
| | | | - Lieuwe de Haan
- Early Psychosis Department, Amsterdam UMC (location AMC), Department of Psychiatry, Amsterdam, the Netherlands; Arkin Institute for Mental Health, Amsterdam, the Netherlands
| | - Frederike Schirmbeck
- Early Psychosis Department, Amsterdam UMC (location AMC), Department of Psychiatry, Amsterdam, the Netherlands; Arkin Institute for Mental Health, Amsterdam, the Netherlands
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15
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Feller C, Ilen L, Eliez S, Schneider M. Characterizing Daily-Life Social Interactions in Adolescents and Young Adults with Neurodevelopmental Disorders: A Comparison Between Individuals with Autism Spectrum Disorders and 22q11.2 Deletion Syndrome. J Autism Dev Disord 2023; 53:245-262. [PMID: 35018586 PMCID: PMC9889413 DOI: 10.1007/s10803-021-05423-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/21/2021] [Indexed: 02/04/2023]
Abstract
Social impairments are common features of 22q11.2 deletion syndrome (22q11DS) and autism spectrum disorders (ASD). The Ecological Momentary Assessment (EMA) allowed access to daily-life information in order to explore the phenomenology of social interactions. 32 individuals with 22q11DS, 26 individuals with ASD and 44 typically developing peers (TD) aged 12-30 were assessed during 6 days 8 times a day using a mobile app. Participants with 22q11DS and ASD did not spend more time alone but showed distinct implication in the social sphere than TD. Distinct profiles emerged between the two conditions regarding the subjective experience of aloneness and the subjective experience of social interactions. This study highlights distinct social functioning profiles in daily-life in 22q11DS and ASD that points towards different therapeutic targets.
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Affiliation(s)
- Clémence Feller
- grid.8591.50000 0001 2322 4988Clinical Psychology Unit for Intellectual and Developmental Disabilities, Faculty of Psychology and Educational Sciences, University of Geneva, 40, Boulevard du Pont-d’Arve, 1205 Geneva, Switzerland
| | - Laura Ilen
- grid.8591.50000 0001 2322 4988Clinical Psychology Unit for Intellectual and Developmental Disabilities, Faculty of Psychology and Educational Sciences, University of Geneva, 40, Boulevard du Pont-d’Arve, 1205 Geneva, Switzerland
| | - Stephan Eliez
- grid.8591.50000 0001 2322 4988Developmental Imaging and Psychopathology Lab Research Unit, Faculty of Medicine, University of Geneva, Geneva, Switzerland ,grid.8591.50000 0001 2322 4988Department of Genetic Medicine and Development, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Maude Schneider
- grid.8591.50000 0001 2322 4988Clinical Psychology Unit for Intellectual and Developmental Disabilities, Faculty of Psychology and Educational Sciences, University of Geneva, 40, Boulevard du Pont-d’Arve, 1205 Geneva, Switzerland ,grid.5596.f0000 0001 0668 7884Department of Neurosciences, Center for Contextual Psychiatry, KU Leuven, Leuven, Belgium
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16
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Perez MM, Tercero BA, Durand F, Gould F, Moore RC, Depp CA, Ackerman RA, Pinkham AE, Harvey PD. Revisiting how People with Schizophrenia Spend Their Days: Associations of lifetime milestone Achievements with Daily Activities examined with Ecological Momentary Assessment. PSYCHIATRY RESEARCH COMMUNICATIONS 2022; 2:100060. [PMID: 36118412 PMCID: PMC9477426 DOI: 10.1016/j.psycom.2022.100060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
Milestone achievements are reduced in people with schizophrenia and are lower in comparison to people with bipolar disorder. However, it is not clear what the implications are for engagement in momentary activities based on milestone achievements. Further, some recent research has suggested that psychotic symptoms are associated with challenges in self-assessment of activities, but there is less information about the correlations of milestone achievements and ongoing psychotic symptoms. We examined momentary activities and symptoms as a function of lifetime milestone achievement in 102 individuals with schizophrenia and 71 with bipolar disorder. Ecological Momentary Assessment (EMA) was used to sample daily activities and concurrent symptoms 3 times per day for 30 days. Each survey asked the participant where they were, who they were with, and what they were doing, as well as sampling the concurrent presence of psychotic symptoms. Not being financially responsible for their residence was associated with engaging in fewer productive activities. Participants who never had a relationship were more commonly home and alone and engaged in fewer social interactions. A lifetime history of employment was correlated with engaging in more productive activities, including at home. More common momentary psychosis was seen in participants who failed to achieve each of the functional milestones. Lifetime milestone achievements were associated with greater frequencies of productive behaviors and with fewer momentary experiences of psychosis, suggesting that psychotic symptoms may have importance for sustaining disability that would be challenging to detect without momentary information.
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Affiliation(s)
- Michelle M. Perez
- Department of Psychiatry and Behavioral Sciences, Miller School of Medicine, University of Miami, 1120 NW 14th Street, Suite 1450, Miami, FL 33136 USA
| | - Bianca A. Tercero
- Department of Psychiatry and Behavioral Sciences, Miller School of Medicine, University of Miami, 1120 NW 14th Street, Suite 1450, Miami, FL 33136 USA
| | | | - Felicia Gould
- Department of Psychiatry and Behavioral Sciences, Miller School of Medicine, University of Miami, 1120 NW 14th Street, Suite 1450, Miami, FL 33136 USA
| | - Raeanne C. Moore
- Department of Psychiatry, University of California, San Diego, California, USA
| | - Colin A. Depp
- Department of Psychiatry, University of California, San Diego, California, USA
- VA San Diego Healthcare System, San Diego, California, USA
| | - Robert A. Ackerman
- School of Behavioral and Brain Sciences, The University of Texas at Dallas, Richardson, TX, USA
| | - Amy E. Pinkham
- School of Behavioral and Brain Sciences, The University of Texas at Dallas, Richardson, TX, USA
- Department of Psychiatry, University of Texas Southwestern Medical School, Dallas, TX, USA
| | - Philip D. Harvey
- Department of Psychiatry and Behavioral Sciences, Miller School of Medicine, University of Miami, 1120 NW 14th Street, Suite 1450, Miami, FL 33136 USA
- Research Service, Miami VA Healthcare System, Miami, FL, USA
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17
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The Associations of Affection and Rejection During Adolescence with Interpersonal Functioning in Young Adulthood: A Macro- and Micro- Level Investigation Using the TRAILS TRANS-ID Study. J Youth Adolesc 2022; 51:2130-2145. [PMID: 35852668 PMCID: PMC9508212 DOI: 10.1007/s10964-022-01660-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2022] [Accepted: 07/05/2022] [Indexed: 11/14/2022]
Abstract
Affection and rejection in close relationships during adolescence are thought to impact adult interpersonal functioning, but few studies focused on how the quality of adolescents’ relationships with different people (e.g. parents, peers, and teachers) impacts the daily, micro-level social experiences as well as general, macro-level interpersonal functioning in young adulthood. The present study investigated the associations between: (i) parental, teacher and peer affection and rejection during adolescence and macro-level (over several months) interpersonal functioning as well as different patterns (i.e. mean, variability and inertia) of micro-level (daily social experiences) during young adulthood; (ii) macro-level interpersonal functioning and the patterns of micro-level social experiences during young adulthood. The sample consisted of N = 122 (43% female) youth. At 11.2 ± 0.4 and 16.0 ± 0.6 years old, self- and other-reported parental, peer and teacher affection and rejection were assessed. At 23.7 ± 0.6 years old, participants reported daily social experiences and interpersonal functioning across six months. The results suggested that: (i) higher teacher-reported peer rejection was associated with lower macro-level interpersonal functioning, higher means and higher variability in negative social experiences during adulthood; (ii) higher macro-level interpersonal functioning during young adulthood was associated with higher means and lower inertia in positive and lower variability in negative daily social experiences. These findings indicate that the affection and rejection during adolescence impact interpersonal functioning at macro- and micro-level during adulthood. The present study also shows distinct associations between macro-level interpersonal functioning and dynamics in daily social experiences.
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18
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Pawliuk N, Malla A, Mohan G, Taksal A, Pope MA, Birchwood M, Mangala R, Ramachandran P, Loohuis H, Schmitz N, Joober R, Shah J, Rangaswamy T, Iyer SN. Adapting, updating and translating the Social Functioning Scale to assess social, recreational and independent functioning among youth with psychosis in diverse sociocultural contexts. Early Interv Psychiatry 2022; 16:812-817. [PMID: 34747136 PMCID: PMC9076754 DOI: 10.1111/eip.13231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2021] [Accepted: 10/19/2021] [Indexed: 11/29/2022]
Abstract
AIM To compare social, recreational and independent functioning among persons with psychosis across two geo-cultural contexts, we adapted the well-established Social Functioning Scale (SFS) and translated it into French and Tamil. We present the development and psychometric testing of this adaptation, the SFS-Early Intervention. METHODS Sixteen items were added to reflect contemporary youth activities (e.g., online games) and 31 items adapted to enhance applicability and/or include context-specific examples (e.g., 'church activity' replaced with 'religious/spiritual activity'). Psychometric properties and participant feedback were evaluated. RESULTS Test-retest reliability (ICCs) ranged from 0.813 to 0.964. Internal consistency (Cronbach's α) ranged from .749 to .936 across sites and languages. Correlations with original subscales were high. The scale was rated easy to complete and understand. CONCLUSIONS The SFS-Early Intervention is a promising patient-reported measure of social, recreational and independent functioning. Our approach shows that conceptually sound existing measures are adaptable to different times and contexts.
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Affiliation(s)
- Nicole Pawliuk
- Prevention and Early Intervention Program for Psychosis (PEPP-Montreal), Douglas Mental Health University Institute, Montreal, Canada
| | - Ashok Malla
- Prevention and Early Intervention Program for Psychosis (PEPP-Montreal), Douglas Mental Health University Institute, Montreal, Canada.,Department of Psychiatry, McGill University, Montreal, Canada
| | - Greeshma Mohan
- Schizophrenia Research Foundation (SCARF), Chennai, India
| | - Aarati Taksal
- Prevention and Early Intervention Program for Psychosis (PEPP-Montreal), Douglas Mental Health University Institute, Montreal, Canada
| | - Megan A Pope
- Prevention and Early Intervention Program for Psychosis (PEPP-Montreal), Douglas Mental Health University Institute, Montreal, Canada
| | | | | | | | - Heleen Loohuis
- Prevention and Early Intervention Program for Psychosis (PEPP-Montreal), Douglas Mental Health University Institute, Montreal, Canada
| | - Norbert Schmitz
- Department of Psychiatry, McGill University, Montreal, Canada
| | - Ridha Joober
- Prevention and Early Intervention Program for Psychosis (PEPP-Montreal), Douglas Mental Health University Institute, Montreal, Canada.,Department of Psychiatry, McGill University, Montreal, Canada
| | - Jai Shah
- Prevention and Early Intervention Program for Psychosis (PEPP-Montreal), Douglas Mental Health University Institute, Montreal, Canada.,Department of Psychiatry, McGill University, Montreal, Canada
| | | | - Srividya N Iyer
- Prevention and Early Intervention Program for Psychosis (PEPP-Montreal), Douglas Mental Health University Institute, Montreal, Canada.,Department of Psychiatry, McGill University, Montreal, Canada
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19
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Miller ML, Raugh IM, Strauss GP, Harvey PD. Remote digital phenotyping in serious mental illness: Focus on negative symptoms, mood symptoms, and self-awareness. Biomark Neuropsychiatry 2022. [DOI: 10.1016/j.bionps.2022.100047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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20
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Helping neighbors and enhancing yourself: a spillover effect of helping neighbors on work-family conflict and thriving at work. CURRENT PSYCHOLOGY 2022. [DOI: 10.1007/s12144-020-00864-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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21
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Leijdesdorff SMJ, Bakker JM, Lange I, Michielse S, Goossens L, Klaassen R, Popma A, Schruers K, Lieverse R, Marcelis M, van Os J, Wichers M, Myin-Germeys I, van Amelsvoort T. Home alone: Social functioning as a transdiagnostic marker of mental health in youth, exploring retrospective and daily life measurements. Compr Psychiatry 2022; 115:152309. [PMID: 35325672 DOI: 10.1016/j.comppsych.2022.152309] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 02/25/2022] [Accepted: 03/10/2022] [Indexed: 11/19/2022] Open
Abstract
PURPOSE Early detection and intervention of mental health problems in youth are topical given that mental disorders often start early in life. Young people with emerging mental disorders however, often present with non-specific, fluctuating symptoms. Recent reports indicate a decline in social functioning (SF) as an early sign of specific emerging mental disorders such as depression or anxiety, making SF a favorable transdiagnostic approach for earlier detection and intervention. Our aim was to investigate the value of SF in relation to transdiagnostic symptoms, and as a predictor of psychopathology over time, while exploring traditional retrospective versus innovative daily diary measurements of SF in youth. METHOD Participants (N = 75) were 16-25 years of age and presented early stage psychiatric symptomatology. Psychiatric symptoms, including anxiety and depression, as well as SF -both in retrospect and in daily life- were assessed at two time points and analyzed cross-sectionally and longitudinally. RESULTS A significant and negative association between SF and all psychiatric symptoms was found, and SF was a significant predictor of change in general psychiatric symptoms over time. Results were only significant when SF was measured traditionally retrospective. CONCLUSION This study confirms a distinct relation between SF and transdiagnostic psychiatric symptoms in youth, even in a (sub)clinical population, and points towards SF as a predictor of transdiagnostic psychiatric symptoms. Further research is needed to learn more about the added value of daily life versus retrospective measurements.
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Affiliation(s)
- Sophie M J Leijdesdorff
- Department of Psychiatry and Neuropsychology, Mental Health and Neuroscience (MNeNS) Maastricht University, Maastricht, the Netherlands.
| | - Jindra M Bakker
- Department of Psychiatry and Neuropsychology, Mental Health and Neuroscience (MNeNS) Maastricht University, Maastricht, the Netherlands; Mondriaan Mental Health Center, Maastricht, the Netherlands
| | - Iris Lange
- Department of Psychiatry and Neuropsychology, Mental Health and Neuroscience (MNeNS) Maastricht University, Maastricht, the Netherlands
| | - Stijn Michielse
- Department of Psychiatry and Neuropsychology, Mental Health and Neuroscience (MNeNS) Maastricht University, Maastricht, the Netherlands
| | - Liesbet Goossens
- Department of Psychiatry and Neuropsychology, Mental Health and Neuroscience (MNeNS) Maastricht University, Maastricht, the Netherlands
| | - Rianne Klaassen
- Department of Child and Adolescent Psychiatry, Levvel, Duivendrecht, the Netherlands
| | - Arne Popma
- Department of Child and Adolescent Psychiatry, Levvel, Duivendrecht, the Netherlands; Amsterdam UMC, Amsterdam, the Netherlands
| | - Koen Schruers
- Department of Psychiatry and Neuropsychology, Mental Health and Neuroscience (MNeNS) Maastricht University, Maastricht, the Netherlands; Mondriaan Mental Health Center, Maastricht, the Netherlands
| | | | - Machteld Marcelis
- Department of Psychiatry and Neuropsychology, Mental Health and Neuroscience (MNeNS) Maastricht University, Maastricht, the Netherlands; GGzE, Eindhoven, the Netherlands
| | | | | | | | - Therese van Amelsvoort
- Department of Psychiatry and Neuropsychology, Mental Health and Neuroscience (MNeNS) Maastricht University, Maastricht, the Netherlands; Mondriaan Mental Health Center, Maastricht, the Netherlands
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22
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Long M, Stansfeld JL, Davies N, Crellin NE, Moncrieff J. A systematic review of social functioning outcome measures in schizophrenia with a focus on suitability for intervention research. Schizophr Res 2022; 241:275-291. [PMID: 35217356 DOI: 10.1016/j.schres.2022.02.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2021] [Revised: 02/08/2022] [Accepted: 02/08/2022] [Indexed: 11/26/2022]
Abstract
Social functioning is an important part of recovery and a key treatment target in clinical research in schizophrenia. Evaluating and comparing interventions is challenged by the choice of many measures which focus on different aspects of functioning, with little to guide selection. This results in difficulties comparing outcomes of treatment where studies have used different measures. To improve the measurement of social functioning in intervention research, we aimed to provide practical information on suitability of measures. We conducted a systematic review of measures developed or psychometrically evaluated since 2007, and assessed and discussed the structure, content, quality, and the use of the measures in intervention research. Thirty-two measures of social functioning and 22 validation papers were identified. Measures included structured questionnaires, semi-structured interviews, and assessment of performance on specific tasks. The content of measures was organised into eight categories, which are in order of frequency with which they were covered by measures: activities of daily living, productive activity, relationships, leisure activities, cognition, anti-social behaviour, psychosis symptoms and self-esteem and empowerment. In terms of quality, most measures were rated as moderate, with the Personal and Social Performance Scale gaining the highest rating. However, there was little data on responsiveness of measures, or how they compare to objective or 'real-world' indicators of functioning. The Social Functioning Scale and Personal and Social Performance Scale have been most frequently used in intervention studies to date. Future research should aim to provide further data on psychometric properties relevant to intervention research.
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Affiliation(s)
- Maria Long
- Division of Psychiatry, University College London, United Kingdom of Great Britain and Northern Ireland; Research and Development, North East London NHS Foundation Trust, United Kingdom of Great Britain and Northern Ireland.
| | - Jacki L Stansfeld
- Division of Psychiatry, University College London, United Kingdom of Great Britain and Northern Ireland; Research and Development, North East London NHS Foundation Trust, United Kingdom of Great Britain and Northern Ireland
| | - Nathan Davies
- Research Department of Primary Care and Population Health, University College London, United Kingdom of Great Britain and Northern Ireland
| | - Nadia E Crellin
- Division of Psychiatry, University College London, United Kingdom of Great Britain and Northern Ireland; Nuffield Trust, United Kingdom of Great Britain and Northern Ireland
| | - Joanna Moncrieff
- Division of Psychiatry, University College London, United Kingdom of Great Britain and Northern Ireland; Research and Development, North East London NHS Foundation Trust, United Kingdom of Great Britain and Northern Ireland
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23
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Affective lability and social functioning in severe mental disorders. Eur Arch Psychiatry Clin Neurosci 2022; 272:873-885. [PMID: 35084540 PMCID: PMC9279216 DOI: 10.1007/s00406-022-01380-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Accepted: 01/09/2022] [Indexed: 12/19/2022]
Abstract
Social functioning is impaired in severe mental disorders despite clinical remission, illustrating the need to identify other mechanisms that hinder psychosocial recovery. Affective lability is elevated and associated with an increased clinical burden in psychosis spectrum disorders. We aimed to investigate putative associations between affective lability and social functioning in 293 participants with severe mental disorders (schizophrenia- and bipolar spectrum), and if such an association was independent of well-established predictors of social impairments. The Affective Lability Scale (ALS-SF) was used to measure affective lability covering the dimensions of anxiety-depression, depression-elation and anger. The interpersonal domain of the Social Functioning Scale (SFS) was used to measure social functioning. Correlation analyses were conducted to investigate associations between affective lability and social functioning, followed by a hierarchical multiple regression and follow-up analyses in diagnostic subgroups. Features related to premorbid and clinical characteristics were entered as independent variables together with the ALS-SF scores. We found that higher scores on all ALS-SF subdimensions were significantly associated with lower social functioning (p < 0.005) in the total sample. For the anxiety-depression dimension of the ALS-SF, this association persisted after controlling for potential confounders such as premorbid social functioning, duration of untreated illness and current symptoms (p = 0.019). Our results indicate that elevated affective lability may have a negative impact on social functioning in severe mental disorders, which warrants further investigation. Clinically, it might be fruitful to target affective lability in severe mental disorders to improve psychosocial outcomes.
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Abstract
Abstract
Purpose of Review
Anhedonia is a transdiagnostic symptom comprising reduced subjective reward or pleasure. Anhedonia influences subjective anticipation and in-the-moment experiences. This review draws together affective learning and engagement evidence for anhedonia affecting subjective experiences of social environments.
Recent Findings
While social engagement is diminished consistently, subjective appraisals of social contexts vary across different mental health disorders. Low positive affect during social experiences or stimuli is reported in PTSD, mood, schizophrenia, and anxiety disorders. Diminished neural reward networks underpin the anticipation of social experiences in ADHD, schizophrenia spectrum, and autistic spectrum disorders. Multiple theories exist to explain how anhedonia might interfere with social environments.
Summary
Anhedonia is a barrier to engagement, motivation, and enjoyment of social contexts. While many studies characterize experiences during social contexts, learning theories provide the most promise for developing targeted interventions.
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25
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Quality versus quantity: Determining real-world social functioning deficits in schizophrenia. Psychiatry Res 2021; 301:113980. [PMID: 33979764 PMCID: PMC8206017 DOI: 10.1016/j.psychres.2021.113980] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Accepted: 04/25/2021] [Indexed: 12/13/2022]
Abstract
Social dysfunction is a hallmark of schizophrenia that is associated with emotional disturbances. Researchers have employed ecological momentary assessment (EMA) to measure social and emotional functioning in people with schizophrenia. Yet, few studies have evaluated quality of real-world social interactions, and it is unclear how interactions impact emotional experiences in this population. Using novel EMA that passively collects audio data, we examined daily social behavior and emotion in schizophrenia (n = 38) and control (n = 36) groups. Contrary to hypotheses, both groups interacted with others at the same rate and exhibited similar levels of positive emotion. However, as expected, the schizophrenia group exhibited significantly less high-quality interactions and reported more negative emotion than controls. Social versus non-social context did not influence experienced emotion in either group. This is the first real-world study to passively assess quality of social interactions in schizophrenia. Although those with schizophrenia did not differ in their number of interactions, they were less likely to engage in substantive, personal conversations. Because high-quality interactions are linked with better social outcomes, this finding has important potential treatment implications. Future research should investigate quality of interactions across different types of social activities to gain a more nuanced understanding of social dysfunction in schizophrenia.
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Ziermans TB, Schirmbeck F, Oosterwijk F, Geurts HM, de Haan L. Autistic traits in psychotic disorders: prevalence, familial risk, and impact on social functioning. Psychol Med 2021; 51:1704-1713. [PMID: 32151297 PMCID: PMC8327624 DOI: 10.1017/s0033291720000458] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2019] [Revised: 02/11/2020] [Accepted: 02/16/2020] [Indexed: 11/19/2022]
Abstract
BACKGROUND Prevalence estimates of autistic traits in individuals with psychotic disorders (PD) vary greatly and it is unclear whether individuals with a familial risk (FR) for psychosis have an increased propensity to display autistic traits. Furthermore, it is unknown whether the presence of comorbid autism traits disproportionally affects the cognitive and behavioral aspects of social functioning in PD. METHODS In total, 504 individuals with PD, 587 unaffected siblings with FR, and 337 typical comparison (TC) individuals (16-50 years) were included. Autistic and psychotic traits were measured with the Autism Spectrum Quotient (AQ) and the Community Assessment of Psychic Experiences (CAPE). Social cognition was assessed with the Picture Sequencing Task (PST) and social behavior with the Social Functioning Scale (SFS). RESULTS For PD 6.5% scored above AQ clinical cut-off (⩾32), 1.0% for FR, and 1.2% for TC. After accounting for age, sex, and IQ, the PD group showed significantly more autistic traits and alterations in social behavior and cognition, while FR and TC only displayed marginal differences. Within the PD group autistic traits were a robust predictor of social behavior and there were no interactions with positive psychotic symptoms. CONCLUSIONS Levels of autistic traits are substantially elevated in PD and have a profoundly negative association with social functioning. In contrast, autistic traits above the clinical cut-off are not elevated in those with FR, and only marginally on a dimensional level. These findings warrant specific clinical guidelines for psychotic patients who present themselves with autistic comorbidity to help address their social needs.
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Affiliation(s)
- Tim B. Ziermans
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
| | - Frederike Schirmbeck
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Arkin Institute for Mental Health, Amsterdam, The Netherlands
| | | | - Hilde M. Geurts
- Department of Psychology, University of Amsterdam, Amsterdam, The Netherlands
- Dr. Leo Kannerhuis, Amsterdam, The Netherlands
| | - Lieuwe de Haan
- Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
- Arkin Institute for Mental Health, Amsterdam, The Netherlands
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27
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Dekker TEG, van der Heijden HS, Schirmbeck F, van Amelsvoort T, Bartels-Velthuis AA, Simons CJP, de Haan L, Vermeulen JM. The association between smoking behaviour, social cognition and social functioning in patients with a non-affective psychotic disorder: A prospective follow-up study. SCHIZOPHRENIA RESEARCH-COGNITION 2021; 26:100206. [PMID: 34258239 PMCID: PMC8259295 DOI: 10.1016/j.scog.2021.100206] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 04/15/2021] [Revised: 06/23/2021] [Accepted: 06/24/2021] [Indexed: 11/30/2022]
Abstract
Introduction In patients with psychotic disorders, both tobacco smoking and deficits in social cognition and social functioning are highly prevalent. However, little is known about their relationship in psychosis. The authors sought to evaluate the multi-cross-sectional and longitudinal associations between tobacco smoking, social cognition and social functioning in a large prospective study. Methods This study was performed within the Genetic Risk and Outcome of Psychosis (GROUP) Study, a cohort study conducted in patients with non-affective psychosis (N = 1074), their unaffected siblings (N = 1047) and healthy controls (N = 549). At baseline, three years and six years of follow-up, data on tobacco smoking (using the Composite International Diagnostic Review), social cognition (emotion processing and theory of mind) and social functioning were collected. To assess associations between tobacco smoking and social cognition or social functioning, multivariate linear mixed-effects models and multiple linear regression models were used. Bonferroni correction for multiple testing was applied. Results A significant positive association was found between smoking and emotion processing (as part of social cognition) in the patient group (estimate = 1.96, SE = 0.6, p = 0.003). However, smoking was significantly negatively associated with participating in pro-social activities compared with non-smoking (estimate = −2.55, SE = 0.9, p = 0.004). Change in smoking behaviour was not associated with social cognition or social functioning in the longitudinal analyses. Conclusion Findings indicate that smoking patients with a non-affective psychotic disorder slightly outperformed their non-smoking peers on a task on social cognition, but participated less in pro-social activities. Commencement or cessation of smoking was not related to social cognition or functioning.
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Affiliation(s)
- Tobias E G Dekker
- Early Psychosis Department, Amsterdam UMC (location AMC), Department of Psychiatry, Amsterdam, the Netherlands
| | | | - Frederike Schirmbeck
- Early Psychosis Department, Amsterdam UMC (location AMC), Department of Psychiatry, Amsterdam, the Netherlands.,Arkin Institute for Mental Health, Amsterdam, the Netherlands
| | - Therese van Amelsvoort
- Maastricht University Medical Center, Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht, the Netherlands
| | - Agna A Bartels-Velthuis
- University of Groningen, University Medical Center Groningen, University Center for Psychiatry, Rob Giel Research Center, Groningen, the Netherlands
| | - Claudia J P Simons
- Maastricht University Medical Center, Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht, the Netherlands.,GGzE Institute for Mental Health Care, Eindhoven, the Netherlands
| | - Lieuwe de Haan
- Early Psychosis Department, Amsterdam UMC (location AMC), Department of Psychiatry, Amsterdam, the Netherlands.,Arkin Institute for Mental Health, Amsterdam, the Netherlands
| | - Jentien M Vermeulen
- Early Psychosis Department, Amsterdam UMC (location AMC), Department of Psychiatry, Amsterdam, the Netherlands
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28
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Abel DB, Minor KS. Social functioning in schizophrenia: Comparing laboratory-based assessment with real-world measures. J Psychiatr Res 2021; 138:500-506. [PMID: 33971484 PMCID: PMC8192459 DOI: 10.1016/j.jpsychires.2021.04.039] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Revised: 04/19/2021] [Accepted: 04/25/2021] [Indexed: 02/06/2023]
Abstract
Researchers have measured social functioning in schizophrenia using many different strategies. Recent technological advances have made it possible to passively measure behaviors in real-world social situations-allowing for more objective, ecologically valid assessments. Yet, research testing the convergent validity among real-world and laboratory-based social functioning assessment is sparse. The purpose of this study was to test the convergent validity among four social functioning measures: two interview-based rating scales, a self-reported ecological momentary assessment (EMA), and a passive, ambulatory ecological assessment. Data was collected from 36 people with schizophrenia and 33 control participants. Across the entire sample, relationships between interview-based ratings and real-world measures of social functioning only demonstrated small correlations (r's = 0.17-0.19), whereas real-world measures exhibited moderate correlations with one another (r = 0.36). Within groups, real-world measures showed moderate, significant relationships in the control group (r = 0.44) but not in the schizophrenia group (r = 0.27). For those with schizophrenia, the interview-based measures of social functioning were moderately associated with ambulatory ecological assessment (r's = 0.38 and 0.47), but only small associations were observed with self-reported EMA (r's = 0.15 and 0.17). Results suggest social functioning assessments are not highly convergent and likely target different aspects of social functioning. Laboratory-based measures offer global impressions of social functioning whereas real-world measures represent a more nuanced approach. Moreover, ambulatory ecological assessment may most accurately gauge frequency of daily social interactions for those with schizophrenia as it circumvents common pitfalls of self-report and offers a less-biased, in-depth evaluation of social behavior.
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Affiliation(s)
- Danielle B. Abel
- Department of Psychology, Indiana University – Purdue University Indianapolis, LD 124, 402 N Blackford St, Indianapolis, IN, USA 46202
| | - Kyle S. Minor
- Department of Psychology, Indiana University – Purdue University Indianapolis, LD 124, 402 N Blackford St, Indianapolis, IN, USA 46202
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29
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Wright AC, Browne J, Skiest H, Bhiku K, Baker JT, Cather C. The relationship between conventional clinical assessments and momentary assessments of symptoms and functioning in schizophrenia spectrum disorders: A systematic review. Schizophr Res 2021; 232:11-27. [PMID: 34004382 DOI: 10.1016/j.schres.2021.04.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Revised: 04/09/2021] [Accepted: 04/25/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Symptoms and functioning are critical dimensions in those with schizophrenia and are typically measured using validated conventional clinical assessments. Researchers and clinicians have begun to use real-time digital methods, such as ecological momentary assessment (EMA), to assess symptoms and functioning in the moment and outside of traditional hospital and laboratory settings, which may yield more naturalistic data. Although digital methods have advantages, it is unclear whether these momentary assessments capture core aspects of symptoms and functioning. OBJECTIVE This systematic literature review aimed to evaluate the association between conventional clinical and momentary-based assessments of functioning and symptoms in individuals with schizophrenia. METHODS Studies were included if they met the following criteria: (1) written or translated into English; (2) peer-reviewed; (3) included primary quantitative data; (4) 60% of the clinical sample included persons with schizophrenia spectrum disorders; (5) included a clinical assessment of functioning and/or symptoms; (6) included active momentary assessment and/or passive data; and (7) assessed the relationship between the momentary and conventional clinical assessments. RESULTS A total of 49 studies (87 analyses) were included. Conventional clinical assessments of functioning and positive, negative, and depressive symptoms were related to momentary assessments of these symptom domains. Passive data was beneficial for assessing negative symptoms, but research is warranted for other domains. CONCLUSIONS The reviewed studies highlight the utility of EMA methodologies to collect detailed data on symptoms and functioning. Such data is being used to develop more sophisticated models of schizophrenia to enhance our understanding of important mechanisms and develop targeted interventions.
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Affiliation(s)
- Abigail C Wright
- Center of Excellence for Psychosocial and Systemic Research, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA.
| | - Julia Browne
- Center of Excellence for Psychosocial and Systemic Research, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA; Geriatric Research, Education and Clinical Center, Durham VA Health Care System, Durham, NC, USA
| | - Hannah Skiest
- Center of Excellence for Psychosocial and Systemic Research, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Kamila Bhiku
- Center of Excellence for Psychosocial and Systemic Research, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Justin T Baker
- Harvard Medical School, Boston, MA, USA; Institute for Technology in Psychiatry, McLean Hospital, Belmont, MA, USA
| | - Corinne Cather
- Center of Excellence for Psychosocial and Systemic Research, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
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30
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Ludwig KA, Browne JW, Nagendra A, Gleeson JF, D'Alfonso S, Penn DL, Alvarez-Jimenez M. Horyzons USA: A moderated online social intervention for first episode psychosis. Early Interv Psychiatry 2021; 15:335-343. [PMID: 32067415 DOI: 10.1111/eip.12947] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2019] [Accepted: 01/31/2020] [Indexed: 12/13/2022]
Abstract
AIM We evaluated the feasibility and acceptability of Horyzons, an online social media platform designed to facilitate relationship development among, and introduce therapeutic content to, first-episode psychosis (FEP) clients. We also evaluated whether participation in the platform was related to reduced loneliness, improved social integration and increased psychological well-being. METHODS Twenty-six participants diagnosed with a schizophrenia spectrum disorder were provided access to the moderated Horyzons platform for 12 weeks. During the intervention period, participants were encouraged to access therapeutic content and social components embedded within the site. Participants were recruited from three first-episode coordinated specialty care clinics in North Carolina and assessed at four time points: baseline, mid-treatment, post-treatment and 1-month follow-up. RESULTS Findings indicated that Horyzons was both feasible and very well tolerated, with a 92.3% retention rate and 79.2% of participants actively engaged in the platform. The most commonly identified personal strengths selected by Horyzons users were creativity (61.5%), curiosity (42.3%) and courage (38.5%). Feedback from participants indicated Horyzons could be improved by the development of a smartphone application, expanding the size of the Horyzons community and facilitating private messages between users. Preliminary results with engaged participants showed the greatest improvements in psychosis-related symptoms, followed by self-reported experience of negative emotions, depressive symptoms and loneliness. CONCLUSIONS This open trial found that Horyzons is both feasible and acceptable to FEP persons early in the course of illness living in the United States.
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Affiliation(s)
- Kelsey A Ludwig
- Department of Psychology and Neuroscience, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - Julia W Browne
- Department of Psychology and Neuroscience, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.,Department of Psychiatry, Yale School of Medicine, New Haven, Connecticut
| | - Arun Nagendra
- Department of Psychology and Neuroscience, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina
| | - John F Gleeson
- School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, Victoria, Australia.,Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Simon D'Alfonso
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - David L Penn
- Department of Psychology and Neuroscience, The University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.,School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, Victoria, Australia
| | - Mario Alvarez-Jimenez
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Victoria, Australia.,Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, Victoria, Australia
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31
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Weittenhiller LP, Mikhail ME, Mote J, Campellone TR, Kring AM. What gets in the way of social engagement in schizophrenia? World J Psychiatry 2021; 11:13-26. [PMID: 33511043 PMCID: PMC7805250 DOI: 10.5498/wjp.v11.i1.13] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Revised: 12/16/2020] [Accepted: 12/27/2020] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Social engagement-important for health and well-being-can be difficult for people with schizophrenia. Past research indicates that despite expressing interest in social interactions, people with schizophrenia report spending less time with others and feeling lonely. Social motivations and barriers may play an important role for understanding social engagement in schizophrenia. AIM To investigate how people with schizophrenia describe factors that impede and promote social engagement. METHODS We interviewed a community sample of people with (n = 35) and without (n = 27) schizophrenia or schizoaffective disorder about their social interactions with friends and family over the past week and planned social activities for the coming week. We reviewed the interview transcripts and developed a novel coding system to capture whether interactions occurred, who had initiated the contact, and frequency of reported social barriers (i.e., internal, conflict-based, logistical) and social motivations (i.e., instrumental, affiliative, obligation-based). We also assessed symptoms and functioning. RESULTS People with schizophrenia were less likely than people without schizophrenia to have spent time with friends [t (51.04) = 2.09, P = 0.042, d = 0.51)], but not family. People with schizophrenia reported more social barriers than people without schizophrenia [F (1, 60) = 10.55, P = 0.002, ηp2 = 0.15)] but did not differ in reported social motivations. Specifically, people with schizophrenia reported more internal [t (45.75) = 3.40, P = 0.001, d = 0.83)] and conflict-based [t (40.11) = 3.03, P = 0.004, d = 0.73)] barriers than people without schizophrenia. Social barriers and motivations were related to real-world social functioning for people with schizophrenia, such that more barriers were associated with more difficulty in close relationships (r = -0.37, P = 0.027) and more motivations were associated with better community functioning (r = 0.38, P = 0.024). CONCLUSION These findings highlight the importance of assessing first person accounts of social barriers and motivations to better understand social engagement in schizophrenia.
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Affiliation(s)
| | - Megan E Mikhail
- Department of Psychology, University of California, Berkeley, CA 94720, United States
- Department of Psychology, Michigan State University, East Lansing, MI 48824, United States
| | - Jasmine Mote
- Department of Psychology, University of California, Berkeley, CA 94720, United States
- Department of Occupational Health, Tufts University, Medford, MA 02155, United States
| | - Timothy R Campellone
- Department of Psychology, University of California, Berkeley, CA 94720, United States
| | - Ann M Kring
- Department of Psychology, University of California, Berkeley, CA 94720, United States
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32
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Uchino T, Nemoto T, Kojima A, Takubo Y, Kotsuji Y, Yamaguchi E, Yamaguchi T, Katagiri N, Tsujino N, Tanaka K, Mizuno M. Effects of motivation domains on social functioning in schizophrenia with consideration of the factor structure and confounding influences. J Psychiatr Res 2021; 133:106-112. [PMID: 33338732 DOI: 10.1016/j.jpsychires.2020.12.027] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2020] [Revised: 10/23/2020] [Accepted: 12/09/2020] [Indexed: 12/21/2022]
Abstract
In patients with schizophrenia, motivation has been assumed to act as an intervening factor between cognitive function and social functioning. Motivation is thought to comprise three domains defined by their orientations: intrinsic motivation, extrinsic motivation, and amotivation. Although these orientations can confound each other, the effects of motivation domains on social functioning remain obscure. We investigated these relationships after confirming the factor structure of social functioning using the Social Functioning Scale (SFS). A total of 97 stable outpatients with schizophrenia were recruited. In addition to the SFS, the General Causality Orientations Scale (GCOS) was used to measure the motivation domains. First, we examined the factor structure of the SFS using exploratory and confirmatory factor analyses. Next, we conducted structural equation modeling to examine the effects of motivation domains on social functioning. The SFS showed a two-factor structure: interpersonal and intrapersonal functioning. The structural equation model revealed that (1) amotivation was negatively related to both intrapersonal and interpersonal functioning, (2) intrinsic motivation was positively related only to intrapersonal functioning, and (3) extrinsic motivation was positively related only to interpersonal functioning. Each motivation domain was associated with different factors of social functioning. Future interventions aimed at improving social functioning should consider these motivation domains based on their orientations. Cognitive remediation accompanied by considerations for and approaches to each of the domains may maximize recovery in patients with schizophrenia.
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Affiliation(s)
- Takashi Uchino
- Department of Neuropsychiatry, Toho University Faculty of Medicine, 6-11-1 Omori-nishi, Ota-ku, Tokyo, 143-8541, Japan; Tokyo Adachi Hospital, 5-23-20 Hokima, Adachi-ku, Tokyo, 121-0064, Japan
| | - Takahiro Nemoto
- Department of Neuropsychiatry, Toho University Faculty of Medicine, 6-11-1 Omori-nishi, Ota-ku, Tokyo, 143-8541, Japan.
| | - Akiko Kojima
- Department of Neuropsychiatry, Toho University Faculty of Medicine, 6-11-1 Omori-nishi, Ota-ku, Tokyo, 143-8541, Japan
| | - Youji Takubo
- Department of Neuropsychiatry, Toho University Graduate School of Medicine, 5-21-16 Omori-nishi, Ota-ku, Tokyo, 143-8540, Japan
| | - Yumi Kotsuji
- Tokyo Adachi Hospital, 5-23-20 Hokima, Adachi-ku, Tokyo, 121-0064, Japan
| | - Eriko Yamaguchi
- Department of Neuropsychiatry, Toho University Graduate School of Medicine, 5-21-16 Omori-nishi, Ota-ku, Tokyo, 143-8540, Japan
| | - Taiju Yamaguchi
- Department of Neuropsychiatry, Toho University Faculty of Medicine, 6-11-1 Omori-nishi, Ota-ku, Tokyo, 143-8541, Japan
| | - Naoyuki Katagiri
- Department of Neuropsychiatry, Toho University Faculty of Medicine, 6-11-1 Omori-nishi, Ota-ku, Tokyo, 143-8541, Japan
| | - Naohisa Tsujino
- Department of Neuropsychiatry, Toho University Faculty of Medicine, 6-11-1 Omori-nishi, Ota-ku, Tokyo, 143-8541, Japan
| | - Kuniaki Tanaka
- Tokyo Adachi Hospital, 5-23-20 Hokima, Adachi-ku, Tokyo, 121-0064, Japan
| | - Masafumi Mizuno
- Department of Neuropsychiatry, Toho University Faculty of Medicine, 6-11-1 Omori-nishi, Ota-ku, Tokyo, 143-8541, Japan
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33
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Strauss GP, Esfahlani FZ, Granholm E, Holden J, Visser KF, Bartolomeo LA, Sayama H. Mathematically Modeling Anhedonia in Schizophrenia: A Stochastic Dynamical Systems Approach. Schizophr Bull 2020; 46:1191-1201. [PMID: 32103266 PMCID: PMC7505187 DOI: 10.1093/schbul/sbaa014] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
OBJECTIVE Anhedonia, traditionally defined as a diminished capacity for pleasure, is a core symptom of schizophrenia (SZ). However, modern empirical evidence indicates that hedonic capacity may be intact in SZ and anhedonia may be better conceptualized as an abnormality in the temporal dynamics of emotion. METHOD To test this theory, the current study used ecological momentary assessment (EMA) to examine whether abnormalities in one aspect of the temporal dynamics of emotion, sustained reward responsiveness, were associated with anhedonia. Two experiments were conducted in outpatients diagnosed with SZ (n = 28; n = 102) and healthy controls (n = 28; n = 71) who completed EMA reports of emotional experience at multiple time points in the day over the course of several days. Markov chain analyses were applied to the EMA data to evaluate stochastic dynamic changes in emotional states to determine processes underlying failures in sustained reward responsiveness. RESULTS In both studies, Markov models indicated that SZ had deficits in the ability to sustain positive emotion over time, which resulted from failures in augmentation (ie, the ability to maintain or increase the intensity of positive emotion from time t to t+1) and diminution (ie, when emotions at time t+1 are opposite in valence from emotions at time t, resulting in a decrease in the intensity of positive emotion over time). Furthermore, in both studies, augmentation deficits were associated with anhedonia. CONCLUSIONS These computational findings clarify how abnormalities in the temporal dynamics of emotion contribute to anhedonia.
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Affiliation(s)
| | - Farnaz Zamani Esfahlani
- Department of Systems Science and Industrial Engineering, Binghamton University Binghamton, NY
| | - Eric Granholm
- Department of Psychiatry, University of California, San Diego, La Jolla, CA
- Psychology Service, Veterans Affairs San Diego Healthcare System San Diego, CA
| | - Jason Holden
- Department of Psychiatry, University of California, San Diego, La Jolla, CA
- Psychology Service, Veterans Affairs San Diego Healthcare System San Diego, CA
| | | | | | - Hiroki Sayama
- Department of Systems Science and Industrial Engineering, Binghamton University Binghamton, NY
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34
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Schneider M, Myin E, Myin-Germeys I. Is theory of mind a prerequisite for social interactions? A study in psychotic disorder. Psychol Med 2020; 50:754-760. [PMID: 30919788 DOI: 10.1017/s0033291719000540] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND A dominant idea is that impaired capacities for theory of mind (ToM) are the reasons for impairments in social functioning in several conditions, including autism and schizophrenia. In this paper, we present empirical evidence that challenges this influential assumption. METHODS We conducted three studies examining the association between ToM and social functioning in participants diagnosed with a non-affective psychotic disorder and healthy individuals. We used both the experience sampling method, a structured diary technique collecting information in daily-life, and a standardised questionnaire to assess social functioning. Analysed data are part of Wave 1 and Wave 3 of the Genetic Risk and Outcome of Psychosis (GROUP) study. RESULTS Results were highly consistent across studies and showed no significant association between the two constructs. CONCLUSIONS These findings question the leading assumption that social cognition is a prerequisite for social functioning, but rather suggest that social cognition is possibly a result of basic social interactive capacities.
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Affiliation(s)
- Maude Schneider
- KU Leuven, Department of Neurosciences, Research Group Psychiatry, Center for Contextual Psychiatry, Leuven, Belgium
- Developmental Imaging and Psychopathology Lab, Department of Psychiatry, Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Erik Myin
- Centre for Philosophical Psychology, Department of Philosophy, University of Antwerp, Antwerp, Belgium
| | - Inez Myin-Germeys
- KU Leuven, Department of Neurosciences, Research Group Psychiatry, Center for Contextual Psychiatry, Leuven, Belgium
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35
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Granholm E, Holden JL, Mikhael T, Link PC, Swendsen J, Depp C, Moore RC, Harvey PD. What Do People With Schizophrenia Do All Day? Ecological Momentary Assessment of Real-World Functioning in Schizophrenia. Schizophr Bull 2020; 46:242-251. [PMID: 31504955 PMCID: PMC7442321 DOI: 10.1093/schbul/sbz070] [Citation(s) in RCA: 32] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Schizophrenia is a major cause of disability worldwide. As new treatments for functioning are tested, the need grows to demonstrate real-world functioning gains. Ecological momentary assessment (EMA) may provide a more ecologically valid measure of functioning. In this study, smartphone-based EMA was used to signal participants with schizophrenia (N = 100) and controls (N = 71) 7 times a day for 7 days to respond to brief questionnaires about social interactions and functioning behaviors. Excellent adherence was found, with both groups completing an average of 85% of surveys and only 3% of participants with schizophrenia excluded for poor adherence. Four-week test-retest reliability was high (r = .83 for total productive behaviors). Relative to controls, participants with schizophrenia reported significantly less total productive activity (d = 1.2), fewer social interactions (d = 0.3), more nonproductive behaviors (d = 1.0; watching TV, resting), and more time at home (d = 0.8). Within the schizophrenia group, participants living independently showed better functioning on EMA relative to participants in supported housing (d = 0.8) and participants engaged in vocational activities showed better functioning than individuals not engaged in vocational activities (d = 0.55). Modest correlations were found between EMA and an in-lab self-report measure of functioning activities performed in the community, but not between EMA and measures of functional capacity or potential. This study demonstrated the feasibility, sensitivity reliability, and validity of EMA methods to assess functioning in schizophrenia. EMA provides a much-needed measure of what individuals with schizophrenia are actually doing in real-world contexts. These results also suggest that there may be important disjunctions between indices of abilities and actual real-world functioning.
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Affiliation(s)
- Eric Granholm
- University of California, San Diego
- VA San Diego Healthcare System, San Diego, CA
| | | | | | | | - Joel Swendsen
- University of Bordeaux, CNRS, EPHE PSL Research University
| | - Colin Depp
- University of California, San Diego
- VA San Diego Healthcare System, San Diego, CA
| | | | - Philip D Harvey
- University of Miami Miller School of Medicine
- Bruce W. Carter VA Medical Center, Miami, FL
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36
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Chun CA, Cooper S, Ellman LM. Associations of psychotic-like experiences, related symptoms, and working memory with functioning. Eur Psychiatry 2020; 63:e20. [PMID: 32093801 PMCID: PMC7315866 DOI: 10.1192/j.eurpsy.2020.21] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/29/2022] Open
Abstract
This study examined the association of spatial working memory and attenuated psychotic-like experiences and related symptoms with social and role functioning. Findings from this study suggest that symptom dimensions and working memory impairment were associated with diminished functioning across a variety of domains. Specifically, negative symptoms and working memory impairment were inversely associated with both social and role functioning, whereas positive and disorganized symptoms showed inverse associations with social functioning only. Symptom dimensions did not moderate cognitive and functional variables, although working memory and attenuated clinical symptoms had an additive effect on functioning. Post-hoc analyses examining symptom dimensions simultaneously showed negative symptoms to be the variable most strongly predictive of overall functioning. These findings suggest that even in a non-clinical sample, sub-threshold psychosis symptoms and cognition may influence people’s social and role functioning.
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Affiliation(s)
- Charlotte A Chun
- Department of Psychology, Temple University, Philadelphia, Pennsylvania, USA
| | - Shanna Cooper
- Department of Mental Health, VA San Diego Healthcare System, San Diego, California, USA.,Department of Psychiatry, University of California, San Diego, California, USA
| | - Lauren M Ellman
- Department of Psychology, Temple University, Philadelphia, Pennsylvania, USA
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Myin-Germeys I. Real-life social interactions in schizophrenia. Schizophr Res 2020; 216:10-11. [PMID: 31818635 DOI: 10.1016/j.schres.2019.11.042] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/23/2019] [Revised: 11/24/2019] [Accepted: 11/24/2019] [Indexed: 11/17/2022]
Affiliation(s)
- Inez Myin-Germeys
- Center for Contextual Psychiatry, Department of Neurosciences, KU Leuven, Kapucijnenvoer 33, box 7001, 3000 Leuven, Belgium.
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Mote J, Fulford D. Ecological momentary assessment of everyday social experiences of people with schizophrenia: A systematic review. Schizophr Res 2020; 216:56-68. [PMID: 31874743 DOI: 10.1016/j.schres.2019.10.021] [Citation(s) in RCA: 57] [Impact Index Per Article: 14.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 08/28/2019] [Accepted: 10/03/2019] [Indexed: 12/22/2022]
Abstract
INTRODUCTION Our goal in the current review was to summarize the existing literature on the utility of ecological momentary assessment (EMA) in assessing the social experiences of people with schizophrenia (SZ). We were further interested in examining the associations between EMA-reported social outcomes and traditional assessments of social functioning. METHODS We conducted a systematic review of EMA studies published between January 1, 1990 and October 31, 2018 from PubMed and PsycINFO electronic databases. We included EMA studies that assessed social experiences (proportion of time spent alone/with others, affective experiences when with others, social stress, factors related to social experiences) in people with SZ. We included studies that examined associations between laboratory-based, self-report, or clinical assessments of functioning with EMA-reported social experiences. RESULTS We identified 22 EMA studies for inclusion in this review. Though heterogeneous in aspects of social experiences assessed, the current literature suggests that people with SZ report more social stress and a preference to be alone when they are with others (nine out of 10 studies). People with SZ report more positive affect when they are with others compared to being alone, and equivalent amounts of positive affect during social experiences as healthy controls (all four studies assessed). Five studies assessed the coherence between functioning assessments and momentary social experiences, with mixed results. CONCLUSION We discuss limitations of the literature and future directions. EMA shows promise in assessing more granular aspects of social experience (including social stress and social pleasure) in people with SZ compared to other methods.
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Affiliation(s)
- Jasmine Mote
- Sargent College of Health and Rehabilitation Sciences, Boston University, 635 Commonwealth Avenue, Boston, MA, 02215, USA.
| | - Daniel Fulford
- Sargent College of Health and Rehabilitation Sciences, Boston University, 635 Commonwealth Avenue, Boston, MA, 02215, USA; Department of Psychological & Brain Sciences, Boston University, 64 Cummington Mall, Boston, MA, 02215, USA
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Reininghaus U, Klippel A, Steinhart H, Vaessen T, van Nierop M, Viechtbauer W, Batink T, Kasanova Z, van Aubel E, van Winkel R, Marcelis M, van Amelsvoort T, van der Gaag M, de Haan L, Myin-Germeys I. Efficacy of Acceptance and Commitment Therapy in Daily Life (ACT-DL) in early psychosis: study protocol for a multi-centre randomized controlled trial. Trials 2019; 20:769. [PMID: 31878966 PMCID: PMC6933690 DOI: 10.1186/s13063-019-3912-4] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2018] [Accepted: 11/15/2019] [Indexed: 01/01/2023] Open
Abstract
Background Psychotic experiences, social functioning and general psychopathology are important targets for early intervention in individuals with Ultra-High-Risk state (UHR) and a first-episode psychosis (FEP). Acceptance and Commitment Therapy (ACT) is a promising, next-generation Cognitive Behavioural Therapy (CBT) that aims to modify these targets, but evidence on sustainable change and its underlying mechanisms in individuals’ daily lives remains limited. The aim of the INTERACT study is to investigate the efficacy of a novel ecological momentary intervention, Acceptance and Commitment Therapy in Daily Life (ACT-DL) in a multi-centre randomised controlled trial of individuals with UHR or FEP. Methods/design In a multi-centre randomised controlled trial, individuals aged 16–65 years with UHR or FEP will be randomly allocated to ACT-DL in addition to treatment as usual (TAU) as the experimental condition or a control condition of TAU only, which will include – for the entire study period – access to routine mental health care and, where applicable, CBT for psychosis (CBTp). Outcomes will be assessed at baseline (i.e. before randomisation), post-intervention (i.e. after the 8-week intervention period), and 6-month and 12-month follow-ups (i.e. 6 and 12 months after completing the intervention period) by blinded assessors. The primary outcome will be distress associated with psychotic experiences, while secondary outcomes will include (momentary) psychotic experiences, social functioning and psychopathology. Process measures to assess putative mechanisms of change will include psychological flexibility, stress sensitivity and reward experiences. In addition, acceptability, treatment adherence and treatment fidelity of ACT-DL will be assessed. Discussion The current study is the first to test the efficacy of ACT-DL in individuals with UHR and FEP. If this trial demonstrates the efficacy of ACT-DL, it has the potential to significantly advance the treatment of people with UHR and FEP and, more generally, provides initial support for implementing mHealth interventions in mental health services. Trial registration Netherlands Trial Register, ID: NTR4252. Registered on 26 September 2013.
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Affiliation(s)
- Ulrich Reininghaus
- Department of Public Mental Health, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany. .,Department of Psychiatry and Psychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands. .,ESRC Centre for Society and Mental Health and Centre for Epidemiology and Public Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
| | - Annelie Klippel
- Department of Psychiatry and Psychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands.,Department of Neurosciences, Psychiatry Research Group, Center for Contextual Psychiatry, KU Leuven, Leuven, Belgium
| | - Henrietta Steinhart
- Department of Psychiatry and Psychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands.,Department of Neurosciences, Psychiatry Research Group, Center for Contextual Psychiatry, KU Leuven, Leuven, Belgium
| | - Thomas Vaessen
- Department of Psychiatry and Psychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands.,Department of Neurosciences, Psychiatry Research Group, Center for Contextual Psychiatry, KU Leuven, Leuven, Belgium
| | - Martine van Nierop
- Department of Neurosciences, Psychiatry Research Group, Center for Contextual Psychiatry, KU Leuven, Leuven, Belgium
| | - Wolfgang Viechtbauer
- Department of Psychiatry and Psychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Tim Batink
- Department of Psychiatry and Psychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Zuzana Kasanova
- Department of Neurosciences, Psychiatry Research Group, Center for Contextual Psychiatry, KU Leuven, Leuven, Belgium
| | - Evelyne van Aubel
- Department of Neurosciences, Psychiatry Research Group, Center for Contextual Psychiatry, KU Leuven, Leuven, Belgium
| | - Ruud van Winkel
- Universitair Psychiatrisch Centrum KU Leuven, Kortenberg, Belgium
| | - Machteld Marcelis
- Department of Psychiatry and Psychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Therese van Amelsvoort
- Department of Psychiatry and Psychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Mark van der Gaag
- Department of Clinical Psychology, VU Amsterdam, Amsterdam, The Netherlands
| | - Lieuwe de Haan
- Department of Psychiatry, University of Amstderdam, Amsterdam, The Netherlands
| | - Inez Myin-Germeys
- Department of Neurosciences, Psychiatry Research Group, Center for Contextual Psychiatry, KU Leuven, Leuven, Belgium
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Depp CA, Bashem J, Moore RC, Holden JL, Mikhael T, Swendsen J, Harvey PD, Granholm EL. GPS mobility as a digital biomarker of negative symptoms in schizophrenia: a case control study. NPJ Digit Med 2019; 2:108. [PMID: 31728415 PMCID: PMC6841669 DOI: 10.1038/s41746-019-0182-1] [Citation(s) in RCA: 58] [Impact Index Per Article: 11.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Accepted: 09/23/2019] [Indexed: 12/20/2022] Open
Abstract
Mobility is an important correlate of physical, cognitive, and mental health in chronic illness, and can be measured passively with mobile phone global positional satellite (GPS) sensors. To date, GPS data have been reported in a few studies of schizophrenia, yet it is unclear whether these data correlate with concurrent momentary reports of location, vary by people with schizophrenia and healthy comparison subjects, or associate with symptom clusters in schizophrenia. A total of 142 participants with schizophrenia (n = 86) or healthy comparison subjects (n = 56) completed 7 days of ecological momentary assessment (EMA) reports of location and behavior, and simultaneous GPS locations were tracked every five minutes. We found that GPS-derived indicators of average distance travelled overall and distance from home, as well as percent of GPS samples at home were highly correlated with EMA reports of location at the day- and week-averaged level. GPS-based mobility indicators were lower in schizophrenia with medium to large effect sizes. Less GPS mobility was related to greater negative symptom severity, particularly diminished motivation, whereas greater GPS mobility was weakly associated with more community functioning. Neurocognition, depression, and positive symptoms were not associated with mobility indicators. Therefore, passive GPS sensing could provide a low-burden proxy measure of important outcomes in schizophrenia, including negative symptoms and possibly of functioning. As such, passive GPS sensing could be used for monitoring and timely interventions for negative symptoms in young persons at high risk for schizophrenia.
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Affiliation(s)
- Colin A Depp
- 1Department of Psychiatry, UC San Diego, La Jolla, CA USA.,Psychology Service, VA San Diego, San Diego, CA USA
| | - Jesse Bashem
- Psychology Service, VA San Diego, San Diego, CA USA
| | - Raeanne C Moore
- 1Department of Psychiatry, UC San Diego, La Jolla, CA USA.,Psychology Service, VA San Diego, San Diego, CA USA
| | - Jason L Holden
- 1Department of Psychiatry, UC San Diego, La Jolla, CA USA
| | | | - Joel Swendsen
- 4National Center for Scientific Research, University of Bordeaux (UMR 5287); EPHE PSL Research University, Bordeaux, France
| | - Philip D Harvey
- 5Department of Psychiatry and Behavioral Sciences, University of Miami, Miami, FL USA
| | - Eric L Granholm
- 1Department of Psychiatry, UC San Diego, La Jolla, CA USA.,Psychology Service, VA San Diego, San Diego, CA USA
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Myin-Germeys I, Kasanova Z, Vaessen T, Vachon H, Kirtley O, Viechtbauer W, Reininghaus U. Experience sampling methodology in mental health research: new insights and technical developments. World Psychiatry 2018; 17:123-132. [PMID: 29856567 PMCID: PMC5980621 DOI: 10.1002/wps.20513] [Citation(s) in RCA: 263] [Impact Index Per Article: 43.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
In the mental health field, there is a growing awareness that the study of psychiatric symptoms in the context of everyday life, using experience sampling methodology (ESM), may provide a powerful and necessary addition to more conventional research approaches. ESM, a structured self-report diary technique, allows the investigation of experiences within, and in interaction with, the real-world context. This paper provides an overview of how zooming in on the micro-level of experience and behaviour using ESM adds new insights and additional perspectives to standard approaches. More specifically, it discusses how ESM: a) contributes to a deeper understanding of psychopathological phenomena, b) allows to capture variability over time, c) aids in identifying internal and situational determinants of variability in symptomatology, and d) enables a thorough investigation of the interaction between the person and his/her environment and of real-life social interactions. Next to improving assessment of psychopathology and its underlying mechanisms, ESM contributes to advancing and changing clinical practice by allowing a more fine-grained evaluation of treatment effects as well as by providing the opportunity for extending treatment beyond the clinical setting into real life with the development of ecological momentary interventions. Furthermore, this paper provides an overview of the technical details of setting up an ESM study in terms of design, questionnaire development and statistical approaches. Overall, although a number of considerations and challenges remain, ESM offers one of the best opportunities for personalized medicine in psychiatry, from both a research and a clinical perspective.
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Affiliation(s)
- Inez Myin-Germeys
- Center for Contextual Psychiatry, Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - Zuzana Kasanova
- Center for Contextual Psychiatry, Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - Thomas Vaessen
- Center for Contextual Psychiatry, Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - Hugo Vachon
- Center for Contextual Psychiatry, Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - Olivia Kirtley
- Center for Contextual Psychiatry, Department of Neurosciences, KU Leuven, Leuven, Belgium
| | - Wolfgang Viechtbauer
- Center for Contextual Psychiatry, Department of Neurosciences, KU Leuven, Leuven, Belgium
- School for Mental Health & Neuroscience, Maastricht University, Maastricht, The Netherlands
| | - Ulrich Reininghaus
- School for Mental Health & Neuroscience, Maastricht University, Maastricht, The Netherlands
- Centre for Epidemiology and Public Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
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Pot-Kolder RMCA, Geraets CNW, Veling W, van Beilen M, Staring ABP, Gijsman HJ, Delespaul PAEG, van der Gaag M. Virtual-reality-based cognitive behavioural therapy versus waiting list control for paranoid ideation and social avoidance in patients with psychotic disorders: a single-blind randomised controlled trial. Lancet Psychiatry 2018; 5:217-226. [PMID: 29429948 DOI: 10.1016/s2215-0366(18)30053-1] [Citation(s) in RCA: 106] [Impact Index Per Article: 17.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2017] [Revised: 01/12/2018] [Accepted: 01/15/2018] [Indexed: 01/30/2023]
Abstract
BACKGROUND Many patients with psychotic disorders have persistent paranoid ideation and avoid social situations because of suspiciousness and anxiety. We investigated the effects of virtual-reality-based cognitive behavioural therapy (VR-CBT) on paranoid thoughts and social participation. METHODS In this randomised controlled trial at seven Dutch mental health centres, outpatients aged 18-65 years with a DSM-IV-diagnosed psychotic disorder and paranoid ideation in the past month were randomly assigned (1:1) via block randomisation to VR-CBT (in addition to treatment as usual) or the waiting list control group (treatment as usual). VR-CBT consisted of 16 individual therapy sessions (each 1 h long). Assessments were done at baseline, after treatment (ie, 3 months from baseline), and at a 6 month follow-up visit. The primary outcome was social participation, which we operationalised as the amount of time spent with other people, momentary paranoia, perceived social threat, and momentary anxiety. Analysis was by intention to treat. This trial was retrospectively registered with ISRCTN, number 12929657. FINDINGS Between April 1, 2014, and Dec 31, 2015, 116 patients with a psychotic disorder were randomly assigned, 58 to the VR-CBT group and 58 to the waiting list control group. Compared with the control, VR-CBT did not significantly increase the amount of time spent with other people at the post-treatment assessment. Momentary paranoid ideation (b=-0·331 [95% CI -0·432 to -0·230], p<0·0001; effect size -1·49) and momentary anxiety (-0·288 [-0·438 to -0·1394]; p=0·0002; -0·75) were significantly reduced in the VR-CBT group compared with the control group at the post-treatment assessment, and these improvements were maintained at the follow-up assessment. Safety behaviour and social cognition problems were mediators of change in paranoid ideation. No adverse events were reported relating to the therapy or assessments. INTERPRETATION Our results suggest that the addition of VR-CBT to standard treatment can reduce paranoid ideation and momentary anxiety in patients with a psychotic disorder. FUNDING Fonds NutsOhra, Stichting tot Steun VCVGZ.
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Affiliation(s)
- Roos M C A Pot-Kolder
- Department of Clinical Psychology, VU University and Amsterdam Public Health Research Institute, Amsterdam, Netherlands; Parnassia Psychiatric Institute, The Hague, Netherlands.
| | - Chris N W Geraets
- Department of Psychiatry, University of Groningen and University Medical Center Groningen, Groningen, Netherlands
| | - Wim Veling
- Department of Psychiatry, University of Groningen and University Medical Center Groningen, Groningen, Netherlands
| | - Marije van Beilen
- Department of Psychiatry, University of Groningen and University Medical Center Groningen, Groningen, Netherlands
| | - Anton B P Staring
- First Episode and Early Detection and Intervention Service, Altrecht Psychiatric Institute, Utrecht, Netherlands
| | | | - Philippe A E G Delespaul
- Department of Psychiatry and Neuropsychology, Maastricht University, Maastricht, Netherlands; Mondriaan Psychiatric Institute zuid-Limburg, Maastricht, Netherlands
| | - Mark van der Gaag
- Department of Clinical Psychology, VU University and Amsterdam Public Health Research Institute, Amsterdam, Netherlands; Parnassia Psychiatric Institute, The Hague, Netherlands
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