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Wynn JK, Green MF. An EEG-Based Neuroplastic Approach to Predictive Coding in People With Schizophrenia or Traumatic Brain Injury. Clin EEG Neurosci 2024:15500594241252897. [PMID: 38711326 DOI: 10.1177/15500594241252897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/08/2024]
Abstract
Despite different etiologies, people with schizophrenia (SCZ) or with traumatic brain injury (TBI) both show aberrant neuroplasticity. One neuroplastic mechanism that may be affected is prediction error coding. We used a roving mismatch negativity (rMMN) paradigm which uses different lengths of standard tone trains and is optimized to assess predictive coding. Twenty-five SCZ, 22 TBI (mild to moderate), and 25 healthy controls were assessed. We used a frequency-deviant rMMN in which the number of standards preceding the deviant was either 2, 6, or 36. We evaluated repetition positivity to the standard tone immediately preceding a deviant tone (repetition positivity [RP], to assess formation of the memory trace), deviant negativity to the deviant stimulus (deviant negativity [DN], which reflects signaling of a prediction error), and the difference wave between the 2 (the MMN). We found that SCZ showed reduced DN and MMN compared with healthy controls and with people with mild to moderate TBI. We did not detect impairments in any index (RP, DN, or MMN) in people with TBI compared to controls. Our findings suggest that prediction error coding assessed with rMMN is aberrant in SCZ but intact in TBI, though there is a suggestion that severity of head injury results in poorer prediction error coding.
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Affiliation(s)
- Jonathan K Wynn
- Center on Enhancement of Community Integration for Homeless Veterans, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
| | - Michael F Green
- Center on Enhancement of Community Integration for Homeless Veterans, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
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Miley K, Bronstein MV, Ma S, Lee H, Green MF, Ventura J, Hooker CI, Nahum M, Vinogradov S. Trajectories and predictors of response to social cognition training in people with schizophrenia: A proof-of-concept machine learning study. Schizophr Res 2024; 266:92-99. [PMID: 38387253 PMCID: PMC11005939 DOI: 10.1016/j.schres.2024.02.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 12/15/2023] [Accepted: 02/17/2024] [Indexed: 02/24/2024]
Abstract
BACKGROUND Social cognition training (SCT) can improve social cognition deficits in schizophrenia. However, little is known about patterns of response to SCT or individual characteristics that predict response. METHODS 76 adults with schizophrenia randomized to receive 8-12 weeks of remotely-delivered SCT were included in this analysis. Social cognition was measured with a composite of six assessments. Latent class growth analyses identified trajectories of social cognitive response to SCT. Random forest and logistic regression models were trained to predict membership in the trajectory group that showed improvement from baseline measures including symptoms, functioning, motivation, and cognition. RESULTS Five trajectory groups were identified: Group 1 (29 %) began with slightly above average social cognition, and this ability significantly improved with SCT. Group 2 (9 %) had baseline social cognition approximately one standard deviation above the sample mean and did not improve with training. Groups 3 (18 %) and 4 (36 %) began with average to slightly below-average social cognition and showed non-significant trends toward improvement. Group 5 (8 %) began with social cognition approximately one standard deviation below the sample mean, and experienced significant deterioration in social cognition. The random forest model had the best performance, predicting Group 1 membership with an area under the curve of 0.73 (SD 0.24; 95 % CI [0.51-0.87]). CONCLUSIONS Findings suggest that there are distinct patterns of response to SCT in schizophrenia and that those with slightly above average social cognition at baseline may be most likely to experience gains. Results may inform future research seeking to individualize SCT treatment for schizophrenia.
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Affiliation(s)
- Kathleen Miley
- HealthPartners Institute, Minneapolis, MN, USA; Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, MN, USA.
| | - Michael V Bronstein
- Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, MN, USA
| | - Sisi Ma
- Institute for Health Informatics, University of Minnesota, MN, USA
| | - Hyunkyu Lee
- Department of Research and Development, Posit Science Inc., San Francisco, CA, USA
| | - Michael F Green
- VA Greater Los Angeles, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
| | - Joseph Ventura
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
| | - Christine I Hooker
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Mor Nahum
- School of Occupational Therapy, Hebrew University of Jerusalem, Israel
| | - Sophia Vinogradov
- Department of Psychiatry and Behavioral Sciences, University of Minnesota Medical School, MN, USA
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Novacek DM, Wynn JK, McCleery A, Reavis EA, Senturk D, Sugar CA, Tsai J, Green MF. Sustained mental health and functional responses to the COVID-19 pandemic in Black and White Veterans with psychosis or recent homelessness. J Psychiatr Res 2024; 172:102-107. [PMID: 38373371 DOI: 10.1016/j.jpsychires.2024.02.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Revised: 02/13/2024] [Accepted: 02/14/2024] [Indexed: 02/21/2024]
Abstract
The COVID-19 pandemic disproportionately impacted marginalized populations including Black Americans, people with serious mental illness, and individuals experiencing homelessness. Although the double disadvantage hypothesis would suggest that individuals with multiple minoritized statuses would experience worse psychosocial impacts from the pandemic, this may not be the case for vulnerable Black Veterans. The present study investigated the sustained mental health and functional responses to the pandemic in Black and White Veterans with psychosis or recent homelessness and in a control group of Veterans enrolled in the Department of Veterans Affairs healthcare services. Clinical interviews and questionnaires were administered remotely by telephone at five time points from May 2020 through July 2021, including a retrospective time point for March 2020 (i.e., before the pandemic started). Overall, there was a striking absence of systematic differences by race in the trajectories of psychiatric symptoms and functioning among Veterans during the study period. These findings are consistent with a report on initial responses to the pandemic that revealed only a few select differences by race among Veteran groups. The lack of racial disparities is inconsistent with the double disadvantage hypothesis. Although further investigation is needed, one possible interpretation is that the wrap-around services offered by the Veterans Health Administration may have mitigated expected differences by race among Veterans with psychosis or homelessness. Future research should continue to examine whether VA services mitigate disparities in mental health and psychosocial outcomes.
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Affiliation(s)
- Derek M Novacek
- Center on Enhancement of Community Integration for Homeless Veterans, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA.
| | - Jonathan K Wynn
- Center on Enhancement of Community Integration for Homeless Veterans, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
| | - Amanda McCleery
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA; Department of Psychological and Brain Sciences, University of Iowa, Iowa City, IA, USA
| | - Eric A Reavis
- Center on Enhancement of Community Integration for Homeless Veterans, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
| | - Damla Senturk
- Department of Biostatistics, University of California, Los Angeles, CA, USA
| | - Catherine A Sugar
- Center on Enhancement of Community Integration for Homeless Veterans, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA; Department of Biostatistics, University of California, Los Angeles, CA, USA
| | - Jack Tsai
- School of Public Health, University of Texas Health Science Center at Houston, Houston, TX, USA; National Center on Homelessness Among Veterans, US Department of Veterans Affairs, Tampa, FL, USA; Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Michael F Green
- Center on Enhancement of Community Integration for Homeless Veterans, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, USA
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Green MF, Wynn JK, Eisenberger NI, Horan WP, Lee J, McCleery A, Miklowitz DJ, Reavis EA, Reddy LF. Social cognition and social motivation in schizophrenia and bipolar disorder: are impairments linked to the disorder or to being socially isolated? Psychol Med 2024:1-9. [PMID: 38314526 DOI: 10.1017/s0033291724000102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2024]
Abstract
BACKGROUND People with schizophrenia on average are more socially isolated, lonelier, have more social cognitive impairment, and are less socially motivated than healthy individuals. People with bipolar disorder also have social isolation, though typically less than that seen in schizophrenia. We aimed to disentangle whether the social cognitive and social motivation impairments observed in schizophrenia are a specific feature of the clinical condition v. social isolation generally. METHODS We compared four groups (clinically stable patients with schizophrenia or bipolar disorder, individuals drawn from the community with self-described social isolation, and a socially connected community control group) on loneliness, social cognition, and approach and avoidance social motivation. RESULTS Individuals with schizophrenia (n = 72) showed intermediate levels of social isolation, loneliness, and social approach motivation between the isolated (n = 96) and connected control (n = 55) groups. However, they showed significant deficits in social cognition compared to both community groups. Individuals with bipolar disorder (n = 48) were intermediate between isolated and control groups for loneliness and social approach. They did not show deficits on social cognition tasks. Both clinical groups had higher social avoidance than both community groups. CONCLUSIONS The results suggest that social cognitive deficits in schizophrenia, and high social avoidance motivation in both schizophrenia and bipolar disorder, are distinct features of the clinical conditions and not byproducts of social isolation. In contrast, differences between clinical and control groups on levels of loneliness and social approach motivation were congruent with the groups' degree of social isolation.
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Affiliation(s)
- Michael F Green
- Department of Psychiatry and Biobehavioral Sciences, Jane and Terry Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA, USA
- VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
- VA Rehabilitation R&D Center on Enhancing Community Integration for Homeless Veterans, Los Angeles, CA, USA
| | - Jonathan K Wynn
- Department of Psychiatry and Biobehavioral Sciences, Jane and Terry Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA, USA
- VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
- VA Rehabilitation R&D Center on Enhancing Community Integration for Homeless Veterans, Los Angeles, CA, USA
| | | | - William P Horan
- Department of Psychiatry and Biobehavioral Sciences, Jane and Terry Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA, USA
- Karuna Therapeutics, Boston, MA, USA
| | - Junghee Lee
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Amanda McCleery
- Department of Psychiatry and Biobehavioral Sciences, Jane and Terry Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA, USA
- Department of Psychological and Brain Sciences, University of Iowa, Iowa City, IA, USA
| | - David J Miklowitz
- Department of Psychiatry and Biobehavioral Sciences, Jane and Terry Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA, USA
| | - Eric A Reavis
- Department of Psychiatry and Biobehavioral Sciences, Jane and Terry Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA, USA
- VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
- VA Rehabilitation R&D Center on Enhancing Community Integration for Homeless Veterans, Los Angeles, CA, USA
| | - L Felice Reddy
- VA Rehabilitation R&D Center on Enhancing Community Integration for Homeless Veterans, Los Angeles, CA, USA
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA
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Tandon R, Nasrallah H, Akbarian S, Carpenter WT, DeLisi LE, Gaebel W, Green MF, Gur RE, Heckers S, Kane JM, Malaspina D, Meyer-Lindenberg A, Murray R, Owen M, Smoller JW, Yassin W, Keshavan M. The schizophrenia syndrome, circa 2024: What we know and how that informs its nature. Schizophr Res 2024; 264:1-28. [PMID: 38086109 DOI: 10.1016/j.schres.2023.11.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Revised: 11/23/2023] [Accepted: 11/29/2023] [Indexed: 03/01/2024]
Abstract
With new data about different aspects of schizophrenia being continually generated, it becomes necessary to periodically revisit exactly what we know. Along with a need to review what we currently know about schizophrenia, there is an equal imperative to evaluate the construct itself. With these objectives, we undertook an iterative, multi-phase process involving fifty international experts in the field, with each step building on learnings from the prior one. This review assembles currently established findings about schizophrenia (construct, etiology, pathophysiology, clinical expression, treatment) and posits what they reveal about its nature. Schizophrenia is a heritable, complex, multi-dimensional syndrome with varying degrees of psychotic, negative, cognitive, mood, and motor manifestations. The illness exhibits a remitting and relapsing course, with varying degrees of recovery among affected individuals with most experiencing significant social and functional impairment. Genetic risk factors likely include thousands of common genetic variants that each have a small impact on an individual's risk and a plethora of rare gene variants that have a larger individual impact on risk. Their biological effects are concentrated in the brain and many of the same variants also increase the risk of other psychiatric disorders such as bipolar disorder, autism, and other neurodevelopmental conditions. Environmental risk factors include but are not limited to urban residence in childhood, migration, older paternal age at birth, cannabis use, childhood trauma, antenatal maternal infection, and perinatal hypoxia. Structural, functional, and neurochemical brain alterations implicate multiple regions and functional circuits. Dopamine D-2 receptor antagonists and partial agonists improve psychotic symptoms and reduce risk of relapse. Certain psychological and psychosocial interventions are beneficial. Early intervention can reduce treatment delay and improve outcomes. Schizophrenia is increasingly considered to be a heterogeneous syndrome and not a singular disease entity. There is no necessary or sufficient etiology, pathology, set of clinical features, or treatment that fully circumscribes this syndrome. A single, common pathophysiological pathway appears unlikely. The boundaries of schizophrenia remain fuzzy, suggesting the absence of a categorical fit and need to reconceptualize it as a broader, multi-dimensional and/or spectrum construct.
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Affiliation(s)
- Rajiv Tandon
- Department of Psychiatry, WMU Homer Stryker School of Medicine, Kalamazoo, MI 49008, United States of America.
| | - Henry Nasrallah
- Department of Psychiatry, University of Cincinnati College of Medicine Cincinnati, OH 45267, United States of America
| | - Schahram Akbarian
- Department of Psychiatry, Icahn School of Medicine at Mt. Sinai, New York, NY 10029, United States of America
| | - William T Carpenter
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD 21201, United States of America
| | - Lynn E DeLisi
- Department of Psychiatry, Cambridge Health Alliance and Harvard Medical School, Cambridge, MA 02139, United States of America
| | - Wolfgang Gaebel
- Department of Psychiatry and Psychotherapy, LVR-Klinikum Dusseldorf, Heinrich-Heine University, Dusseldorf, Germany
| | - Michael F Green
- Department of Psychiatry and Biobehavioral Sciences, Jane and Terry Semel Institute of Neuroscience and Human Behavior, UCLA, Los Angeles, CA 90024, United States of America; Greater Los Angeles Veterans' Administration Healthcare System, United States of America
| | - Raquel E Gur
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA 19104, United States of America
| | - Stephan Heckers
- Department of Psychiatry, Vanderbilt University Medical Center, Nashville, TN 37232, United States of America
| | - John M Kane
- Department of Psychiatry, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Glen Oaks, NY 11004, United States of America
| | - Dolores Malaspina
- Department of Psychiatry, Neuroscience, Genetics, and Genomics, Icahn School of Medicine at Mt. Sinai, New York, NY 10029, United States of America
| | - Andreas Meyer-Lindenberg
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Mannhein/Heidelberg University, Mannheim, Germany
| | - Robin Murray
- Institute of Psychiatry, Psychology, and Neuroscience, Kings College, London, UK
| | - Michael Owen
- Centre for Neuropsychiatric Genetics and Genomics, and Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - Jordan W Smoller
- Center for Precision Psychiatry, Department of Psychiatry, Psychiatric and Neurodevelopmental Unit, Center for Genomic Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA 02114, United States of America
| | - Walid Yassin
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02115, United States of America
| | - Matcheri Keshavan
- Department of Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA 02115, United States of America
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Catalano LT, Wynn JK, Eisenberger NI, Horan WP, Lee J, McCleery A, Miklowitz DJ, Reavis EA, Reddy LF, Green MF. An ERP Study of Face Processing in Schizophrenia, Bipolar Disorder, and Socially Isolated Individuals from the Community. Clin EEG Neurosci 2024:15500594231222979. [PMID: 38298008 DOI: 10.1177/15500594231222979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2024]
Abstract
People with schizophrenia (SCZ) and bipolar disorder (BD) have impairments in processing social information, including faces. The neural correlates of face processing are widely studied with the N170 ERP component. However, it is unclear whether N170 deficits reflect neural abnormalities associated with these clinical conditions or differences in social environments. The goal of this study was to determine whether N170 deficits would still be present in SCZ and BD when compared with socially isolated community members. Participants included 66 people with SCZ, 37 with BD, and 125 community members (76 "Community-Isolated"; 49 "Community-Connected"). Electroencephalography was recorded during a face processing task in which participants identified the gender of a face, the emotion of a face (angry, happy, neutral), or the number of stories in a building. We examined group differences in the N170 face effect (greater amplitudes for faces vs buildings) and the N170 emotion effect (greater amplitudes for emotional vs neutral expressions). Groups significantly differed in levels of social isolation (Community-Isolated > SCZ > BD = Community-Connected). SCZ participants had significantly reduced N170 amplitudes to faces compared with both community groups, which did not differ from each other. The BD group was intermediate and did not differ from any group. There were no significant group differences in the processing of specific emotional facial expressions. The N170 is abnormal in SCZ even when compared to socially isolated community members. Hence, the N170 seems to reflect a social processing impairment in SCZ that is separate from level of social isolation.
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Affiliation(s)
- Lauren T Catalano
- Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA, USA
| | - Jonathan K Wynn
- Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA, USA
| | - Naomi I Eisenberger
- Department of Psychology, University of California Los Angeles, Los Angeles, CA, USA
| | - William P Horan
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA, USA
- VeraSci, Durham, NC, USA
| | - Junghee Lee
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Amanda McCleery
- Department of Psychological and Brain Sciences, University of Iowa, Iowa City, IA, USA
| | - David J Miklowitz
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA, USA
| | - Eric A Reavis
- Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA, USA
| | - L Felice Reddy
- Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA, USA
| | - Michael F Green
- Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA, USA
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Abplanalp SJ, Braff DL, Light GA, Joshi YB, Nuechterlein KH, Green MF. Clarifying directional dependence among measures of early auditory processing and cognition in schizophrenia: leveraging Gaussian graphical models and Bayesian networks. Psychol Med 2024:1-10. [PMID: 38287656 DOI: 10.1017/s0033291724000023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/31/2024]
Abstract
BACKGROUND Research using latent variable models demonstrates that pre-attentive measures of early auditory processing (EAP) and cognition may initiate a cascading effect on daily functioning in schizophrenia. However, such models fail to account for relationships among individual measures of cognition and EAP, thereby limiting their utility. Hence, EAP and cognition may function as complementary and interacting measures of brain function rather than independent stages of information processing. Here, we apply a data-driven approach to identifying directional relationships among neurophysiologic and cognitive variables. METHODS Using data from the Consortium on the Genetics of Schizophrenia 2, we estimated Gaussian Graphical Models and Bayesian networks to examine undirected and directed connections between measures of EAP, including mismatch negativity and P3a, and cognition in 663 outpatients with schizophrenia and 630 control participants. RESULTS Chain structures emerged among EAP and attention/vigilance measures in schizophrenia and control groups. Concerning differences between the groups, object memory was an influential variable in schizophrenia upon which other cognitive domains depended, and working memory was an influential variable in controls. CONCLUSIONS Measures of EAP and attention/vigilance are conditionally independent of other cognitive domains that were used in this study. Findings also revealed additional causal assumptions among measures of cognition that could help guide statistical control and ultimately help identify early-stage targets or surrogate endpoints in schizophrenia.
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Affiliation(s)
- Samuel J Abplanalp
- Desert Pacific Mental Illness Research, Education and Clinical Center, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA
| | - David L Braff
- Desert Pacific Mental Illness Research Education and Clinical Center, VA San Diego Healthcare System, San Diego, CA, USA
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - Gregory A Light
- Desert Pacific Mental Illness Research Education and Clinical Center, VA San Diego Healthcare System, San Diego, CA, USA
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - Yash B Joshi
- Desert Pacific Mental Illness Research Education and Clinical Center, VA San Diego Healthcare System, San Diego, CA, USA
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - Keith H Nuechterlein
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA
| | - Michael F Green
- Desert Pacific Mental Illness Research, Education and Clinical Center, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA
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McCleery A, Wynn JK, Novacek DM, Reavis EA, Senturk D, Sugar CA, Tsai J, Green MF. The impact of psychological strengths on Veteran populations' mental health trajectories during the COVID-19 pandemic. Soc Psychiatry Psychiatr Epidemiol 2024; 59:111-120. [PMID: 37314492 PMCID: PMC10719422 DOI: 10.1007/s00127-023-02518-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/16/2023] [Accepted: 06/07/2023] [Indexed: 06/15/2023]
Abstract
PURPOSE Mental health trajectories during the COVID-19 pandemic have been examined in Veterans with tenuous social connections, i.e., those with recent homelessness (RHV) or a psychotic disorder (PSY), and in control Veterans (CTL). We test potential moderating effects on these trajectories by psychological factors that may help individuals weather the socio-emotional challenges associated with the pandemic (i.e., 'psychological strengths'). METHODS We assessed 81 PSY, 76 RHV, and 74 CTL over 5 periods between 05/2020 and 07/2021. Mental health outcomes (i.e., symptoms of depression, anxiety, contamination concerns, loneliness) were assessed at each period, and psychological strengths (i.e., a composite score based on tolerance of uncertainty, performance beliefs, coping style, resilience, perceived stress) were assessed at the initial assessment. Generalized models tested fixed and time-varying effects of a composite psychological strengths score on clinical trajectories across samples and within each group. RESULTS Psychological strengths had a significant effect on trajectories for each outcome (ps < 0.05), serving to ameliorate changes in mental health symptoms. The timing of this effect varied across outcomes, with early effects for depression and anxiety, later effects for loneliness, and sustained effects for contamination concerns. A significant time-varying effect of psychological strengths on depressive symptoms was evident in RHV and CTL, anxious symptoms in RHV, contamination concerns in PSY and CTL, and loneliness in CTL (ps < 0.05). CONCLUSION Across vulnerable and non-vulnerable Veterans, presence of psychological strengths buffered against exacerbations in clinical symptoms. The timing of the effect varied across outcomes and by group.
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Affiliation(s)
- Amanda McCleery
- Department of Psychological and Brain Sciences, University of Iowa, Iowa City, IA, 52242, USA.
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA.
| | - Jonathan K Wynn
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
- VA Rehabilitation R&D Center on Enhancing Community Integration for Homeless Veterans, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, USA
| | - Derek M Novacek
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
- VA Rehabilitation R&D Center on Enhancing Community Integration for Homeless Veterans, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, USA
| | - Eric A Reavis
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
- VA Rehabilitation R&D Center on Enhancing Community Integration for Homeless Veterans, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, USA
| | - Damla Senturk
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
- Department of Biostatistics, University of California, Los Angeles, CA, USA
| | - Catherine A Sugar
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
- Department of Biostatistics, University of California, Los Angeles, CA, USA
| | - Jack Tsai
- VA National Center on Homelessness Among Veterans, Washington, DC, USA
- School of Public Health, University of Texas Health Science Center at Houston, Houston, TX, USA
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Michael F Green
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
- VA Rehabilitation R&D Center on Enhancing Community Integration for Homeless Veterans, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, USA
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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] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [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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10
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Hajdúk M, Abplanalp SJ, Jimenez AM, Fisher M, Haut KM, Hooker CI, Lee H, Ventura J, Nahum M, Green MF. Linking social motivation, general motivation, and social cognition to interpersonal functioning in schizophrenia: insights from exploratory graph analysis. Eur Arch Psychiatry Clin Neurosci 2023:10.1007/s00406-023-01733-4. [PMID: 38110742 DOI: 10.1007/s00406-023-01733-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Accepted: 11/21/2023] [Indexed: 12/20/2023]
Abstract
Motivation in general, and social motivation in particular are important for interpersonal functioning in individuals with schizophrenia. Still, their roles after accounting for social cognition, are not well understood. The sample consisted of 147 patients with schizophrenia. General motivation was measured using the Behavioral inhibition/activation scale (BIS/BAS). Social motivation was measured by Passive social withdrawal and Active social avoidance items from PANSS. Interpersonal functioning was evaluated with Birchwood's Social Functioning Scale (SFS). We used Exploratory Graph Analysis for network estimation and community detection. Active social avoidance, passive social withdrawal, and social withdrawal/engagement (from SFS) were the most important nodes. In addition, three distinct communities were identified: Social cognition, Social motivation, and Interpersonal functioning. Notably, the BIS and BAS measures of general motivation were not part of any community. BAS showed stronger links to functioning than BIS. Passive social withdrawal was more strongly linked to interpersonal functioning than social cognitive abilities. Results suggest that social motivation, especially social approach, is more closely related to interpersonal functioning in schizophrenia than general motivation. In contrast, we found that general motivation was largely unrelated to social motivation. This pattern highlights the importance of type of motivation for understanding variability in interpersonal difficulties in schizophrenia.
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Affiliation(s)
- Michal Hajdúk
- Department of Psychology, Faculty of Arts, Comenius University in Bratislava, Gondova 2, Bratislava, 811 02, Slovakia.
- The Centre for Psychiatric Disorders Research, Science Park, Comenius University in Bratislava, Bratislava, Slovakia.
- Department of Psychiatry, Faculty of Medicine, Comenius University in Bratislava, Bratislava, Slovakia.
| | - Samuel J Abplanalp
- Department of Veterans Affairs, Desert Pacific Mental Illness Research, Education, and Clinical Center, Los Angeles, USA
- Department of Psychiatry and Biobehavioral Sciences, Jane and Terry Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, USA
| | - Amy M Jimenez
- Department of Veterans Affairs, Desert Pacific Mental Illness Research, Education, and Clinical Center, Los Angeles, USA
- Department of Psychiatry and Biobehavioral Sciences, Jane and Terry Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, USA
| | - Melissa Fisher
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN, USA
| | - Kristen M Haut
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Christine I Hooker
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL, USA
| | - Hyunkyu Lee
- Department of Research and Development, Posit Science Inc, San Francisco, USA
| | - Joseph Ventura
- Department of Psychiatry and Biobehavioral Sciences, Jane and Terry Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, USA
| | - Mor Nahum
- School of Occupational Therapy, Faculty of Medicine, Hebrew University, Jerusalem, Israel
| | - Michael F Green
- Department of Veterans Affairs, Desert Pacific Mental Illness Research, Education, and Clinical Center, Los Angeles, USA
- Department of Psychiatry and Biobehavioral Sciences, Jane and Terry Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, USA
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11
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Le TP, Green MF, Wynn JK, Iglesias JE, Franco RL, Kopelowicz A, Kern RS. Effort-based decision-making as a determinant of supported employment outcomes in psychotic disorders. Schizophr Res 2023; 262:149-155. [PMID: 37979418 PMCID: PMC10923523 DOI: 10.1016/j.schres.2023.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Revised: 09/29/2023] [Accepted: 11/04/2023] [Indexed: 11/20/2023]
Abstract
Schizophrenia is associated with a heavy economic burden in the United States that is partly due to the high rates of chronic unemployment. Individual Placement and Support (IPS) is an evidenced-based type of supported employment that can improve job obtainment and work outcomes in psychotic disorders. Outcomes vary widely and a persistent challenge for IPS is low levels of engagement in the initial job search phase. Past studies have focused on interview-based motivation deficits as a key determinant of poor treatment engagement and work outcomes in schizophrenia. New validated performance-based measures of motivation, including effort-based decision-making (EBDM) tasks, may explain supported employment outcomes and provide insights into individual differences in IPS outcomes. This study investigated the degree to which IPS engagement (i.e., number of sessions attended during the first four months of service delivery) was related to baseline interview-based motivation deficits and performance on three EBDM tasks - two tasks of physical effort and one of cognitive effort (i.e., Balloon Task, Effort Expenditure for Rewards Task, Deck Choice Effort Task) - in a sample (N = 47) of people with a psychotic disorder. Results indicated that the level of EBDM performance, specifically on the Balloon Task, predicted IPS engagement, accounting for an additional 17 % of the variance above and beyond interview-based motivation deficits (total R2 = 24 %). Overall, these findings suggest that addressing motivational deficits in effort-based decision-making may be beneficial to IPS engagement, which in turn may improve the trajectory of work outcomes.
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Affiliation(s)
- Thanh P Le
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, United States of America; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States of America; Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, United States of America.
| | - Michael F Green
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States of America; Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, United States of America
| | - Jonathan K Wynn
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States of America; Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, United States of America
| | - Julio E Iglesias
- Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, United States of America
| | - Richard L Franco
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States of America
| | - Alex Kopelowicz
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States of America
| | - Robert S Kern
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, United States of America; Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, United States of America
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12
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Jimenez AM, Green MF. Understanding the Causal Pathway of Social Determinants of Psychosis: The Role of Social Functioning, Relevance of Animal Models, and Implications for Treatment. Schizophr Bull 2023; 49:1422-1424. [PMID: 37672342 PMCID: PMC10686331 DOI: 10.1093/schbul/sbad133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2023] [Accepted: 08/25/2023] [Indexed: 09/08/2023]
Abstract
There is mounting evidence that the social determinants of psychosis operate via a long and circuitous route. Here, we comment on the striking findings from a recent study by Ku et al., that area-level social environmental factors yield social disability and increased risk for schizophrenia through intervening variables and over a long time course. We discuss the relevance of animal models of social isolation to understand how environmental factors interrelate with individual-level mechanisms. We also discuss treatment implications, including the search for novel psychopharmacological treatments for reduced social motivation, and the need for a comprehensive prediction and prevention model.
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Affiliation(s)
- Amy M Jimenez
- Department of Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA
| | - Michael F Green
- Department of Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA
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13
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Tsai J, McCleery A, Wynn JK, Green MF. Unconditional Cash Transfers and Association With Clinical Outcomes Among U.S. Veterans With Psychosis or Recent Homelessness. Psychiatr Serv 2023; 74:1123-1131. [PMID: 37161346 DOI: 10.1176/appi.ps.20230021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
OBJECTIVE Three rounds of stimulus checks were distributed to middle- and low-income U.S. adults during the COVID-19 pandemic. This 15-month longitudinal study examined rates of receipt of these stimulus checks, planned expenses, and associations with clinical outcomes among three veteran groups. METHODS In total, 158 veterans, consisting of 59 with a psychotic disorder, 49 recently homeless veterans, and a comparison group of 50 veterans without a history of psychosis or homelessness, were assessed five times between May 2020 and July 2021. Bivariate analyses were used to compare receipt of stimulus checks and planned expenses among the groups, and multivariable analyses examined how receipt of checks was related to mental health and substance use over time. RESULTS No group difference was found in receipt of stimulus checks, and 74%-84% of veterans reported receipt of more than one check. Most participants reported plans to use their stimulus checks to pay for bills, groceries, credit card debt, and rent or mortgage or to save the money. Over time, participants who received a greater number of stimulus checks reported significantly decreased symptoms of depression (B=-0.48) and anxiety (B=-0.84) and improved social functioning (B=0.24). For the recently homeless group, a greater number of stimulus checks received was associated with decreases in days of alcohol intoxication and drug use, but the reverse was found for the psychosis group. CONCLUSIONS Multiple short-term unconditional government cash transfers may improve mental and social functioning among vulnerable populations during major crises, a finding that contributes to the research literature and has policy implications for pandemic and emergency preparedness.
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Affiliation(s)
- Jack Tsai
- National Center on Homelessness Among Veterans, U.S. Department of Veterans Affairs (VA), Washington, D.C. (Tsai); School of Public Health, University of Texas Health Science Center at Houston, Houston (Tsai); Department of Psychology, University of Iowa, Iowa City (McCleery); VA Greater Los Angeles Healthcare System, Los Angeles (Wynn, Green); Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles (Wynn, Green)
| | - Amanda McCleery
- National Center on Homelessness Among Veterans, U.S. Department of Veterans Affairs (VA), Washington, D.C. (Tsai); School of Public Health, University of Texas Health Science Center at Houston, Houston (Tsai); Department of Psychology, University of Iowa, Iowa City (McCleery); VA Greater Los Angeles Healthcare System, Los Angeles (Wynn, Green); Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles (Wynn, Green)
| | - Jonathan K Wynn
- National Center on Homelessness Among Veterans, U.S. Department of Veterans Affairs (VA), Washington, D.C. (Tsai); School of Public Health, University of Texas Health Science Center at Houston, Houston (Tsai); Department of Psychology, University of Iowa, Iowa City (McCleery); VA Greater Los Angeles Healthcare System, Los Angeles (Wynn, Green); Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles (Wynn, Green)
| | - Michael F Green
- National Center on Homelessness Among Veterans, U.S. Department of Veterans Affairs (VA), Washington, D.C. (Tsai); School of Public Health, University of Texas Health Science Center at Houston, Houston (Tsai); Department of Psychology, University of Iowa, Iowa City (McCleery); VA Greater Los Angeles Healthcare System, Los Angeles (Wynn, Green); Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles (Wynn, Green)
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14
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Jimenez AM, Clayson PE, Hasratian AS, Lee J, Reavis EA, Wynn JK, Green MF, Horan WP. Neuroimaging of social motivation during winning and losing: Associations with social anhedonia across the psychosis spectrum. Neuropsychologia 2023; 188:108621. [PMID: 37321406 PMCID: PMC10527321 DOI: 10.1016/j.neuropsychologia.2023.108621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2022] [Revised: 06/10/2023] [Accepted: 06/10/2023] [Indexed: 06/17/2023]
Abstract
BACKGROUND Individuals with psychosis spectrum disorders (PSD) have difficulty developing social relationships. This difficulty may reflect reduced response to social feedback involving functional alterations in brain regions that support the social motivation system: ventral striatum, orbital frontal cortex, insula, dorsal anterior cingulate cortex, and amygdala. Whether these alterations span PSD is unknown. METHODS 71 individuals with PSD, 27 unaffected siblings, and 37 control participants completed a team-based fMRI task. After each trial, participants received performance feedback paired with the expressive face of a teammate or opponent. A 2 × 2 (win versus loss outcome x teammate versus opponent) repeated measures ANOVA by group was performed on activation in the five key regions of interest during receipt of feedback. RESULTS Across groups, three social motivation regions, ventral striatum, orbital frontal cortex, and amygdala, showed sensitivity to feedback (significant main effect of outcome), with greater activation during win versus loss trials, regardless of whether the feedback was from a teammate or opponent. In PSD, ventral striatum and orbital frontal cortex activation to win feedback was negatively correlated with social anhedonia scores. CONCLUSIONS Patterns of neural activation during social feedback were similar in PSD, their unaffected siblings, and healthy controls. Across the psychosis spectrum, activity in key social motivation regions during social feedback was associated with individual differences in social anhedonia.
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Affiliation(s)
- Amy M Jimenez
- Department of Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, CA, USA.
| | - Peter E Clayson
- Department of Psychology, University of South Florida, Tampa, FL, USA
| | - Arpi S Hasratian
- Department of Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, USA
| | - Junghee Lee
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Eric A Reavis
- Department of Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Jonathan K Wynn
- Department of Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
| | - Michael F Green
- Department of Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, CA, USA
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15
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Catalano LT, Green MF. Approaches to Studying and Improving Social Motivation in Schizophrenia. Schizophr Bull 2023; 49:1108-1111. [PMID: 37410026 PMCID: PMC10483455 DOI: 10.1093/schbul/sbad101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/07/2023]
Abstract
Social motivation impairments, or "asociality," have long been considered a core clinical feature of schizophrenia. Although the prevalence and pervasive negative impact of poor social motivation is well-documented, our understanding is limited regarding causal mechanisms. Advances in definition, conceptualization, and characterization are needed to inform research aimed at understanding these mechanisms and developing effective interventions. This theme issue is intended to accelerate efforts to study and treat social motivation in schizophrenia by synthesizing the current knowledge and providing new frameworks to guide future research in this area.
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Affiliation(s)
- Lauren T Catalano
- Desert Pacific Mental Illness Research, Education and Clinical Center, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA, USA
| | - Michael F Green
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA, USA
- Desert Pacific Mental Illness Research, Education and Clinical Center, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, USA
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16
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Catalano LT, Green MF. Social Motivation in Schizophrenia: What's Effort Got to Do With It? Schizophr Bull 2023; 49:1127-1137. [PMID: 37354079 PMCID: PMC10483329 DOI: 10.1093/schbul/sbad090] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/26/2023]
Abstract
BACKGROUND AND HYPOTHESIS Social motivation, defined as the fundamental human desire to seek out, engage in, and maintain interpersonal bonds, has become a growing area of research in schizophrenia. The major focus has been on understanding the impact of social reward-related processes. An obvious but rarely acknowledged fact is that social interactions, much like other goal-directed acts, require the exertion of effort. In this Review Article, we argue that social motivation in schizophrenia can be conceptualized through the lens of an established framework: effort-based decision-making (EBDM). STUDY DESIGN We conducted a literature review on social reward processing in schizophrenia, then extended these findings by applying concepts and insights from the literature on EBDM to the study of social motivation. STUDY RESULTS Within the EBDM framework, decisions about whether or not to pursue social interactions are bound by cost/benefit calculations. That is, people do not pursue social behaviors when the estimated "cost" of the required effort outweighs the anticipated "benefit" or reward. We propose that people with schizophrenia are less likely to engage in social interaction compared with healthy samples because they: (1) underestimate the benefits of relationships (based on expectations of reward/punishment), (2) overestimate the effort costs associated with social interaction, and/or (3) fail to integrate cost-benefit information in an optimal manner. CONCLUSIONS EBDM is an especially promising framework of social motivation that goes beyond the current focus on social reward processing to include a focus on effort.
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Affiliation(s)
- Lauren T Catalano
- Desert Pacific Mental Illness Research, Education and Clinical Center, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA, USA
| | - Michael F Green
- Desert Pacific Mental Illness Research, Education and Clinical Center, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA, USA
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17
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Abplanalp SJ, Lee J, Horan WP, Kern RS, Penn DL, Green MF. A Bayesian Network Approach to Social and Nonsocial Cognition in Schizophrenia: Are Some Domains More Fundamental than Others? Schizophr Bull 2023; 49:997-1006. [PMID: 36869810 PMCID: PMC10318874 DOI: 10.1093/schbul/sbad012] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/05/2023]
Abstract
OBJECTIVES Social and nonsocial cognition are defined as distinct yet related constructs. However, the relative independence of individual variables-and whether specific tasks directly depend on performance in other tasks-is still unclear. The current study aimed to answer this question by using a Bayesian network approach to explore directional dependencies among social and nonsocial cognitive domains. STUDY DESIGN The study sample comprised 173 participants with schizophrenia (71.7% male; 28.3% female). Participants completed 5 social cognitive tasks and the MATRICS Consensus Cognitive Battery. We estimated Bayesian networks using directed acyclic graph structures to examine directional dependencies among the variables. STUDY RESULTS After accounting for negative symptoms and demographic variables, including age and sex, all nonsocial cognitive variables depended on processing speed. More specifically, attention, verbal memory, and reasoning and problem solving solely depended on processing speed, while a causal chain emerged between processing speed and visual memory (processing speed → attention → working memory → visual memory). Social processing variables within social cognition, including emotion in biological motion and empathic accuracy, depended on facial affect identification. CONCLUSIONS These results suggest that processing speed and facial affect identification are fundamental domains of nonsocial and social cognition, respectively. We outline how these findings could potentially help guide specific interventions that aim to improve social and nonsocial cognition in people with schizophrenia.
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Affiliation(s)
- Samuel J Abplanalp
- Desert Pacific Mental Illness Research, Education and Clinical Center, Veterans Affairs Greater Los Angeles Healthcare System, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA
| | - Junghee Lee
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham AL, USA
| | - William P Horan
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA
- WCG VeraSci, Durham, NC, USA
| | - Robert S Kern
- Desert Pacific Mental Illness Research, Education and Clinical Center, Veterans Affairs Greater Los Angeles Healthcare System, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA
| | - David L Penn
- Departement of Psychology and Neuroscience, University of North Carolina at Chapel Hill, Chappel Hill, NC, USA
- School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, VIC, Australia
| | - Michael F Green
- Desert Pacific Mental Illness Research, Education and Clinical Center, Veterans Affairs Greater Los Angeles Healthcare System, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA
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18
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Joshi YB, Molina JL, Braff DL, Green MF, Gur RC, Gur RE, Nuechterlein KH, Stone WS, Greenwood TA, Lazzeroni LC, Radant AD, Silverman JM, Sprock J, Sugar CA, Tsuang DW, Tsuang MT, Turetsky BI, Swerdlow NR, Light GA. Sensitivity of Schizophrenia Endophenotype Biomarkers to Anticholinergic Medication Burden. Am J Psychiatry 2023; 180:519-523. [PMID: 37038743 DOI: 10.1176/appi.ajp.20220649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/12/2023]
Affiliation(s)
- Yash B Joshi
- Desert Pacific Mental Illness Research Education and Clinical Center, VA San Diego Healthcare System (Joshi, Molina, Braff, Sprock, Swerdlow, Light); Department of Psychiatry, University of California, San Diego (Joshi, Molina, Braff, Greenwood, Sprock, M. Tsuang, Swerdlow, Light); Department of Psychiatry and Biobehavioral Sciences, UCLA, Los Angeles (Green, Neuchterlein); Desert Pacific Mental Illness Research Education and Clinical Center, VA Greater Los Angeles Healthcare System, Los Angeles (Green, Sugar); Department of Psychiatry, University of Pennsylvania, Philadelphia (Ruben C. Gur, Raquel E. Gur, Turetsky); Department of Psychiatry, Harvard Medical School, Boston (Stone); Massachusetts Mental Health Center Public Psychiatry Division of the Beth Israel Deaconess Medical Center, Boston (Stone); Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford (Lazzeroni); Department of Biomedical Data Science, Stanford University, Stanford (Lazzeroni); Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle (Radant, D. Tsuang); Northwest Geriatric Research Education and Clinical Center, VA Puget Sound Health Care System, Seattle (D. Tsuang); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Silverman); Research & Development, James J. Peters VA Medical Center, New York (Silverman); Department of Biostatistics, UCLA School of Public Health, Los Angeles (Sugar)
| | - Juan L Molina
- Desert Pacific Mental Illness Research Education and Clinical Center, VA San Diego Healthcare System (Joshi, Molina, Braff, Sprock, Swerdlow, Light); Department of Psychiatry, University of California, San Diego (Joshi, Molina, Braff, Greenwood, Sprock, M. Tsuang, Swerdlow, Light); Department of Psychiatry and Biobehavioral Sciences, UCLA, Los Angeles (Green, Neuchterlein); Desert Pacific Mental Illness Research Education and Clinical Center, VA Greater Los Angeles Healthcare System, Los Angeles (Green, Sugar); Department of Psychiatry, University of Pennsylvania, Philadelphia (Ruben C. Gur, Raquel E. Gur, Turetsky); Department of Psychiatry, Harvard Medical School, Boston (Stone); Massachusetts Mental Health Center Public Psychiatry Division of the Beth Israel Deaconess Medical Center, Boston (Stone); Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford (Lazzeroni); Department of Biomedical Data Science, Stanford University, Stanford (Lazzeroni); Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle (Radant, D. Tsuang); Northwest Geriatric Research Education and Clinical Center, VA Puget Sound Health Care System, Seattle (D. Tsuang); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Silverman); Research & Development, James J. Peters VA Medical Center, New York (Silverman); Department of Biostatistics, UCLA School of Public Health, Los Angeles (Sugar)
| | - David L Braff
- Desert Pacific Mental Illness Research Education and Clinical Center, VA San Diego Healthcare System (Joshi, Molina, Braff, Sprock, Swerdlow, Light); Department of Psychiatry, University of California, San Diego (Joshi, Molina, Braff, Greenwood, Sprock, M. Tsuang, Swerdlow, Light); Department of Psychiatry and Biobehavioral Sciences, UCLA, Los Angeles (Green, Neuchterlein); Desert Pacific Mental Illness Research Education and Clinical Center, VA Greater Los Angeles Healthcare System, Los Angeles (Green, Sugar); Department of Psychiatry, University of Pennsylvania, Philadelphia (Ruben C. Gur, Raquel E. Gur, Turetsky); Department of Psychiatry, Harvard Medical School, Boston (Stone); Massachusetts Mental Health Center Public Psychiatry Division of the Beth Israel Deaconess Medical Center, Boston (Stone); Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford (Lazzeroni); Department of Biomedical Data Science, Stanford University, Stanford (Lazzeroni); Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle (Radant, D. Tsuang); Northwest Geriatric Research Education and Clinical Center, VA Puget Sound Health Care System, Seattle (D. Tsuang); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Silverman); Research & Development, James J. Peters VA Medical Center, New York (Silverman); Department of Biostatistics, UCLA School of Public Health, Los Angeles (Sugar)
| | - Michael F Green
- Desert Pacific Mental Illness Research Education and Clinical Center, VA San Diego Healthcare System (Joshi, Molina, Braff, Sprock, Swerdlow, Light); Department of Psychiatry, University of California, San Diego (Joshi, Molina, Braff, Greenwood, Sprock, M. Tsuang, Swerdlow, Light); Department of Psychiatry and Biobehavioral Sciences, UCLA, Los Angeles (Green, Neuchterlein); Desert Pacific Mental Illness Research Education and Clinical Center, VA Greater Los Angeles Healthcare System, Los Angeles (Green, Sugar); Department of Psychiatry, University of Pennsylvania, Philadelphia (Ruben C. Gur, Raquel E. Gur, Turetsky); Department of Psychiatry, Harvard Medical School, Boston (Stone); Massachusetts Mental Health Center Public Psychiatry Division of the Beth Israel Deaconess Medical Center, Boston (Stone); Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford (Lazzeroni); Department of Biomedical Data Science, Stanford University, Stanford (Lazzeroni); Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle (Radant, D. Tsuang); Northwest Geriatric Research Education and Clinical Center, VA Puget Sound Health Care System, Seattle (D. Tsuang); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Silverman); Research & Development, James J. Peters VA Medical Center, New York (Silverman); Department of Biostatistics, UCLA School of Public Health, Los Angeles (Sugar)
| | - Ruben C Gur
- Desert Pacific Mental Illness Research Education and Clinical Center, VA San Diego Healthcare System (Joshi, Molina, Braff, Sprock, Swerdlow, Light); Department of Psychiatry, University of California, San Diego (Joshi, Molina, Braff, Greenwood, Sprock, M. Tsuang, Swerdlow, Light); Department of Psychiatry and Biobehavioral Sciences, UCLA, Los Angeles (Green, Neuchterlein); Desert Pacific Mental Illness Research Education and Clinical Center, VA Greater Los Angeles Healthcare System, Los Angeles (Green, Sugar); Department of Psychiatry, University of Pennsylvania, Philadelphia (Ruben C. Gur, Raquel E. Gur, Turetsky); Department of Psychiatry, Harvard Medical School, Boston (Stone); Massachusetts Mental Health Center Public Psychiatry Division of the Beth Israel Deaconess Medical Center, Boston (Stone); Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford (Lazzeroni); Department of Biomedical Data Science, Stanford University, Stanford (Lazzeroni); Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle (Radant, D. Tsuang); Northwest Geriatric Research Education and Clinical Center, VA Puget Sound Health Care System, Seattle (D. Tsuang); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Silverman); Research & Development, James J. Peters VA Medical Center, New York (Silverman); Department of Biostatistics, UCLA School of Public Health, Los Angeles (Sugar)
| | - Raquel E Gur
- Desert Pacific Mental Illness Research Education and Clinical Center, VA San Diego Healthcare System (Joshi, Molina, Braff, Sprock, Swerdlow, Light); Department of Psychiatry, University of California, San Diego (Joshi, Molina, Braff, Greenwood, Sprock, M. Tsuang, Swerdlow, Light); Department of Psychiatry and Biobehavioral Sciences, UCLA, Los Angeles (Green, Neuchterlein); Desert Pacific Mental Illness Research Education and Clinical Center, VA Greater Los Angeles Healthcare System, Los Angeles (Green, Sugar); Department of Psychiatry, University of Pennsylvania, Philadelphia (Ruben C. Gur, Raquel E. Gur, Turetsky); Department of Psychiatry, Harvard Medical School, Boston (Stone); Massachusetts Mental Health Center Public Psychiatry Division of the Beth Israel Deaconess Medical Center, Boston (Stone); Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford (Lazzeroni); Department of Biomedical Data Science, Stanford University, Stanford (Lazzeroni); Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle (Radant, D. Tsuang); Northwest Geriatric Research Education and Clinical Center, VA Puget Sound Health Care System, Seattle (D. Tsuang); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Silverman); Research & Development, James J. Peters VA Medical Center, New York (Silverman); Department of Biostatistics, UCLA School of Public Health, Los Angeles (Sugar)
| | - Keith H Nuechterlein
- Desert Pacific Mental Illness Research Education and Clinical Center, VA San Diego Healthcare System (Joshi, Molina, Braff, Sprock, Swerdlow, Light); Department of Psychiatry, University of California, San Diego (Joshi, Molina, Braff, Greenwood, Sprock, M. Tsuang, Swerdlow, Light); Department of Psychiatry and Biobehavioral Sciences, UCLA, Los Angeles (Green, Neuchterlein); Desert Pacific Mental Illness Research Education and Clinical Center, VA Greater Los Angeles Healthcare System, Los Angeles (Green, Sugar); Department of Psychiatry, University of Pennsylvania, Philadelphia (Ruben C. Gur, Raquel E. Gur, Turetsky); Department of Psychiatry, Harvard Medical School, Boston (Stone); Massachusetts Mental Health Center Public Psychiatry Division of the Beth Israel Deaconess Medical Center, Boston (Stone); Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford (Lazzeroni); Department of Biomedical Data Science, Stanford University, Stanford (Lazzeroni); Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle (Radant, D. Tsuang); Northwest Geriatric Research Education and Clinical Center, VA Puget Sound Health Care System, Seattle (D. Tsuang); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Silverman); Research & Development, James J. Peters VA Medical Center, New York (Silverman); Department of Biostatistics, UCLA School of Public Health, Los Angeles (Sugar)
| | - William S Stone
- Desert Pacific Mental Illness Research Education and Clinical Center, VA San Diego Healthcare System (Joshi, Molina, Braff, Sprock, Swerdlow, Light); Department of Psychiatry, University of California, San Diego (Joshi, Molina, Braff, Greenwood, Sprock, M. Tsuang, Swerdlow, Light); Department of Psychiatry and Biobehavioral Sciences, UCLA, Los Angeles (Green, Neuchterlein); Desert Pacific Mental Illness Research Education and Clinical Center, VA Greater Los Angeles Healthcare System, Los Angeles (Green, Sugar); Department of Psychiatry, University of Pennsylvania, Philadelphia (Ruben C. Gur, Raquel E. Gur, Turetsky); Department of Psychiatry, Harvard Medical School, Boston (Stone); Massachusetts Mental Health Center Public Psychiatry Division of the Beth Israel Deaconess Medical Center, Boston (Stone); Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford (Lazzeroni); Department of Biomedical Data Science, Stanford University, Stanford (Lazzeroni); Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle (Radant, D. Tsuang); Northwest Geriatric Research Education and Clinical Center, VA Puget Sound Health Care System, Seattle (D. Tsuang); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Silverman); Research & Development, James J. Peters VA Medical Center, New York (Silverman); Department of Biostatistics, UCLA School of Public Health, Los Angeles (Sugar)
| | - Tiffany A Greenwood
- Desert Pacific Mental Illness Research Education and Clinical Center, VA San Diego Healthcare System (Joshi, Molina, Braff, Sprock, Swerdlow, Light); Department of Psychiatry, University of California, San Diego (Joshi, Molina, Braff, Greenwood, Sprock, M. Tsuang, Swerdlow, Light); Department of Psychiatry and Biobehavioral Sciences, UCLA, Los Angeles (Green, Neuchterlein); Desert Pacific Mental Illness Research Education and Clinical Center, VA Greater Los Angeles Healthcare System, Los Angeles (Green, Sugar); Department of Psychiatry, University of Pennsylvania, Philadelphia (Ruben C. Gur, Raquel E. Gur, Turetsky); Department of Psychiatry, Harvard Medical School, Boston (Stone); Massachusetts Mental Health Center Public Psychiatry Division of the Beth Israel Deaconess Medical Center, Boston (Stone); Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford (Lazzeroni); Department of Biomedical Data Science, Stanford University, Stanford (Lazzeroni); Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle (Radant, D. Tsuang); Northwest Geriatric Research Education and Clinical Center, VA Puget Sound Health Care System, Seattle (D. Tsuang); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Silverman); Research & Development, James J. Peters VA Medical Center, New York (Silverman); Department of Biostatistics, UCLA School of Public Health, Los Angeles (Sugar)
| | - Laura C Lazzeroni
- Desert Pacific Mental Illness Research Education and Clinical Center, VA San Diego Healthcare System (Joshi, Molina, Braff, Sprock, Swerdlow, Light); Department of Psychiatry, University of California, San Diego (Joshi, Molina, Braff, Greenwood, Sprock, M. Tsuang, Swerdlow, Light); Department of Psychiatry and Biobehavioral Sciences, UCLA, Los Angeles (Green, Neuchterlein); Desert Pacific Mental Illness Research Education and Clinical Center, VA Greater Los Angeles Healthcare System, Los Angeles (Green, Sugar); Department of Psychiatry, University of Pennsylvania, Philadelphia (Ruben C. Gur, Raquel E. Gur, Turetsky); Department of Psychiatry, Harvard Medical School, Boston (Stone); Massachusetts Mental Health Center Public Psychiatry Division of the Beth Israel Deaconess Medical Center, Boston (Stone); Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford (Lazzeroni); Department of Biomedical Data Science, Stanford University, Stanford (Lazzeroni); Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle (Radant, D. Tsuang); Northwest Geriatric Research Education and Clinical Center, VA Puget Sound Health Care System, Seattle (D. Tsuang); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Silverman); Research & Development, James J. Peters VA Medical Center, New York (Silverman); Department of Biostatistics, UCLA School of Public Health, Los Angeles (Sugar)
| | - Allen D Radant
- Desert Pacific Mental Illness Research Education and Clinical Center, VA San Diego Healthcare System (Joshi, Molina, Braff, Sprock, Swerdlow, Light); Department of Psychiatry, University of California, San Diego (Joshi, Molina, Braff, Greenwood, Sprock, M. Tsuang, Swerdlow, Light); Department of Psychiatry and Biobehavioral Sciences, UCLA, Los Angeles (Green, Neuchterlein); Desert Pacific Mental Illness Research Education and Clinical Center, VA Greater Los Angeles Healthcare System, Los Angeles (Green, Sugar); Department of Psychiatry, University of Pennsylvania, Philadelphia (Ruben C. Gur, Raquel E. Gur, Turetsky); Department of Psychiatry, Harvard Medical School, Boston (Stone); Massachusetts Mental Health Center Public Psychiatry Division of the Beth Israel Deaconess Medical Center, Boston (Stone); Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford (Lazzeroni); Department of Biomedical Data Science, Stanford University, Stanford (Lazzeroni); Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle (Radant, D. Tsuang); Northwest Geriatric Research Education and Clinical Center, VA Puget Sound Health Care System, Seattle (D. Tsuang); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Silverman); Research & Development, James J. Peters VA Medical Center, New York (Silverman); Department of Biostatistics, UCLA School of Public Health, Los Angeles (Sugar)
| | - Jeremy M Silverman
- Desert Pacific Mental Illness Research Education and Clinical Center, VA San Diego Healthcare System (Joshi, Molina, Braff, Sprock, Swerdlow, Light); Department of Psychiatry, University of California, San Diego (Joshi, Molina, Braff, Greenwood, Sprock, M. Tsuang, Swerdlow, Light); Department of Psychiatry and Biobehavioral Sciences, UCLA, Los Angeles (Green, Neuchterlein); Desert Pacific Mental Illness Research Education and Clinical Center, VA Greater Los Angeles Healthcare System, Los Angeles (Green, Sugar); Department of Psychiatry, University of Pennsylvania, Philadelphia (Ruben C. Gur, Raquel E. Gur, Turetsky); Department of Psychiatry, Harvard Medical School, Boston (Stone); Massachusetts Mental Health Center Public Psychiatry Division of the Beth Israel Deaconess Medical Center, Boston (Stone); Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford (Lazzeroni); Department of Biomedical Data Science, Stanford University, Stanford (Lazzeroni); Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle (Radant, D. Tsuang); Northwest Geriatric Research Education and Clinical Center, VA Puget Sound Health Care System, Seattle (D. Tsuang); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Silverman); Research & Development, James J. Peters VA Medical Center, New York (Silverman); Department of Biostatistics, UCLA School of Public Health, Los Angeles (Sugar)
| | - Joyce Sprock
- Desert Pacific Mental Illness Research Education and Clinical Center, VA San Diego Healthcare System (Joshi, Molina, Braff, Sprock, Swerdlow, Light); Department of Psychiatry, University of California, San Diego (Joshi, Molina, Braff, Greenwood, Sprock, M. Tsuang, Swerdlow, Light); Department of Psychiatry and Biobehavioral Sciences, UCLA, Los Angeles (Green, Neuchterlein); Desert Pacific Mental Illness Research Education and Clinical Center, VA Greater Los Angeles Healthcare System, Los Angeles (Green, Sugar); Department of Psychiatry, University of Pennsylvania, Philadelphia (Ruben C. Gur, Raquel E. Gur, Turetsky); Department of Psychiatry, Harvard Medical School, Boston (Stone); Massachusetts Mental Health Center Public Psychiatry Division of the Beth Israel Deaconess Medical Center, Boston (Stone); Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford (Lazzeroni); Department of Biomedical Data Science, Stanford University, Stanford (Lazzeroni); Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle (Radant, D. Tsuang); Northwest Geriatric Research Education and Clinical Center, VA Puget Sound Health Care System, Seattle (D. Tsuang); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Silverman); Research & Development, James J. Peters VA Medical Center, New York (Silverman); Department of Biostatistics, UCLA School of Public Health, Los Angeles (Sugar)
| | - Catherine A Sugar
- Desert Pacific Mental Illness Research Education and Clinical Center, VA San Diego Healthcare System (Joshi, Molina, Braff, Sprock, Swerdlow, Light); Department of Psychiatry, University of California, San Diego (Joshi, Molina, Braff, Greenwood, Sprock, M. Tsuang, Swerdlow, Light); Department of Psychiatry and Biobehavioral Sciences, UCLA, Los Angeles (Green, Neuchterlein); Desert Pacific Mental Illness Research Education and Clinical Center, VA Greater Los Angeles Healthcare System, Los Angeles (Green, Sugar); Department of Psychiatry, University of Pennsylvania, Philadelphia (Ruben C. Gur, Raquel E. Gur, Turetsky); Department of Psychiatry, Harvard Medical School, Boston (Stone); Massachusetts Mental Health Center Public Psychiatry Division of the Beth Israel Deaconess Medical Center, Boston (Stone); Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford (Lazzeroni); Department of Biomedical Data Science, Stanford University, Stanford (Lazzeroni); Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle (Radant, D. Tsuang); Northwest Geriatric Research Education and Clinical Center, VA Puget Sound Health Care System, Seattle (D. Tsuang); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Silverman); Research & Development, James J. Peters VA Medical Center, New York (Silverman); Department of Biostatistics, UCLA School of Public Health, Los Angeles (Sugar)
| | - Debby W Tsuang
- Desert Pacific Mental Illness Research Education and Clinical Center, VA San Diego Healthcare System (Joshi, Molina, Braff, Sprock, Swerdlow, Light); Department of Psychiatry, University of California, San Diego (Joshi, Molina, Braff, Greenwood, Sprock, M. Tsuang, Swerdlow, Light); Department of Psychiatry and Biobehavioral Sciences, UCLA, Los Angeles (Green, Neuchterlein); Desert Pacific Mental Illness Research Education and Clinical Center, VA Greater Los Angeles Healthcare System, Los Angeles (Green, Sugar); Department of Psychiatry, University of Pennsylvania, Philadelphia (Ruben C. Gur, Raquel E. Gur, Turetsky); Department of Psychiatry, Harvard Medical School, Boston (Stone); Massachusetts Mental Health Center Public Psychiatry Division of the Beth Israel Deaconess Medical Center, Boston (Stone); Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford (Lazzeroni); Department of Biomedical Data Science, Stanford University, Stanford (Lazzeroni); Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle (Radant, D. Tsuang); Northwest Geriatric Research Education and Clinical Center, VA Puget Sound Health Care System, Seattle (D. Tsuang); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Silverman); Research & Development, James J. Peters VA Medical Center, New York (Silverman); Department of Biostatistics, UCLA School of Public Health, Los Angeles (Sugar)
| | - Ming T Tsuang
- Desert Pacific Mental Illness Research Education and Clinical Center, VA San Diego Healthcare System (Joshi, Molina, Braff, Sprock, Swerdlow, Light); Department of Psychiatry, University of California, San Diego (Joshi, Molina, Braff, Greenwood, Sprock, M. Tsuang, Swerdlow, Light); Department of Psychiatry and Biobehavioral Sciences, UCLA, Los Angeles (Green, Neuchterlein); Desert Pacific Mental Illness Research Education and Clinical Center, VA Greater Los Angeles Healthcare System, Los Angeles (Green, Sugar); Department of Psychiatry, University of Pennsylvania, Philadelphia (Ruben C. Gur, Raquel E. Gur, Turetsky); Department of Psychiatry, Harvard Medical School, Boston (Stone); Massachusetts Mental Health Center Public Psychiatry Division of the Beth Israel Deaconess Medical Center, Boston (Stone); Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford (Lazzeroni); Department of Biomedical Data Science, Stanford University, Stanford (Lazzeroni); Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle (Radant, D. Tsuang); Northwest Geriatric Research Education and Clinical Center, VA Puget Sound Health Care System, Seattle (D. Tsuang); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Silverman); Research & Development, James J. Peters VA Medical Center, New York (Silverman); Department of Biostatistics, UCLA School of Public Health, Los Angeles (Sugar)
| | - Bruce I Turetsky
- Desert Pacific Mental Illness Research Education and Clinical Center, VA San Diego Healthcare System (Joshi, Molina, Braff, Sprock, Swerdlow, Light); Department of Psychiatry, University of California, San Diego (Joshi, Molina, Braff, Greenwood, Sprock, M. Tsuang, Swerdlow, Light); Department of Psychiatry and Biobehavioral Sciences, UCLA, Los Angeles (Green, Neuchterlein); Desert Pacific Mental Illness Research Education and Clinical Center, VA Greater Los Angeles Healthcare System, Los Angeles (Green, Sugar); Department of Psychiatry, University of Pennsylvania, Philadelphia (Ruben C. Gur, Raquel E. Gur, Turetsky); Department of Psychiatry, Harvard Medical School, Boston (Stone); Massachusetts Mental Health Center Public Psychiatry Division of the Beth Israel Deaconess Medical Center, Boston (Stone); Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford (Lazzeroni); Department of Biomedical Data Science, Stanford University, Stanford (Lazzeroni); Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle (Radant, D. Tsuang); Northwest Geriatric Research Education and Clinical Center, VA Puget Sound Health Care System, Seattle (D. Tsuang); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Silverman); Research & Development, James J. Peters VA Medical Center, New York (Silverman); Department of Biostatistics, UCLA School of Public Health, Los Angeles (Sugar)
| | - Neal R Swerdlow
- Desert Pacific Mental Illness Research Education and Clinical Center, VA San Diego Healthcare System (Joshi, Molina, Braff, Sprock, Swerdlow, Light); Department of Psychiatry, University of California, San Diego (Joshi, Molina, Braff, Greenwood, Sprock, M. Tsuang, Swerdlow, Light); Department of Psychiatry and Biobehavioral Sciences, UCLA, Los Angeles (Green, Neuchterlein); Desert Pacific Mental Illness Research Education and Clinical Center, VA Greater Los Angeles Healthcare System, Los Angeles (Green, Sugar); Department of Psychiatry, University of Pennsylvania, Philadelphia (Ruben C. Gur, Raquel E. Gur, Turetsky); Department of Psychiatry, Harvard Medical School, Boston (Stone); Massachusetts Mental Health Center Public Psychiatry Division of the Beth Israel Deaconess Medical Center, Boston (Stone); Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford (Lazzeroni); Department of Biomedical Data Science, Stanford University, Stanford (Lazzeroni); Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle (Radant, D. Tsuang); Northwest Geriatric Research Education and Clinical Center, VA Puget Sound Health Care System, Seattle (D. Tsuang); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Silverman); Research & Development, James J. Peters VA Medical Center, New York (Silverman); Department of Biostatistics, UCLA School of Public Health, Los Angeles (Sugar)
| | - Gregory A Light
- Desert Pacific Mental Illness Research Education and Clinical Center, VA San Diego Healthcare System (Joshi, Molina, Braff, Sprock, Swerdlow, Light); Department of Psychiatry, University of California, San Diego (Joshi, Molina, Braff, Greenwood, Sprock, M. Tsuang, Swerdlow, Light); Department of Psychiatry and Biobehavioral Sciences, UCLA, Los Angeles (Green, Neuchterlein); Desert Pacific Mental Illness Research Education and Clinical Center, VA Greater Los Angeles Healthcare System, Los Angeles (Green, Sugar); Department of Psychiatry, University of Pennsylvania, Philadelphia (Ruben C. Gur, Raquel E. Gur, Turetsky); Department of Psychiatry, Harvard Medical School, Boston (Stone); Massachusetts Mental Health Center Public Psychiatry Division of the Beth Israel Deaconess Medical Center, Boston (Stone); Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford (Lazzeroni); Department of Biomedical Data Science, Stanford University, Stanford (Lazzeroni); Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle (Radant, D. Tsuang); Northwest Geriatric Research Education and Clinical Center, VA Puget Sound Health Care System, Seattle (D. Tsuang); Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Silverman); Research & Development, James J. Peters VA Medical Center, New York (Silverman); Department of Biostatistics, UCLA School of Public Health, Los Angeles (Sugar)
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Reddy LF, Glynn SM, McGovern JE, Sugar CA, Reavis EA, Green MF. A Novel Psychosocial Intervention for Motivational Negative Symptoms in Schizophrenia: Combined Motivational Interviewing and CBT. Am J Psychiatry 2023; 180:367-376. [PMID: 36891649 DOI: 10.1176/appi.ajp.20220243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/10/2023]
Abstract
OBJECTIVE Negative symptoms are a primary cause of disability in schizophrenia for which there are no established pharmacotherapies. This study evaluated a novel psychosocial intervention that combined two evidence-based practices-motivational interviewing and cognitive-behavioral therapy (MI-CBT)-for the treatment of motivational negative symptoms. METHODS Seventy-nine participants with schizophrenia and moderate to severe negative symptoms were included in a randomized controlled trial comparing the 12-session MI-CBT treatment with a mindfulness control condition. Participants were assessed at three time points through the study period, which included 12 weeks of active treatment and 12 weeks of follow-up. The primary outcome measures were motivational negative symptoms and community functioning; the secondary outcomes included a posited biomarker of negative symptoms: pupillometric response to cognitive effort. RESULTS Compared with the control group, participants in the MI-CBT group showed significantly greater improvements in motivational negative symptoms over the acute treatment period. Their gains relative to baseline were maintained at follow-up, although the differential benefit relative to control subjects was attenuated. There were nonsignificant effects toward improvements in community functioning and differential change in the pupillometric markers of cognitive effort. CONCLUSIONS The results show that combining motivational interviewing with CBT yields improvements in negative symptoms, a feature of schizophrenia generally thought of as resistant to intervention. Motivational negative symptoms not only responded to the novel treatment, but the gains were maintained over the follow-up period. Implications for future studies and for improving the generalization of the negative symptom gains to daily functioning domains are discussed.
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Affiliation(s)
- L Felice Reddy
- Department of Veterans Affairs VISN 22 Mental Illness Research, Education, and Clinical Center, Los Angeles (Reddy, Glynn, McGovern, Green); UCLA Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, Los Angeles (Reddy, Glynn, McGovern, Sugar, Reavis, Green); Department of Biostatistics, UCLA Fielding School of Public Health, Los Angeles (Sugar)
| | - Shirley M Glynn
- Department of Veterans Affairs VISN 22 Mental Illness Research, Education, and Clinical Center, Los Angeles (Reddy, Glynn, McGovern, Green); UCLA Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, Los Angeles (Reddy, Glynn, McGovern, Sugar, Reavis, Green); Department of Biostatistics, UCLA Fielding School of Public Health, Los Angeles (Sugar)
| | - Jessica E McGovern
- Department of Veterans Affairs VISN 22 Mental Illness Research, Education, and Clinical Center, Los Angeles (Reddy, Glynn, McGovern, Green); UCLA Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, Los Angeles (Reddy, Glynn, McGovern, Sugar, Reavis, Green); Department of Biostatistics, UCLA Fielding School of Public Health, Los Angeles (Sugar)
| | - Catherine A Sugar
- Department of Veterans Affairs VISN 22 Mental Illness Research, Education, and Clinical Center, Los Angeles (Reddy, Glynn, McGovern, Green); UCLA Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, Los Angeles (Reddy, Glynn, McGovern, Sugar, Reavis, Green); Department of Biostatistics, UCLA Fielding School of Public Health, Los Angeles (Sugar)
| | - Eric A Reavis
- Department of Veterans Affairs VISN 22 Mental Illness Research, Education, and Clinical Center, Los Angeles (Reddy, Glynn, McGovern, Green); UCLA Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, Los Angeles (Reddy, Glynn, McGovern, Sugar, Reavis, Green); Department of Biostatistics, UCLA Fielding School of Public Health, Los Angeles (Sugar)
| | - Michael F Green
- Department of Veterans Affairs VISN 22 Mental Illness Research, Education, and Clinical Center, Los Angeles (Reddy, Glynn, McGovern, Green); UCLA Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine, Los Angeles (Reddy, Glynn, McGovern, Sugar, Reavis, Green); Department of Biostatistics, UCLA Fielding School of Public Health, Los Angeles (Sugar)
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Harris T, Gabrielian S, Ilagan B, Olsen MK, Green MF. Acceptability of a mobile sensing application to characterize community integration among homeless-experienced veterans. J Community Psychol 2023; 51:7-16. [PMID: 35567522 DOI: 10.1002/jcop.22874] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/22/2022] [Revised: 03/11/2022] [Accepted: 04/12/2022] [Indexed: 06/15/2023]
Abstract
Mobile sensing applications that collect active, Ecological Momentary Assessment data, and passive, Global Positioning System data provide reliable, longitudinal assessments of community integration. Ensuring their acceptability by vulnerable populations is warranted. Acceptability-related perceptions of a mobile sensing application were gathered via focus groups with homeless-experienced Veterans with serious mental illness (n = 19) and individual interviews with providers (n = 5) to inform subsequent application tailoring and testing. Rapid assessment generated structured summaries and matrix analyses integrated participant data. Active data collection was deemed noninvasive, with more concerns of passive data "ending up in the wrong hands." Providers recommended clear descriptions and promotion of choice to navigate privacy concerns and guardedness. Participants felt the application possessed clinical value for enhancing patient-provider interactions and community integration efforts. Overall, participants found application features acceptable and expressed Veterans' willingness to engage in research using mobile sensing technology. Recommendations to enhance acceptability are discussed.
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Affiliation(s)
- Taylor Harris
- Department of Veterans Affairs, National Center on Homelessness among Veterans (NCHAV), Greater Los Angeles, California, USA
| | - Sonya Gabrielian
- Department of Psychiatry, Department of Veterans Affairs, Greater Los Angeles, California, USA
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, California, USA
- Department of Veterans Affairs, Rehabilitation Research & Development Service (RR&D), Center on Enhancing Community Integration for Homeless Veterans, Washington, Washington, USA
| | - Brian Ilagan
- Department of Veterans Affairs, Rehabilitation Research & Development Service (RR&D), Center on Enhancing Community Integration for Homeless Veterans, Washington, Washington, USA
| | - Megan K Olsen
- Department of Veterans Affairs, Rehabilitation Research & Development Service (RR&D), Center on Enhancing Community Integration for Homeless Veterans, Washington, Washington, USA
| | - Michael F Green
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, California, USA
- Department of Veterans Affairs, Rehabilitation Research & Development Service (RR&D), Center on Enhancing Community Integration for Homeless Veterans, Washington, Washington, USA
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Moore EM, Gabrielian S, Zito MF, Kozikowski SD, Lopez JR, Lesgart M, Green MF. Social Connectivity and Coping Among Vulnerable Veterans During the COVID-19 Pandemic. J Health Care Poor Underserved 2023; 34:1051-1059. [PMID: 38015136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2023]
Abstract
The coronavirus disease 2019 (COVID-19) pandemic dramatically changed how people socialized. However, little is known about the extent to which the pandemic changed the social connections of people with tenuous interpersonal relationships at baseline, including homeless-experienced people and people with psychotic disorders. We sought to understand how these populations experienced changes in their social connectivity and to identify coping strategies employed. We conducted 43 semi-structured interviews with 27 vulnerable participants (11 homeless-experienced people and 16 people with psychotic disorders) and 16 comparison group participants, all of whom used services at the Department of Veterans Affairs (VA). Vulnerable participants in both groups had sparse prepandemic social connectedness; few perceived pandemic-related social network changes. While many homeless-experienced participants struggled with transitioning to technology to communicate, participants with psychotic disorders used technology to stay connected. Resilience derived from military service experiences was adaptive during the pandemic, complemented by VA services that provided supports.
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22
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Hajdúk M, Straková A, Januška J, Ivančík V, Dančík D, Čavojská N, Valkučáková V, Heretik A, Pečeňák J, Abplanalp SJ, Green MF. Connections between and within extended psychosis and autistic phenotypes and social relationships in the general population. J Psychiatr Res 2023; 157:36-42. [PMID: 36436426 DOI: 10.1016/j.jpsychires.2022.11.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/12/2022] [Revised: 10/24/2022] [Accepted: 11/18/2022] [Indexed: 11/21/2022]
Abstract
OBJECTIVES Non - clinical individuals with higher levels of autistic traits and psychotic experiences also have problems in social relationships. Therefore, this study aimed to model complex associations between autistic and psychotic phenotypes and indicators of social relationships in the general population using a network approach. METHODS The sample consisted of 649 participants with a mean age of M = 40.23 and SD = 13.09 sampled from the general population. The sample was representative for the 18-65 years old general population in the Slovak Republic. The following scales were administered: Community Assessment of Psychic Experiences, The Comprehensive Autistic Trait Inventory, and NIH Toolbox Adult Social Relationship Scales. Associations between variables and the presence of communities were identified using Exploratory Graph Analysis. RESULTS Results revealed four highly stable and densely connected communities within the network: social relationships, autistic traits, positive symptoms, and the last one consisting of all negative symptoms, problems in social interactions, and depression. The most important variables in the network were difficulties in social interaction, perceived rejection, bizarre ideas, depression, and social withdrawal. CONCLUSIONS The psychotic and autistic phenotypes in the general population showed a network of connections with characteristics of social relationships. Community detection revealed that autistic traits and psychotic-like experiences formed relatively independent communities. Further, there was substantial overlap between negative symptoms (e.g., social withdrawal), and core features of the autistic phenotype, especially social interaction difficulties.
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Affiliation(s)
- Michal Hajdúk
- Department of Psychology, Faculty of Arts, Comenius University in Bratislava, Slovakia; The Centre for Psychiatric Disorders Research, Science Park, Comenius University in Bratislava, Slovakia; Department of Psychiatry, Faculty of Medicine, Comenius University in Bratislava, Slovakia.
| | - Alexandra Straková
- Department of Psychology, Faculty of Arts, Comenius University in Bratislava, Slovakia; Department of Psychiatry, Faculty of Medicine, Comenius University in Bratislava, Slovakia
| | - Jakub Januška
- Department of Psychology, Faculty of Arts, Comenius University in Bratislava, Slovakia; Department of Psychiatry, Faculty of Medicine, Comenius University in Bratislava, Slovakia
| | - Vladimír Ivančík
- Department of Psychology, Faculty of Arts, Comenius University in Bratislava, Slovakia; Department of Psychiatry, Faculty of Medicine, Comenius University in Bratislava, Slovakia
| | - Daniel Dančík
- Department of Psychology, Faculty of Arts, Comenius University in Bratislava, Slovakia; Department of Psychiatry, Faculty of Medicine, Comenius University in Bratislava, Slovakia
| | - Natália Čavojská
- The Centre for Psychiatric Disorders Research, Science Park, Comenius University in Bratislava, Slovakia; Department of Psychiatry, Faculty of Medicine, Comenius University in Bratislava, Slovakia
| | - Vanda Valkučáková
- The Centre for Psychiatric Disorders Research, Science Park, Comenius University in Bratislava, Slovakia
| | - Anton Heretik
- Department of Psychology, Faculty of Arts, Comenius University in Bratislava, Slovakia; Department of Psychiatry, Faculty of Medicine, Comenius University in Bratislava, Slovakia
| | - Ján Pečeňák
- The Centre for Psychiatric Disorders Research, Science Park, Comenius University in Bratislava, Slovakia; Department of Psychiatry, Faculty of Medicine, Comenius University in Bratislava, Slovakia
| | - Samuel J Abplanalp
- Department of Veterans Affairs, Desert Pacific Mental Illness Research, Education, and Clinical Center, United States; VA Rehabilitation R&D Center on Enhancing Community Integration for Homeless Veterans, United States; Jane and Terry Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, UCLA, United States
| | - Michael F Green
- Department of Veterans Affairs, Desert Pacific Mental Illness Research, Education, and Clinical Center, United States; VA Rehabilitation R&D Center on Enhancing Community Integration for Homeless Veterans, United States; Jane and Terry Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, UCLA, United States
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23
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Le TP, Green MF, Lee J, Clayson PE, Jimenez AM, Reavis EA, Wynn JK, Horan WP. Aberrant reward processing to positive versus negative outcomes across psychotic disorders. J Psychiatr Res 2022; 156:1-7. [PMID: 36201975 PMCID: PMC10163955 DOI: 10.1016/j.jpsychires.2022.09.045] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Revised: 09/14/2022] [Accepted: 09/23/2022] [Indexed: 01/20/2023]
Abstract
Several studies of reward processing in schizophrenia have shown reduced sensitivity to positive, but not negative, outcomes although inconsistencies have been reported. In addition, few studies have investigated whether patients show a relative deficit to social versus nonsocial rewards, whether deficits occur across the spectrum of psychosis, or whether deficits relate to negative symptoms and functioning. This study examined probabilistic implicit learning via two visually distinctive slot machines for social and nonsocial rewards in 101 outpatients with diverse psychotic disorders and 48 community controls. The task consisted of two trial types: positive (optimal to choose a positive vs. neutral machine) and negative (optimal to choose a neutral vs. negative machine), with two reward conditions: social (faces) and nonsocial (money) reward conditions. A significant group X trial type interaction indicated that controls performed better on positive than negative trials, whereas patients showed the opposite pattern of better performance on negative than positive trials. In addition, both groups performed better for social than nonsocial stimuli, despite lower overall task performance in patients. Within patients, worse performance on negative trials showed significant, small-to-moderate correlations with motivation and pleasure-related negative symptoms and social functioning. The current findings suggest reward processing disturbances, particularly decreased sensitivity to positive outcomes, extend beyond schizophrenia to a broader spectrum of psychotic disorders and relate to important clinical outcomes.
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Affiliation(s)
- Thanh P Le
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA; Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, USA.
| | - Michael F Green
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA; Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, USA
| | - Junghee Lee
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Peter E Clayson
- Department of Psychology, University of South Florida, Tampa, FL, USA
| | - Amy M Jimenez
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA; Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, USA
| | - Eric A Reavis
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA; Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, USA
| | - Jonathan K Wynn
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA; Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, USA
| | - William P Horan
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA; Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, USA; WCG VeraSci, Durham, NC, USA
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24
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Riedel P, Lee J, Watson CG, Jimenez AM, Reavis EA, Green MF. Reorganization of the functional connectome from rest to a visual perception task in schizophrenia and bipolar disorder. Psychiatry Res Neuroimaging 2022; 327:111556. [PMID: 36327867 PMCID: PMC10611423 DOI: 10.1016/j.pscychresns.2022.111556] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2022] [Revised: 09/13/2022] [Accepted: 10/17/2022] [Indexed: 11/06/2022]
Abstract
Functional connectome organization is altered in schizophrenia (SZ) and bipolar disorder (BD). However, it remains unclear whether network reorganization during a task relative to rest is also altered in these disorders. This study examined connectome organization in patients with SZ (N = 43) and BD (N = 42) versus healthy controls (HC; N = 39) using fMRI data during a visual object-perception task and at rest. Graph analyses were conducted for the whole-brain network using indices selected a priori: three reflecting network segregation (clustering coefficient, local efficiency, modularity), two reflecting integration (characteristic path length, global efficiency). Group differences were limited to network segregation and were more evident in SZ (clustering coefficient, modularity) than in BD (clustering coefficient) compared to HC. State differences were found across groups for segregation (local efficiency) and integration (characteristic path length). There was no group-by-state interaction for any graph index. In summary, aberrant network organization compared to HC was confirmed, and was more evident in SZ than in BD. Yet, reorganization was largely intact in both disorders. These findings help to constrain models of dysconnection in SZ and BD, suggesting that the extent of functional dysconnectivity in these disorders tends to persist across changes in mental state.
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Affiliation(s)
- Philipp Riedel
- Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, 760 Westwood Plaza, Los Angeles, CA 90024, USA; Department of Psychiatry and Neuroimaging Center, Technische Universität Dresden, Würzburger Straße 35, Dresden 01187, Germany.
| | - Junghee Lee
- Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, 760 Westwood Plaza, Los Angeles, CA 90024, USA; Desert Pacific Mental Illness Research, Education, and Clinical Center, Greater Los Angeles VA Healthcare System, Bldg. 210, 11301 Wilshire Blvd, Los Angeles, CA 90073, USA; Department of Psychiatry and Behavioral Neurobiology, School of Medicine, The University of Alabama at Birmingham, SC 560, 1720 2nd Ave S, Birmingham, AL 35294-0017, USA
| | - Christopher G Watson
- Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, One Baylor Plaza, Houston, TX 77030, USA
| | - Amy M Jimenez
- Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, 760 Westwood Plaza, Los Angeles, CA 90024, USA; Desert Pacific Mental Illness Research, Education, and Clinical Center, Greater Los Angeles VA Healthcare System, Bldg. 210, 11301 Wilshire Blvd, Los Angeles, CA 90073, USA
| | - Eric A Reavis
- Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, 760 Westwood Plaza, Los Angeles, CA 90024, USA; Desert Pacific Mental Illness Research, Education, and Clinical Center, Greater Los Angeles VA Healthcare System, Bldg. 210, 11301 Wilshire Blvd, Los Angeles, CA 90073, USA
| | - Michael F Green
- Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, 760 Westwood Plaza, Los Angeles, CA 90024, USA; Desert Pacific Mental Illness Research, Education, and Clinical Center, Greater Los Angeles VA Healthcare System, Bldg. 210, 11301 Wilshire Blvd, Los Angeles, CA 90073, USA
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25
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Nuechterlein KH, Green MF, Kern RS. The MATRICS Consensus Cognitive Battery: An Update. Curr Top Behav Neurosci 2022; 63:1-18. [PMID: 36306054 DOI: 10.1007/7854_2022_395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Through a series of NIMH-supported consensus-building meetings of experts and empirical comparisons of candidate tests, the Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) initiative developed a battery of standardized cognitive measures to allow reliable evaluation of results from clinical trials of promising interventions for core cognitive deficits in this disorder. Ten tests in seven cognitive domains were selected for the MATRICS Consensus Cognitive Battery (MCCB). The MCCB has now been translated into 39 languages/dialects and has been employed in more than 145 clinical trials. It has become the standard cognitive change measure for studies of both pharmacological and training-based interventions seeking to improve cognitive deficits in schizophrenia. We summarize its applications and its relationship to the subsequent development of the NIMH RDoC Matrix.
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Affiliation(s)
- Keith H Nuechterlein
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA. .,Department of Psychology, University of California, Los Angeles, Los Angeles, CA, USA.
| | - Michael F Green
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA.,VISN 22 Mental Illness Research, Education, and Clinical Center, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
| | - Robert S Kern
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA.,VISN 22 Mental Illness Research, Education, and Clinical Center, VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
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26
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Reavis EA, Wynn JK, Green MF. The flickering spotlight of visual attention: Characterizing abnormal object-based attention in schizophrenia. Schizophr Res 2022; 248:151-157. [PMID: 36063606 PMCID: PMC10362949 DOI: 10.1016/j.schres.2022.08.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Revised: 07/22/2022] [Accepted: 08/21/2022] [Indexed: 10/14/2022]
Abstract
Schizophrenia is associated with deficits in both object perception and visual attention. However, few studies in schizophrenia have investigated object-based attention, which is dissociable from other forms of visuospatial attention. Recent research in healthy populations has shown that the 'spotlight' of sustained visual attention flickers in a rhythmic, oscillatory fashion at specific frequencies in the 4-12 Hz range. In healthy samples, this oscillatory signature has been used to investigate spatiotemporal dynamics of object-based attention, showing that the attentional spotlight spreads to uncued locations within cued objects, and also periodically alternates focus between cued and uncued objects. In this study, we adapted a performance-based visual object cueing task to investigate object-based attention in individuals with a schizophrenia diagnosis and healthy controls. In controls, spatiotemporal patterns of object-based attention closely resembled those reported in previous studies of healthy individuals. In the schizophrenia group, the oscillatory signature of attention also appeared in the location of the cue and on uncued objects, similar to the effects in controls. Indeed, the oscillatory signature of attention at the spatial location of the cue was stronger in the schizophrenia group than in controls. However, attention did not spread across the cued object in schizophrenia; rather, attention appeared to remain hyperfocused at the spatial location of the cue. These findings provide the first evidence that visual attention has oscillatory characteristics in schizophrenia, as in the general population. The results also show that the fundamental process of attentional spreading which underlies object-based attention is abnormal in schizophrenia.
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Affiliation(s)
- Eric A Reavis
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, United States of America; VA Greater Los Angeles Healthcare System, United States of America.
| | - Jonathan K Wynn
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, United States of America; VA Greater Los Angeles Healthcare System, United States of America
| | - Michael F Green
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, United States of America; VA Greater Los Angeles Healthcare System, United States of America
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27
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Yang YS, Maddock RJ, Zhang H, Lee J, Hellemann G, Marder SR, Green MF. N-Acetylcysteine effects on glutathione and glutamate in schizophrenia: A preliminary MRS study. Psychiatry Res Neuroimaging 2022; 325:111515. [PMID: 35839558 DOI: 10.1016/j.pscychresns.2022.111515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 05/24/2022] [Accepted: 06/15/2022] [Indexed: 10/17/2022]
Abstract
N-acetylcysteine (NAC) is a commonly used antioxidant that may have beneficial effects for schizophrenia. In this double-blind, randomized, placebo-controlled preliminary study, 40 patients with schizophrenia or schizoaffective disorder were randomized to receive 2400 mg NAC daily or placebo over eight weeks to examine the effects of NAC on prefrontal magnetic resonance spectroscopy levels of glutathione and glutamate. Secondary outcomes included negative symptoms, cognition, and plasma glutathione levels. We found that NAC treatment was associated with increased glutathione (statistically significant) and decreased glutamate (trend-level) compared with placebo in medial prefrontal cortex but not dorsolateral prefrontal cortex. We also observed a baseline association between medial prefrontal cortex levels of glutathione and plasma reduced / oxidized glutathione ratios. No treatment effects on symptoms or cognition were observed. Taken together, these findings indicate that treatment with N-acetylcysteine may increase medial prefrontal cortical levels of glutathione after eight weeks of treatment. These changes in cortical levels of glutathione may serve as an early biomarker of later clinical change and may underlie the cognitive and symptomatic improvements reported in longer-term treatment studies.
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Affiliation(s)
- Yvonne S Yang
- VISN22 Mental Illness Research, Education and Clinical Center, VA Greater Los Angeles Healthcare System, Los Angeles, CA, U.S.A; Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, U.S.A.
| | - Richard J Maddock
- Department of Psychiatry and Biobehavioral Sciences, University of California, Davis, CA, U.S.A
| | - Huailin Zhang
- David Geffen School of Medicine, University of California, Los Angeles, CA, U.S.A
| | - Junghee Lee
- Department of Psychiatry and Behavioral Neurobiology, The University of Alabama at Birmingham, Birmingham, Alabama, U.S.A
| | - Gerhard Hellemann
- Department of Psychiatry and Behavioral Neurobiology, The University of Alabama at Birmingham, Birmingham, Alabama, U.S.A
| | - Stephen R Marder
- VISN22 Mental Illness Research, Education and Clinical Center, VA Greater Los Angeles Healthcare System, Los Angeles, CA, U.S.A; Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, U.S.A
| | - Michael F Green
- VISN22 Mental Illness Research, Education and Clinical Center, VA Greater Los Angeles Healthcare System, Los Angeles, CA, U.S.A; Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, U.S.A
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28
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Kern RS, Reddy LF, Horan WP, Glynn SM, Stigers PJ, Sugar CA, Green MF. Social cognition and social problem solving skills training to improve job functioning and tenure in veterans with psychotic disorders. Psychiatr Rehabil J 2022; 45:291-298. [PMID: 35404648 DOI: 10.1037/prj0000518] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
OBJECTIVE Veterans with psychotic disorders often experience employment difficulties. Job tenure is highly variable with shorter tenure frequently tied to interpersonal difficulties in the workplace. The present study sought to address this problem by examining the efficacy of social cognition skills training (SCST) and social problem solving skills training (SPSST) interventions, implemented sequentially, and added to usual VA employment services (augmented vocational rehabilitation [VR]). METHOD Participants were 91 Veterans with schizophrenia and other psychotic disorders who were recently enrolled in one of three types of VA employment services (incentive therapy, transitional work, supported employment), and randomized 1:1 to augmented VR versus control VR. Training for the augmented VR group included 12 weeks of SCST plus 6 weeks of work-related SPSST; training for the control VR group included a control intervention (symptom management training) matched in instructional format and length of training to the SCST and SPSST interventions. All participants received baseline and posttraining measures of social cognition. For those who got jobs, the primary work outcome measures were social skills work behavior and job tenure. RESULTS Results showed a significant group x time interaction favoring the augmented VR group on measures of social cognition and social skills work behavior, but there were no significant differences in job tenure. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE The findings for workplace social skills support a promising new direction for enhancing work outcomes in this population; the null effect on job tenure may have been due to high job retention rates across the three types of employment service programs. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Affiliation(s)
- Robert S Kern
- UCLA Semel Institute for Neuroscience and Human Behavior
| | - L Felice Reddy
- UCLA Semel Institute for Neuroscience and Human Behavior
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29
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Horan WP, Catalano LT, Green MF. An Update on Treatment of Cognitive Impairment Associated with Schizophrenia. Curr Top Behav Neurosci 2022; 63:407-436. [PMID: 35915386 DOI: 10.1007/7854_2022_382] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Cognitive impairment associated with schizophrenia (CIAS) is widely regarded as a critically important treatment target for schizophrenia. Despite major efforts and a number of promising findings, we do not yet have an approved drug for CIAS. Similarly, promising cognitive remediation approaches are limited in their ability to help patients achieve real-world functional gains on a wide scale. This article provides an update and critical evaluation of recent treatment development activities for CIAS. First, we provide update on pharmacological approaches, which include a glutamatergic drug that is currently in Phase III trials for CIAS, and discuss factors that may have impacted past efforts to identify efficacious drugs. Second, we review positive findings, limitations, and current trends involving cognitive remediation approaches. Third, we consider newer transdiagnostic approaches aimed at looking beyond, or identifying more homogenous subgroups within, the diagnostic category schizophrenia to advance treatment development. Despite its many challenges, treatment development for CIAS remains a major public health issue and research continues to push forward on several encouraging fronts.
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Affiliation(s)
- William P Horan
- WCG VeraSci, Durham, NC, USA. .,Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA.
| | - Lauren T Catalano
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA.,Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, USA
| | - Michael F Green
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA.,Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, USA
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30
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Catalano LT, Wynn JK, Green MF, Gold JM. Reduced neural activity when anticipating social versus nonsocial rewards in schizophrenia: Preliminary evidence from an ERP study. Schizophr Res 2022; 246:7-16. [PMID: 35696860 DOI: 10.1016/j.schres.2022.05.028] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Revised: 05/09/2022] [Accepted: 05/31/2022] [Indexed: 11/20/2022]
Abstract
Diminished social motivation is a core feature of schizophrenia that might reflect disturbances in social reward processing. It is not known whether these disturbances reflect anticipatory ("wanting") and/or consummatory ("liking") pleasure deficits. The primary aim of this study was to examine social versus nonsocial reward processing during these temporally distinct substages using event-related potential (ERP) components. Twenty-three schizophrenia participants and 20 healthy participants completed an incentive delay task with social (i.e., smiling expressions) and nonsocial (i.e., money) rewards. We measured two anticipatory ERPs (i.e., "wanting") (target anticipation: Contingent Negative Variation [CNV]; feedback anticipation: Stimulus Preceding Negativity [SPN]) and one consummatory ERP (i.e., "liking") (feedback receipt: P300). As a secondary aim, we examined correlations between the ERPs and interview-rated motivational negative symptoms and social functioning. Schizophrenia participants showed overall less target anticipation (blunted CNV) across all trials (social and nonsocial) than healthy participants. Importantly, schizophrenia participants exhibited less anticipation of social rewards relative to nonsocial rewards (SPN), whereas healthy participants showed similar anticipation for both reward types. Both groups showed similar responses to social and nonsocial reward receipt (P300). Furthermore, social reward anticipation during the incentive delay task was associated with more social approach behaviors in the real-world. Together, these findings provide preliminary evidence for intact social reward "liking" and impaired "wanting" in schizophrenia.
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Affiliation(s)
- Lauren T Catalano
- Desert Pacific Mental Illness Research, Education and Clinical Center, Veterans Affairs Greater Los Angeles Healthcare System, CA, United States; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA, United States.
| | - Jonathan K Wynn
- Desert Pacific Mental Illness Research, Education and Clinical Center, Veterans Affairs Greater Los Angeles Healthcare System, CA, United States; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA, United States
| | - Michael F Green
- Desert Pacific Mental Illness Research, Education and Clinical Center, Veterans Affairs Greater Los Angeles Healthcare System, CA, United States; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA, United States
| | - James M Gold
- Department of Psychiatry, University of Maryland School of Medicine, Baltimore, MD, United States
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31
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Clayson PE, Wynn JK, Jimenez AM, Reavis EA, Lee J, Green MF, Horan WP. Intact differentiation of responses to socially-relevant emotional stimuli across psychotic disorders: An event-related potential (ERP) study. Schizophr Res 2022; 246:250-257. [PMID: 35843157 PMCID: PMC10413986 DOI: 10.1016/j.schres.2022.06.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 06/20/2022] [Accepted: 06/26/2022] [Indexed: 11/30/2022]
Abstract
Event-related potential (ERP) studies of motivated attention in schizophrenia typically show intact sensitivity to affective vs. non-affective images depicting diverse types of content. However, it is not known whether this ERP pattern: 1) extends to images that solely depict social content, (2) applies across a broad sample with diverse psychotic disorders, and (3) relates to self-reported trait social anhedonia. We examined late positive potential (LPP) amplitudes to images involving people that were normatively pleasant (affiliative), unpleasant (threatening), or neutral in 97 stable outpatients with various psychotic disorders and 38 healthy controls. Both groups showed enhanced LPP to pleasant and unpleasant vs. neutral images to a similar degree, despite lower overall LPP in patients. Within the patients, there were no significant LPP differences among subgroups (schizophrenia vs. other psychotic disorders; affective vs. non-affective psychosis) for the valence effect (pleasant/unpleasant vs. neutral). Higher social anhedonia showed a small, significant relation to lower LPP to pleasant images across all groups. These findings suggest intact motivated attention to social images extends across psychotic disorder subgroups. Dimensional transdiagnostic analyses revealed a modest association between self-reported trait social anhedonia and an LPP index of neural sensitivity to pleasant affiliative images.
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Affiliation(s)
- Peter E Clayson
- Department of Psychology, University of South Florida, Tampa, FL, USA.
| | - Jonathan K Wynn
- Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Amy M Jimenez
- Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Eric A Reavis
- Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Junghee Lee
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Michael F Green
- Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - William P Horan
- Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, USA; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA; VeraSci, Durham, Durham, NC, USA
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Gabrielian S, Koosis ER, Cohenmehr J, Hellemann G, Tuepker A, Green MF, Vazzano JK, Young AS. Factors associated with recovery from homelessness among veterans in permanent supportive housing. J Community Psychol 2022; 50:2144-2162. [PMID: 34862803 DOI: 10.1002/jcop.22760] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 09/13/2021] [Accepted: 11/15/2021] [Indexed: 06/13/2023]
Abstract
AIMS We sought to identify person- and program-level factors distinguishing permanent supportive housing (PSH) residents with higher versus lower social integration; and higher versus lower instrumental functioning. METHODS Among 60 PSH residents at Los Angeles' VA, surveys and medical records captured person-level factors. Using a median split, we dichotomized participants with higher versus lower social integration; and higher versus lower instrumental functioning. Recursive partitioning (RP) identified variables that best-differentiated these subgroups. Interviews with 26 participants captured their perceptions on social integration and instrumental functioning. RESULTS Using RP, health-related quality of life, psychiatric symptoms and case management frequency best-differentiated the social integration subgroups. Few perceived that PSH affected social integration. RP did not yield a stable model to differentiate the instrumental functioning subgroups; participants perceived that PSH addressed most functional deficits. CONCLUSIONS Services that enhance social integration may benefit PSH residents with poor health; existing services may adequately address instrumental functioning.
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Affiliation(s)
- Sonya Gabrielian
- Desert Pacific Mental Illness Research, Education, and Clinical Center, VA Greater Los Angeles, Los Angeles, California, USA
- Department of Psychiatry, VA Greater Los Angeles, Los Angeles, California, USA
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, California, USA
| | - Ella R Koosis
- Desert Pacific Mental Illness Research, Education, and Clinical Center, VA Greater Los Angeles, Los Angeles, California, USA
| | - Jennifer Cohenmehr
- Department of Psychiatry, VA Greater Los Angeles, Los Angeles, California, USA
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, California, USA
| | - Gerhard Hellemann
- Desert Pacific Mental Illness Research, Education, and Clinical Center, VA Greater Los Angeles, Los Angeles, California, USA
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, California, USA
| | - Anaïs Tuepker
- VA HSR&D Center to Improve Veteran Involvement in Care, VA Portland Health Care, Portland, Oregon, USA
- Division of General Internal Medicine, Oregon Health and Science University, Portland, Oregon, USA
| | - Michael F Green
- Desert Pacific Mental Illness Research, Education, and Clinical Center, VA Greater Los Angeles, Los Angeles, California, USA
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, California, USA
| | - Jesse K Vazzano
- Care Management and Social Work, VA Western Colorado Health Care System, Grand Junction, Colorado, USA
| | - Alexander S Young
- Desert Pacific Mental Illness Research, Education, and Clinical Center, VA Greater Los Angeles, Los Angeles, California, USA
- Department of Psychiatry, VA Greater Los Angeles, Los Angeles, California, USA
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, California, USA
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Trubetskoy V, Pardiñas AF, Qi T, Panagiotaropoulou G, Awasthi S, Bigdeli TB, Bryois J, Chen CY, Dennison CA, Hall LS, Lam M, Watanabe K, Frei O, Ge T, Harwood JC, Koopmans F, Magnusson S, Richards AL, Sidorenko J, Wu Y, Zeng J, Grove J, Kim M, Li Z, Voloudakis G, Zhang W, Adams M, Agartz I, Atkinson EG, Agerbo E, Al Eissa M, Albus M, Alexander M, Alizadeh BZ, Alptekin K, Als TD, Amin F, Arolt V, Arrojo M, Athanasiu L, Azevedo MH, Bacanu SA, Bass NJ, Begemann M, Belliveau RA, Bene J, Benyamin B, Bergen SE, Blasi G, Bobes J, Bonassi S, Braun A, Bressan RA, Bromet EJ, Bruggeman R, Buckley PF, Buckner RL, Bybjerg-Grauholm J, Cahn W, Cairns MJ, Calkins ME, Carr VJ, Castle D, Catts SV, Chambert KD, Chan RCK, Chaumette B, Cheng W, Cheung EFC, Chong SA, Cohen D, Consoli A, Cordeiro Q, Costas J, Curtis C, Davidson M, Davis KL, de Haan L, Degenhardt F, DeLisi LE, Demontis D, Dickerson F, Dikeos D, Dinan T, Djurovic S, Duan J, Ducci G, Dudbridge F, Eriksson JG, Fañanás L, Faraone SV, Fiorentino A, Forstner A, Frank J, Freimer NB, Fromer M, Frustaci A, Gadelha A, Genovese G, Gershon ES, Giannitelli M, Giegling I, Giusti-Rodríguez P, Godard S, Goldstein JI, González Peñas J, González-Pinto A, Gopal S, Gratten J, Green MF, Greenwood TA, Guillin O, Gülöksüz S, Gur RE, Gur RC, Gutiérrez B, Hahn E, Hakonarson H, Haroutunian V, Hartmann AM, Harvey C, Hayward C, Henskens FA, Herms S, Hoffmann P, Howrigan DP, Ikeda M, Iyegbe C, Joa I, Julià A, Kähler AK, Kam-Thong T, Kamatani Y, Karachanak-Yankova S, Kebir O, Keller MC, Kelly BJ, Khrunin A, Kim SW, Klovins J, Kondratiev N, Konte B, Kraft J, Kubo M, Kučinskas V, Kučinskiene ZA, Kusumawardhani A, Kuzelova-Ptackova H, Landi S, Lazzeroni LC, Lee PH, Legge SE, Lehrer DS, Lencer R, Lerer B, Li M, Lieberman J, Light GA, Limborska S, Liu CM, Lönnqvist J, Loughland CM, Lubinski J, Luykx JJ, Lynham A, Macek M, Mackinnon A, Magnusson PKE, Maher BS, Maier W, Malaspina D, Mallet J, Marder SR, Marsal S, Martin AR, Martorell L, Mattheisen M, McCarley RW, McDonald C, McGrath JJ, Medeiros H, Meier S, Melegh B, Melle I, Mesholam-Gately RI, Metspalu A, Michie PT, Milani L, Milanova V, Mitjans M, Molden E, Molina E, Molto MD, Mondelli V, Moreno C, Morley CP, Muntané G, Murphy KC, Myin-Germeys I, Nenadić I, Nestadt G, Nikitina-Zake L, Noto C, Nuechterlein KH, O'Brien NL, O'Neill FA, Oh SY, Olincy A, Ota VK, Pantelis C, Papadimitriou GN, Parellada M, Paunio T, Pellegrino R, Periyasamy S, Perkins DO, Pfuhlmann B, Pietiläinen O, Pimm J, Porteous D, Powell J, Quattrone D, Quested D, Radant AD, Rampino A, Rapaport MH, Rautanen A, Reichenberg A, Roe C, Roffman JL, Roth J, Rothermundt M, Rutten BPF, Saker-Delye S, Salomaa V, Sanjuan J, Santoro ML, Savitz A, Schall U, Scott RJ, Seidman LJ, Sharp SI, Shi J, Siever LJ, Sigurdsson E, Sim K, Skarabis N, Slominsky P, So HC, Sobell JL, Söderman E, Stain HJ, Steen NE, Steixner-Kumar AA, Stögmann E, Stone WS, Straub RE, Streit F, Strengman E, Stroup TS, Subramaniam M, Sugar CA, Suvisaari J, Svrakic DM, Swerdlow NR, Szatkiewicz JP, Ta TMT, Takahashi A, Terao C, Thibaut F, Toncheva D, Tooney PA, Torretta S, Tosato S, Tura GB, Turetsky BI, Üçok A, Vaaler A, van Amelsvoort T, van Winkel R, Veijola J, Waddington J, Walter H, Waterreus A, Webb BT, Weiser M, Williams NM, Witt SH, Wormley BK, Wu JQ, Xu Z, Yolken R, Zai CC, Zhou W, Zhu F, Zimprich F, Atbaşoğlu EC, Ayub M, Benner C, Bertolino A, Black DW, Bray NJ, Breen G, Buccola NG, Byerley WF, Chen WJ, Cloninger CR, Crespo-Facorro B, Donohoe G, Freedman R, Galletly C, Gandal MJ, Gennarelli M, Hougaard DM, Hwu HG, Jablensky AV, McCarroll SA, Moran JL, Mors O, Mortensen PB, Müller-Myhsok B, Neil AL, Nordentoft M, Pato MT, Petryshen TL, Pirinen M, Pulver AE, Schulze TG, Silverman JM, Smoller JW, Stahl EA, Tsuang DW, Vilella E, Wang SH, Xu S, Adolfsson R, Arango C, Baune BT, Belangero SI, Børglum AD, Braff D, Bramon E, Buxbaum JD, Campion D, Cervilla JA, Cichon S, Collier DA, Corvin A, Curtis D, Forti MD, Domenici E, Ehrenreich H, Escott-Price V, Esko T, Fanous AH, Gareeva A, Gawlik M, Gejman PV, Gill M, Glatt SJ, Golimbet V, Hong KS, Hultman CM, Hyman SE, Iwata N, Jönsson EG, Kahn RS, Kennedy JL, Khusnutdinova E, Kirov G, Knowles JA, Krebs MO, Laurent-Levinson C, Lee J, Lencz T, Levinson DF, Li QS, Liu J, Malhotra AK, Malhotra D, McIntosh A, McQuillin A, Menezes PR, Morgan VA, Morris DW, Mowry BJ, Murray RM, Nimgaonkar V, Nöthen MM, Ophoff RA, Paciga SA, Palotie A, Pato CN, Qin S, Rietschel M, Riley BP, Rivera M, Rujescu D, Saka MC, Sanders AR, Schwab SG, Serretti A, Sham PC, Shi Y, St Clair D, Stefánsson H, Stefansson K, Tsuang MT, van Os J, Vawter MP, Weinberger DR, Werge T, Wildenauer DB, Yu X, Yue W, Holmans PA, Pocklington AJ, Roussos P, Vassos E, Verhage M, Visscher PM, Yang J, Posthuma D, Andreassen OA, Kendler KS, Owen MJ, Wray NR, Daly MJ, Huang H, Neale BM, Sullivan PF, Ripke S, Walters JTR, O'Donovan MC. Mapping genomic loci implicates genes and synaptic biology in schizophrenia. Nature 2022; 604:502-508. [PMID: 35396580 PMCID: PMC9392466 DOI: 10.1038/s41586-022-04434-5] [Citation(s) in RCA: 745] [Impact Index Per Article: 372.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 01/10/2022] [Indexed: 01/16/2023]
Abstract
Schizophrenia has a heritability of 60-80%1, much of which is attributable to common risk alleles. Here, in a two-stage genome-wide association study of up to 76,755 individuals with schizophrenia and 243,649 control individuals, we report common variant associations at 287 distinct genomic loci. Associations were concentrated in genes that are expressed in excitatory and inhibitory neurons of the central nervous system, but not in other tissues or cell types. Using fine-mapping and functional genomic data, we identify 120 genes (106 protein-coding) that are likely to underpin associations at some of these loci, including 16 genes with credible causal non-synonymous or untranslated region variation. We also implicate fundamental processes related to neuronal function, including synaptic organization, differentiation and transmission. Fine-mapped candidates were enriched for genes associated with rare disruptive coding variants in people with schizophrenia, including the glutamate receptor subunit GRIN2A and transcription factor SP4, and were also enriched for genes implicated by such variants in neurodevelopmental disorders. We identify biological processes relevant to schizophrenia pathophysiology; show convergence of common and rare variant associations in schizophrenia and neurodevelopmental disorders; and provide a resource of prioritized genes and variants to advance mechanistic studies.
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Affiliation(s)
- Vassily Trubetskoy
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin, Berlin, Germany
| | - Antonio F Pardiñas
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - Ting Qi
- Institute for Molecular Bioscience, University of Queensland, Brisbane, Queensland, Australia
- School of Life Sciences, Westlake University, Hangzhou, China
| | | | - Swapnil Awasthi
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin, Berlin, Germany
| | - Tim B Bigdeli
- Department of Psychiatry and the Behavioral Sciences, SUNY Downstate Medical Center, New York, NY, USA
- Institute for Genomic Health, SUNY Downstate Medical Center, New York, NY, USA
- Department of Psychiatry, Veterans Affairs New York Harbor Healthcare System, New York, NY, USA
| | - Julien Bryois
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Chia-Yen Chen
- Biogen, Cambridge, MA, USA
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA, USA
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Charlotte A Dennison
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - Lynsey S Hall
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - Max Lam
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Research Division, Institute of Mental Health, Singapore, Republic of Singapore
- Division of Psychiatry Research, Zucker Hillside Hospital, Glen Oaks, NY, USA
| | - Kyoko Watanabe
- Department of Complex Trait Genetics, Center for Neurogenomics and Cognitive Research, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Oleksandr Frei
- NORMENT Centre, Division of Mental Health and Addiction, University of Oslo, Oslo, Norway
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- Center for Bioinformatics, Department of Informatics, University of Oslo, Oslo, Norway
| | - Tian Ge
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Janet C Harwood
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - Frank Koopmans
- Department of Molecular and Cellular Neurobiology, Center for Neurogenomics and Cognitive Research, Faculty of Science, Amsterdam Neuroscience, Vrije Universiteit, Amsterdam, The Netherlands
| | | | - Alexander L Richards
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - Julia Sidorenko
- Institute for Molecular Bioscience, University of Queensland, Brisbane, Queensland, Australia
| | - Yang Wu
- Institute for Molecular Bioscience, University of Queensland, Brisbane, Queensland, Australia
| | - Jian Zeng
- Institute for Molecular Bioscience, University of Queensland, Brisbane, Queensland, Australia
| | - Jakob Grove
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Department of Biomedicine and Centre for Integrative Sequencing (iSEQ), Aarhus University, Aarhus, Denmark
- Center for Genomics and Personalized Medicine, Aarhus, Denmark
| | - Minsoo Kim
- Department of Psychiatry, Semel Institute, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Zhiqiang Li
- Affiliated Hospital of Qingdao University and Biomedical Sciences Institute of Qingdao University (Qingdao Branch of SJTU Bio-X Institutes), Qingdao University, Qingdao, China
- Bio-X Institutes, Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders (Ministry of Education), Collaborative Innovation Center for Brain Science, Shanghai Jiao Tong University, Shanghai, China
| | - Georgios Voloudakis
- Department of Psychiatry, Pamela Sklar Division of Psychiatric Genomics, Friedman Brain Institute, Department of Genetics and Genomic Science and Institute for Data Science and Genomic Technology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Wen Zhang
- Department of Psychiatry, Pamela Sklar Division of Psychiatric Genomics, Friedman Brain Institute, Department of Genetics and Genomic Science and Institute for Data Science and Genomic Technology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Genetics and Genomic Sciences and Institute for Genomics and Multiscale Biology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Mark Adams
- Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, Royal Edinburgh Hospital, Edinburgh, UK
| | - Ingrid Agartz
- NORMENT Centre, Division of Mental Health and Addiction, University of Oslo, Oslo, Norway
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet and Stockholm Health Care Services, Stockholm Region, Stockholm, Sweden
| | - Elizabeth G Atkinson
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Esben Agerbo
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- National Centre for Register-based Research, Aarhus University, Aarhus, Denmark
| | - Mariam Al Eissa
- Molecular Psychiatry Laboratory, Division of Psychiatry, University College London, London, UK
| | | | - Madeline Alexander
- Center for Depression, Anxiety and Stress Research, McLean Hospital, Belmont, MA, USA
| | - Behrooz Z Alizadeh
- University Medical Center Groningen, University Center for Psychiatry, Rob Giel Research Center, University of Groningen, Groningen, The Netherlands
- Department of Epidemiology, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Köksal Alptekin
- Department of Psychiatry, Dokuz Eylül University School of Medicine, Izmir, Turkey
- Department of Neuroscience, Dokuz Eylül University Graduate School of Health Sciences, Izmir, Turkey
| | - Thomas D Als
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Department of Biomedicine and Centre for Integrative Sequencing (iSEQ), Aarhus University, Aarhus, Denmark
- Center for Genomics and Personalized Medicine, Aarhus, Denmark
| | - Farooq Amin
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, USA
| | - Volker Arolt
- Department of Psychiatry, University of Münster, Münster, Germany
| | - Manuel Arrojo
- Servizo de Psiquiatría, Complexo Hospitalario Universitario de Santiago de Compostela, Servizo Galego de Saúde (SERGAS), Santiago de Compostela, Spain
| | - Lavinia Athanasiu
- NORMENT Centre, Division of Mental Health and Addiction, University of Oslo, Oslo, Norway
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Maria Helena Azevedo
- Institute of Medical Psychology, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Silviu A Bacanu
- Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA
| | - Nicholas J Bass
- Molecular Psychiatry Laboratory, Division of Psychiatry, University College London, London, UK
| | - Martin Begemann
- Clinical Neuroscience, Max Planck Institute of Experimental Medicine, Göttingen, Germany
| | - Richard A Belliveau
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Judit Bene
- Department of Medical Genetics, Medical School, University of Pécs, Pécs, Hungary
| | - Beben Benyamin
- Australian Centre for Precision Health, University of South Australia Cancer Research Institute, University of South Australia, Adelaide, South Australia, Australia
- UniSA Allied Health and Human Performance, University of South Australia, Adelaide, South Australia, Australia
- South Australian Health and Medical Research Institute, Adelaide, South Australia, Australia
| | - Sarah E Bergen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Giuseppe Blasi
- Department of Basic Medical Science, Neuroscience and Sense Organs, University of Bari 'Aldo Moro', Bari, Italy
| | - Julio Bobes
- Área de Psiquiatría-Universidad de Oviedo, Hospital Universitario Central de Asturias (HUCA), Asturias, Spain
- Instituto de Investigación Sanitaria del Principado de Asturias (ISPA), Oviedo, Asturias, Spain
- Centro de Investigación Biomédica en Red de Salud Mental, Oviedo, Asturias, Spain
| | - Stefano Bonassi
- Unit of Clinical and Molecular Epidemiology, IRCCS San Raffaele Roma and San Raffaele University, Rome, Italy
| | - Alice Braun
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin, Berlin, Germany
| | - Rodrigo Affonseca Bressan
- Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil
- Laboratory of Integrative Neuroscience, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Evelyn J Bromet
- Department of Psychiatry and Behavioural Health, Stony Brook University, Stony Brook, NY, USA
| | - Richard Bruggeman
- University Medical Center Groningen, University Center for Psychiatry, Rob Giel Research Center, University of Groningen, Groningen, The Netherlands
- Department of Clinical and Developmental Neuropsychology, University of Groningen, Groningen, The Netherlands
| | - Peter F Buckley
- Health Science Center, University of Tennessee, Memphis, TN, USA
| | - Randy L Buckner
- Department of Psychology, Harvard University, Cambridge, MA, USA
| | - Jonas Bybjerg-Grauholm
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Center for Neonatal Screening, Department for Congenital Disorders, Statens Serum Institut, Copenhagen, Denmark
| | - Wiepke Cahn
- University Medical Center Utrecht, Department of Psychiatry, Rudolf Magnus Institute of Neuroscience, Utrecht, The Netherlands
- Altrecht, General Menthal Health Care, Utrecht, The Netherlands
| | - Murray J Cairns
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Newcastle, New South Wales, Australia
- Hunter Medical Research Institute, Newcastle, New South Wales, Australia
- Centre for Brain and Mental Health Research, University of Newcastle, Newcastle, New South Wales, Australia
| | - Monica E Calkins
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | - Vaughan J Carr
- School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia
- Department of Psychiatry, Monash University, Melbourne, Victoria, Australia
- Neuroscience Research Australia, Sydney, New South Wales, Australia
| | - David Castle
- Department of Psychiatry, University of Melbourne, Parkville, Victoria, Australia
- St Vincent's Hospital, Melbourne, Victoria, Australia
| | - Stanley V Catts
- Brain and Mind Centre, The University of Sydney, Sydney, New South Wales, Australia
- School of Medicine, University of Queensland, Herston, Queensland, Australia
| | - Kimberley D Chambert
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Raymond C K Chan
- Institute of Psychology, Chinese Academy of Science, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Boris Chaumette
- INSERM U1266, Institute of Psychiatry and Neuroscience of Paris, Université de Paris, GHU Paris Psychiatrie & Neurosciences, Paris, France
- Department of Psychiatry, McGill University, Montreal, Québec, Canada
| | - Wei Cheng
- Department of Computer Science, University of North Carolina, Chapel Hill, NC, USA
| | | | - Siow Ann Chong
- Research Division, Institute of Mental Health, Singapore, Republic of Singapore
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Republic of Singapore
| | - David Cohen
- Faculté de Médecine Sorbonne Université, Groupe de Recherche Clinique no. 15 - Troubles Psychiatriques et Développement (PSYDEV), Department of Child and Adolescent Psychiatry, Hôpital Universitaire de la Pitié-Salpêtrière, Paris, France
- Centre de Référence des Maladies Rares à Expression Psychiatrique, Department of Child and Adolescent Psychiatry, AP-HP Sorbonne Université, Hôpital Universitaire de la Pitié-Salpêtrière, Paris, France
- Institut des Systèmes Intelligents et de Robotique (ISIR), CNRS UMR7222, Faculté des Sciences et Ingénierie, Sorbonne Université, Paris, France
| | - Angèle Consoli
- Faculté de Médecine Sorbonne Université, Groupe de Recherche Clinique no. 15 - Troubles Psychiatriques et Développement (PSYDEV), Department of Child and Adolescent Psychiatry, Hôpital Universitaire de la Pitié-Salpêtrière, Paris, France
- Centre de Référence des Maladies Rares à Expression Psychiatrique, Department of Child and Adolescent Psychiatry, AP-HP Sorbonne Université, Hôpital Universitaire de la Pitié-Salpêtrière, Paris, France
| | - Quirino Cordeiro
- Department of Psychiatry, Irmandade da Santa Casa de Misericórdia de São Paulo, São Paulo, Brazil
| | - Javier Costas
- Instituto de Investigación Sanitaria (IDIS) de Santiago de Compostela, Complexo Hospitalario Universitario de Santiago de Compostela (CHUS), Servizo Galego de Saúde (SERGAS), Santiago de Compostela, Spain
| | - Charles Curtis
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- National Institute for Health Research (NIHR) Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, UK
| | | | - Kenneth L Davis
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Lieuwe de Haan
- Department of Psychiatry, Academic Medical Centre, University of Amsterdam, Amsterdam, The Netherlands
- Arkin, Institute for Mental Health, Amsterdam, The Netherlands
| | | | - Lynn E DeLisi
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Cambridge Health Alliance, Cambridge, MA, USA
| | - Ditte Demontis
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Department of Biomedicine and Centre for Integrative Sequencing (iSEQ), Aarhus University, Aarhus, Denmark
- Center for Genomics and Personalized Medicine, Aarhus, Denmark
| | | | - Dimitris Dikeos
- First Department of Psychiatry, Medical School, National and Kapodistrian University of Athens, Eginition Hospital, Athens, Greece
| | - Timothy Dinan
- Department of Psychiatry and Neurobehavioural Sciences, University College Cork, Cork, Ireland
- APC Microbiome Ireland, University College Cork, Cork, Ireland
| | - Srdjan Djurovic
- NORMENT Centre, Department of Clinical Science, University of Bergen, Bergen, Norway
- Department of Medical Genetics, Oslo University Hospital, Oslo, Norway
| | - Jubao Duan
- Center for Psychiatric Genetics, NorthShore University HealthSystem, Evanston, IL, USA
- Department of Psychiatry and Behavioral Neurosciences, The University of Chicago, Chicago, IL, USA
| | | | - Frank Dudbridge
- Department of Health Sciences, University of Leicester, Leicester, UK
| | - Johan G Eriksson
- Department of General Practice and Primary Health Care, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Folkhälsan Research Center, Helsinki, Finland
- Department of Obstetrics and Gynecology, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Republic of Singapore
| | - Lourdes Fañanás
- Department of Evolutionary Biology, Ecology and Environmental Sciences, Faculty of Biology, University of Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Madrid, Spain
| | - Stephen V Faraone
- Departments of Psychiatry and Neuroscience and Physiology, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Alessia Fiorentino
- Molecular Psychiatry Laboratory, Division of Psychiatry, University College London, London, UK
| | - Andreas Forstner
- Institute of Human Genetics, University of Bonn, Bonn, Germany
- Centre for Human Genetics, University of Marburg, Marburg, Germany
| | - Josef Frank
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Nelson B Freimer
- Department of Human Genetics, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
- Department of Psychiatry and Biobehavioral Sciences, University of California Los Angeles, Los Angeles, CA, USA
| | - Menachem Fromer
- Division of Psychiatric Genomics, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Alessandra Frustaci
- Barnet, Enfield and Haringey Mental Health NHS Trust, St Ann's Hospital, London, UK
| | - Ary Gadelha
- Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil
- Laboratory of Integrative Neuroscience, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Giulio Genovese
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Elliot S Gershon
- Departments of Psychiatry and Human Genetics, University of Chicago, Chicago, IL, USA
| | - Marianna Giannitelli
- Faculté de Médecine Sorbonne Université, Groupe de Recherche Clinique no. 15 - Troubles Psychiatriques et Développement (PSYDEV), Department of Child and Adolescent Psychiatry, Hôpital Universitaire de la Pitié-Salpêtrière, Paris, France
- Centre de Référence des Maladies Rares à Expression Psychiatrique, Department of Child and Adolescent Psychiatry, AP-HP Sorbonne Université, Hôpital Universitaire de la Pitié-Salpêtrière, Paris, France
| | - Ina Giegling
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | | | - Stephanie Godard
- Departments of Psychiatry and Human and Molecular Genetics, INSERM, Institut de Myologie, Hôpital de la Pitiè-Salpêtrière, Paris, France
| | - Jacqueline I Goldstein
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA, USA
| | - Javier González Peñas
- Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Madrid, Spain
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, Madrid, Spain
| | - Ana González-Pinto
- Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Madrid, Spain
- BIOARABA Health Research Institute, OSI Araba, University Hospital, University of the Basque Country, Vitoria, Spain
| | - Srihari Gopal
- Neuroscience Therapeutic Area, Janssen Research and Development, Titusville, NJ, USA
| | - Jacob Gratten
- Institute for Molecular Bioscience, University of Queensland, Brisbane, Queensland, Australia
- Mater Research Institute, University of Queensland, Brisbane, Queensland, Australia
| | - Michael F Green
- Department of Psychiatry and Biobehavioral Sciences, Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
- VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA
| | - Tiffany A Greenwood
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Olivier Guillin
- INSERM, Rouen, France
- Centre Hospitalier du Rouvray, Rouen, France
- UFR Santé, Université de Rouen Normandie, Rouen, France
| | - Sinan Gülöksüz
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Raquel E Gur
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | - Ruben C Gur
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | - Blanca Gutiérrez
- Department of Psychiatry, Faculty of Medicine and Biomedical Research Centre (CIBM), University of Granada, Granada, Spain
| | - Eric Hahn
- Department of Psychiatry, Charité - Universitätsmedizin, Berlin, Germany
| | - Hakon Hakonarson
- Children's Hospital of Philadelphia, Leonard Madlyn Abramson Research Center, Philadelphia, PA, USA
| | - Vahram Haroutunian
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Mental Illness Research Clinical and Education Center (MIRECC), JJ Peters VA Medical Center, New York, NY, USA
| | - Annette M Hartmann
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Carol Harvey
- Department of Psychiatry, University of Melbourne, Parkville, Victoria, Australia
- NorthWestern Mental Health, Melbourne, Victoria, Australia
| | - Caroline Hayward
- MRC Human Genetics Unit, University of Edinburgh, Institute of Genetics and Cancer, Western General Hospital, Edinburgh, UK
| | - Frans A Henskens
- School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia
| | - Stefan Herms
- Division of Medical Genetics, Department of Biomedicine, University of Basel, Basel, Switzerland
| | - Per Hoffmann
- Division of Medical Genetics, Department of Biomedicine, University of Basel, Basel, Switzerland
| | - Daniel P Howrigan
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA, USA
- Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Masashi Ikeda
- Department of Psychiatry, Fujita Health University School of Medicine, Toyoake Aichi, Japan
| | - Conrad Iyegbe
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Inge Joa
- Regional Centre for Clinical Research in Psychosis, Department of Psychiatry, Stavanger University Hospital, Stavanger, Norway
| | - Antonio Julià
- Rheumatology Research Group, Vall d'Hebron Research Institute, Barcelona, Spain
| | - Anna K Kähler
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Tony Kam-Thong
- Roche Pharma Research and Early Development, Pharmaceutical Sciences, Roche Innovation Center Basel, F. Hoffman-La Roche, Basel, Switzerland
| | - Yoichiro Kamatani
- Laboratory of Complex Trait Genomics, Department of Computational Biology and Medical Sciences, Graduate School of Frontier Sciences, The University of Tokyo, Tokyo, Japan
- Laboratory for Statistical Analysis, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
| | - Sena Karachanak-Yankova
- Department of Medical Genetics, Medical University, Sofia, Bulgaria
- Department of Genetics, Faculty of Biology, Sofia University "St. Kliment Ohridski", Sofia, Bulgaria
| | - Oussama Kebir
- INSERM U1266, Institute of Psychiatry and Neuroscience of Paris, Université de Paris, GHU Paris Psychiatrie & Neurosciences, Paris, France
| | - Matthew C Keller
- Institute for Behavioural Genetics, University of Colorado Boulder, Boulder, CO, USA
| | - Brian J Kelly
- School of Medicine and Public Health, University of Newcastle, Newcastle, New South Wales, Australia
| | - Andrey Khrunin
- Institute of Molecular Genetics of National Research Centre "Kurchatov Institute", Moscow, Russia
| | - Sung-Wan Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
| | - Janis Klovins
- Latvian Biomedical Research and Study Centre, Riga, Latvia
| | | | - Bettina Konte
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Julia Kraft
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin, Berlin, Germany
- Berlin School of Mind and Brain, Humboldt-Universität zu Berlin, Berlin, Germany
| | - Michiaki Kubo
- RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
| | | | | | - Agung Kusumawardhani
- Psychiatry Department, University of Indonesia - Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia
| | - Hana Kuzelova-Ptackova
- Department of Psychiatry, 1st Faculty of Medicine and General University Hospital, Prague, Czech Republic
| | - Stefano Landi
- Dipartimento di Biologia, Universita' di Pisa, Pisa, Italy
| | - Laura C Lazzeroni
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
- Department of Biomedical Data Science, Stanford University, Stanford, CA, USA
| | - Phil H Lee
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Psychiatric and Neurodevelopmental Genetics Unit, Department of Psychiatry and Center for Genomic Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Sophie E Legge
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - Douglas S Lehrer
- Department of Psychiatry, Wright State University, Dayton, OH, USA
| | - Rebecca Lencer
- Department of Psychiatry, University of Münster, Münster, Germany
| | - Bernard Lerer
- Department of Psychiatry, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | - Miaoxin Li
- Zhongshan School of Medicine and Key Laboratory of Tropical Diseases Control (SYSU), Sun Yat-sen University, Guangzhou, China
| | | | - Gregory A Light
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- VISN 22, Mental Illness Research, Education and Clinical Center (MIRECC), VA San Diego Healthcare System, San Diego, CA, USA
| | - Svetlana Limborska
- Institute of Molecular Genetics of National Research Centre "Kurchatov Institute", Moscow, Russia
| | - Chih-Min Liu
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan
- Neurobiology and Cognitive Science Center, National Taiwan University, Taipei, Taiwan
| | - Jouko Lönnqvist
- Mental Health Unit, Department of Public Health Solutions, National Institute for Health and Welfare, Helsinki, Finland
- Department of Psychiatry, University of Helsinki, Helsinki, Finland
| | - Carmel M Loughland
- Hunter New England Health and University of Newcastle, Newcastle, New South Wales, Australia
| | - Jan Lubinski
- Department of Genetics and Pathology, International Hereditary Cancer Center, Pomeranian Medical University in Szczecin, Szczecin, Poland
| | - Jurjen J Luykx
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
- Department of Psychiatry, UMC Utrecht Brain Center, University Medical Centre Utrecht, Utrecht University, Utrecht, The Netherlands
- Department of Translational Neuroscience, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
- Second Opinion Outpatient Clinic, GGNet Mental Health, Warnsveld, The Netherlands
| | - Amy Lynham
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - Milan Macek
- Department of Biology and Medical Genetics, 2nd Faculty of Medicine and University Hospital Motol, Prague, Czech Republic
| | - Andrew Mackinnon
- Black Dog Institute, University of New South Wales, Randwick, New South Wales, Australia
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Patrik K E Magnusson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Brion S Maher
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Wolfgang Maier
- Department for Neurodegenerative Diseases and Geriatric Psychiatry, University Hospital Bonn, Bonn, Germany
| | - Dolores Malaspina
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Genetics and Genomics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jacques Mallet
- Asfalia Biologics, iPEPS-ICM, Hôpital Universitaire de la Pitié-Salpêtrière, Paris, France
| | - Stephen R Marder
- Semel Institute for Neurosciene, University of California Los Angeles, Los Angeles, CA, USA
| | - Sara Marsal
- Rheumatology Research Group, Vall d'Hebron Research Institute, Barcelona, Spain
| | - Alicia R Martin
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Lourdes Martorell
- Hospital Universitari Institut Pere Mata, IISPV, Universitat Rovira i Virgili, CIBERSAM, Reus, Spain
| | - Manuel Mattheisen
- Department of Biomedicine and Centre for Integrative Sequencing (iSEQ), Aarhus University, Aarhus, Denmark
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany
| | | | - Colm McDonald
- Centre for Neuroimaging, Cognition and Genomics (NICOG), National University of Ireland Galway, Galway, Ireland
| | - John J McGrath
- National Centre for Register-based Research, Aarhus University, Aarhus, Denmark
- Queensland Brain Institute, University of Queensland, Brisbane, Queensland, Australia
- Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Brisbane, Queensland, Australia
| | - Helena Medeiros
- Department of Psychiatry and the Behavioral Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- College of Medicine, SUNY Downstate Health Sciences University, New York, NY, USA
| | - Sandra Meier
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
| | - Bela Melegh
- Department of Medical Genetics, University of Pécs, School of Medicine, Pécs, Hungary
| | - Ingrid Melle
- NORMENT Centre, Division of Mental Health and Addiction, University of Oslo, Oslo, Norway
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Raquelle I Mesholam-Gately
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Massachusetts Mental Health Center Public Psychiatry Division of the Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Andres Metspalu
- Estonian Genome Center, Institute of Genomics, University of Tartu, Tartu, Estonia
| | - Patricia T Michie
- School of Psychology, University of Newcastle, Newcastle, New South Wales, Australia
| | - Lili Milani
- Estonian Genome Center, Institute of Genomics, University of Tartu, Tartu, Estonia
| | - Vihra Milanova
- Psychiatric Clinic, Alexandrovska University Hospital, Sofia, Bulgaria
| | - Marina Mitjans
- Clinical Neuroscience, Max Planck Institute of Experimental Medicine, Göttingen, Germany
| | - Espen Molden
- Department of Pharmacy, University of Oslo, Oslo, Norway
- Center for Psychopharmacology, Diakonhjemmet Hospital, Oslo, Norway
| | - Esther Molina
- Department of Nursing, Faculty of Health Sciences and Biomedical Research Centre (CIBM), University of Granada, Granada, Spain
| | - María Dolores Molto
- Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Madrid, Spain
- Department of Genetics, Faculty of Biological Sciences, Universidad de Valencia, Valencia, Spain
- Biomedical Research Institute INCLIVA, Valencia, Spain
| | - Valeria Mondelli
- National Institute for Health Research (NIHR) Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, UK
- Department of Psychological Medicine, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Carmen Moreno
- Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Madrid, Spain
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, Madrid, Spain
| | - Christopher P Morley
- Departments of Public Health and Preventive Medicine, Family Medicine, and Psychiatry and Behavioral Sciences, State University of New York, Upstate Medical University, Syracuse, NY, USA
| | - Gerard Muntané
- Hospital Universitari Institut Pere Mata, IISPV, Universitat Rovira i Virgili, CIBERSAM, Reus, Spain
- Institut de Biologia Evolutiva (UPF-CSIC), Departament de Ciències Experimentals i de la Salut, Universitat Pompeu Fabra, PRBB, Barcelona, Spain
| | - Kieran C Murphy
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Inez Myin-Germeys
- Department for Neurosciences, Center for Contextual Psychiatry, KU Leuven, Leuven, Belgium
| | - Igor Nenadić
- Cognitive Neuropsychiatry Laboratory, Department of Psychiatry and Psychotherapy, Philipps Universität Marburg, Marburg, Germany
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
| | - Gerald Nestadt
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | | | - Cristiano Noto
- Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil
- Laboratory of Integrative Neuroscience, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Keith H Nuechterlein
- Department of Psychiatry and Biobehavioral Sciences, Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Niamh Louise O'Brien
- Molecular Psychiatry Laboratory, Division of Psychiatry, University College London, London, UK
| | - F Anthony O'Neill
- Centre for Public Health, Institute of Clinical Sciences, Queen's University Belfast, Belfast, UK
| | - Sang-Yun Oh
- Department of Statistics and Applied Probability, University of California at Santa Barbara, Santa Barbara, CA, USA
- Computational Research Division, Lawrence Berkeley National Laboratory, Berkeley, CA, USA
| | - Ann Olincy
- Department of Psychiatry, University of Colorado Denver, Aurora, CO, USA
| | - Vanessa Kiyomi Ota
- Laboratory of Integrative Neuroscience, Universidade Federal de São Paulo, São Paulo, Brazil
- Department of Morphology and Genetics, Laboratorio de Genetica, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Christos Pantelis
- NorthWestern Mental Health, Melbourne, Victoria, Australia
- Melbourne Neuropsychiatry Centre, University of Melbourne and Melbourne Health, Melbourne, Victoria, Australia
- The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, Victoria, Australia
- Department of Psychiatry, Melbourne Medical School, University of Melbourne, Parkville, Victoria, Australia
| | - George N Papadimitriou
- First Department of Psychiatry, Medical School, National and Kapodistrian University of Athens, Eginition Hospital, Athens, Greece
| | - Mara Parellada
- Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Madrid, Spain
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, Madrid, Spain
| | - Tiina Paunio
- Department of Public Health Solutions, Genomics and Biomarkers Unit, National Institute for Health and Welfare, Helsinki, Finland
- Department of Psychiatry and SleepWell Research Program, Faculty of Medicine, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
| | - Renata Pellegrino
- Children's Hospital of Philadelphia, Leonard Madlyn Abramson Research Center, Philadelphia, PA, USA
| | - Sathish Periyasamy
- Queensland Brain Institute, University of Queensland, Brisbane, Queensland, Australia
- Queensland Centre for Mental Health Research, University of Queensland, Brisbane, Queensland, Australia
| | - Diana O Perkins
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA
| | - Bruno Pfuhlmann
- Clinic of Psychiatry and Psychotherapy, Weißer Hirsch, Dresden, Germany
| | - Olli Pietiläinen
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Department of Stem Cell and Regenerative Biology, Harvard University, Cambridge, MA, USA
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
| | - Jonathan Pimm
- Molecular Psychiatry Laboratory, Division of Psychiatry, University College London, London, UK
| | - David Porteous
- Centre for Genomic and Experimental Medicine, Institute of Genetics and Molecular Medicine, University of Edinburgh, Western General Hospital, Edinburgh, UK
| | - John Powell
- Department of Basic and Clinical Neuroscience, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Diego Quattrone
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- National Institute for Health Research (NIHR) Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, UK
- South London and Maudsley NHS Mental Health Foundation Trust, London, UK
| | - Digby Quested
- Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Allen D Radant
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA
- VA Puget Sound Health Care System, Seattle, WA, USA
| | - Antonio Rampino
- Department of Basic Medical Science, Neuroscience and Sense Organs, University of Bari 'Aldo Moro', Bari, Italy
| | - Mark H Rapaport
- Huntsman Mental Health Institute, Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Anna Rautanen
- Roche Pharma Research and Early Development, Pharmaceutical Sciences, Roche Innovation Center Basel, F. Hoffman-La Roche, Basel, Switzerland
| | - Abraham Reichenberg
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Cheryl Roe
- SUNY Upstate Medical University, Syracuse, NY, USA
| | - Joshua L Roffman
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Julian Roth
- Department of Psychiatry, Psychosomatics and Psychotherapy, Julius-Maximilians-Universität Würzburg, Würzburg, Germany
| | | | - Bart P F Rutten
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
| | | | - Veikko Salomaa
- THL-Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Julio Sanjuan
- Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Madrid, Spain
- Biomedical Research Institute INCLIVA, Valencia, Spain
- Department of Psychiatry, School of Medicine, University of Valencia, Hospital Clínico Universitario de Valencia, Valencia, Spain
| | - Marcos Leite Santoro
- Laboratory of Integrative Neuroscience, Universidade Federal de São Paulo, São Paulo, Brazil
- Department of Morphology and Genetics, Laboratorio de Genetica, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Adam Savitz
- Neuroscience Therapeutic Area, Janssen Research and Development, Titusville, NJ, USA
| | - Ulrich Schall
- Hunter Medical Research Institute, Newcastle, New South Wales, Australia
- Priority Centre for Brain and Mental Health Research, University of Newcastle, Mater Hospital, McAuley Centre, Newcastle, New South Wales, Australia
| | - Rodney J Scott
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Newcastle, New South Wales, Australia
- Hunter Medical Research Institute, Newcastle, New South Wales, Australia
- Division of Molecular Medicine, NSW Health Pathology North, Newcastle, New South Wales, Australia
| | - Larry J Seidman
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Massachusetts Mental Health Center Public Psychiatry Division of the Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Sally Isabel Sharp
- Molecular Psychiatry Laboratory, Division of Psychiatry, University College London, London, UK
| | - Jianxin Shi
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Larry J Siever
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- James J. Peters VA Medical Center, Bronx, NY, USA
| | - Engilbert Sigurdsson
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
- Department of Psychiatry, Landspitali University Hospital, Reykjavik, Iceland
| | - Kang Sim
- West Region, Institute of Mental Health, Singapore, Singapore
- Yoo Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Nora Skarabis
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin, Berlin, Germany
| | - Petr Slominsky
- Institute of Molecular Genetics of National Research Centre "Kurchatov Institute", Moscow, Russia
| | - Hon-Cheong So
- School of Biomedical Sciences, The Chinese University of Hong Kong, Hong Kong, China
- Department of Psychiatry, The Chinese University of Hong Kong, Hong Kong, China
| | - Janet L Sobell
- Department of Psychiatry and the Behavioral Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Erik Söderman
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet and Stockholm Health Care Services, Stockholm Region, Stockholm, Sweden
| | - Helen J Stain
- School of Social and Health Sciences, Leeds Trinity University, Leeds, UK
- TIPS - Network for Clinical Research in Psychosis, Stavanger University Hospital, Stavanger, Norway
| | - Nils Eiel Steen
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Agnes A Steixner-Kumar
- Clinical Neuroscience, Max Planck Institute of Experimental Medicine, Göttingen, Germany
| | | | - William S Stone
- Harvard Medical School Department of Psychiatry at Beth Israel Deaconess Medical Center, Boston, MA, USA
- Massachusetts Mental Health Center, Boston, MA, USA
| | | | - Fabian Streit
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Eric Strengman
- Department of Medical Genetics, University Medical Centre Utrecht, Utrecht, The Netherlands
| | - T Scott Stroup
- Department of Psychiatry, Columbia University, New York, NY, USA
| | - Mythily Subramaniam
- Research Division, Institute of Mental Health, Singapore, Republic of Singapore
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Republic of Singapore
| | - Catherine A Sugar
- Department of Psychiatry and Biobehavioral Sciences, Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
- Department of Biostatistics, Fielding School of Public Health, University of California Los Angeles, Los Angeles, CA, USA
| | - Jaana Suvisaari
- THL-Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Dragan M Svrakic
- Department of Psychiatry, Washington University, St Louis, MO, USA
| | - Neal R Swerdlow
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Jin P Szatkiewicz
- Department of Genetics, University of North Carolina, Chapel Hill, NC, USA
| | - Thi Minh Tam Ta
- Department of Psychiatry, Charité - Universitätsmedizin Berlin, Berlin, Germany
- Berlin Institute of Health (BIH), Berlin, Germany
| | - Atsushi Takahashi
- Laboratory for Statistical and Translational Genetics, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
| | - Chikashi Terao
- Laboratory for Statistical and Translational Genetics, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
| | - Florence Thibaut
- Université de Paris, Faculté de Médecine, Hôpital Cochin-Tarnier, Paris, France
- INSERM U1266, Institut de Psychiatrie et de Neurosciences, Paris, France
| | - Draga Toncheva
- Department of Medical Genetics, Medical University, Sofia, Bulgaria
- Bulgarian Academy of Science, Sofia, Bulgaria
| | - Paul A Tooney
- School of Biomedical Sciences and Pharmacy, University of Newcastle, Newcastle, New South Wales, Australia
- Hunter Medical Research Institute, Newcastle, New South Wales, Australia
- Centre for Brain and Mental Health Research, University of Newcastle, Newcastle, New South Wales, Australia
| | - Silvia Torretta
- Department of Basic Medical Science, Neuroscience and Sense Organs, University of Bari 'Aldo Moro', Bari, Italy
| | - Sarah Tosato
- Department of Neuroscience, Biomedicine and Movement Sciences, Section of Psychiatry, University of Verona, Verona, Italy
| | - Gian Battista Tura
- Psychiatry Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Bruce I Turetsky
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | - Alp Üçok
- Department of Psychiatry, Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Arne Vaaler
- Division of Mental Health, St. Olav's Hospital, Trondheim University Hospital, Trondheim, Norway
- Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway
| | - Therese van Amelsvoort
- National Institute for Health Research (NIHR) Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, UK
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
| | - Ruud van Winkel
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, The Netherlands
- Department of Neurosciences, Center for Clinical Psychiatry, KU Leuven, Leuven, Belgium
| | - Juha Veijola
- Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - John Waddington
- Molecular and Cellular Therapeutics, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Henrik Walter
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin, Berlin, Germany
| | - Anna Waterreus
- Neuropsychiatric Epidemiology Research Unit, School of Population and Global Health, University of Western Australia, Perth, Western Australia, Australia
- Centre for Clinical Research in Neuropsychiatry, University of Western Australia, Perth, Western Australia, Australia
| | - Bradley T Webb
- Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA
| | | | - Nigel M Williams
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - Stephanie H Witt
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Brandon K Wormley
- Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA
| | - Jing Qin Wu
- Baker Heart and Diabetes Institute, Melbourne, Victoria, Australia
| | - Zhida Xu
- Department of Psychiatry, GGz Centraal, Utrecht, The Netherlands
| | - Robert Yolken
- Stanley Neurovirology Laboratory, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Clement C Zai
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Wei Zhou
- Bio-X Institutes, Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders (Ministry of Education), Collaborative Innovation Center for Brain Science, Shanghai Jiao Tong University, Shanghai, China
| | - Feng Zhu
- Department of Psychiatry, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
- Center for Translational Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Fritz Zimprich
- Department of Neurology, Medical University of Vienna, Vienna, Austria
| | - Eşref Cem Atbaşoğlu
- Department of Genetics and Genomics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Psychiatry, School of Medicine, Ankara University, Ankara, Turkey
| | - Muhammad Ayub
- Department of Psychiatry, Queens University Kingston, Kingston, Ontario, Canada
| | - Christian Benner
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
| | - Alessandro Bertolino
- Department of Basic Medical Science, Neuroscience and Sense Organs, University of Bari 'Aldo Moro', Bari, Italy
| | - Donald W Black
- Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, IA, USA
| | - Nicholas J Bray
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - Gerome Breen
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Nancy G Buccola
- School of Nursing, Louisiana State University Health Sciences Center, New Orleans, LA, USA
| | - William F Byerley
- Department of Psychiatry, University of California San Francisco, San Francisco, CA, USA
| | - Wei J Chen
- Center for Neuropsychiatric Research, National Health Research Institutes, Zhunan Town, Taiwan
- Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | | | - Benedicto Crespo-Facorro
- University of Sevilla, CIBERSAM IBiS, Seville, Spain
- Hospital Universitario Virgen del Rocio, Department of Psychiatry, Universidad del Sevilla, Seville, Spain
| | - Gary Donohoe
- Centre for Neuroimaging, Cognition and Genomics (NICOG), National University of Ireland Galway, Galway, Ireland
| | - Robert Freedman
- Department of Psychiatry, University of Colorado Denver, Aurora, CO, USA
| | - Cherrie Galletly
- Discipline of Psychiatry, Adelaide Medical School, University of Adelaide, Adelaide, South Australia, Australia
- Ramsay Health Care (SA) Mental Health, Adelaide, South Australia, Australia
- Northern Adelaide Local Health Network, Adelaide, South Australia, Australia
| | - Michael J Gandal
- Department of Psychiatry, Semel Institute, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Massimo Gennarelli
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
- Genetic Unit, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - David M Hougaard
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Center for Neonatal Screening, Department for Congenital Disorders, Statens Serum Institut, Copenhagen, Denmark
| | - Hai-Gwo Hwu
- Neurobiology and Cognitive Science Center, National Taiwan University, Taipei, Taiwan
- Department of Psychiatry, College of Medicine and National Taiwan University Hospital, National Taiwan University, Taipei, Taiwan
| | - Assen V Jablensky
- Centre for Clinical Research in Neuropsychiatry, University of Western Australia, Perth, Western Australia, Australia
| | - Steven A McCarroll
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Jennifer L Moran
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Ole Mors
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Psychosis Research Unit, Aarhus University Hospital, Aarhus, Denmark
| | - Preben B Mortensen
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- National Centre for Register-based Research, Aarhus University, Aarhus, Denmark
| | - Bertram Müller-Myhsok
- Max Planck Institute of Psychiatry, Munich, Germany
- Munich Cluster for Systems Neurology, Munich, Germany
- Department of Health Data Science, University of Liverpool, Liverpool, UK
| | - Amanda L Neil
- Menzies Institute for Medical Research, University of Tasmania, Hobart, Tasmania, Australia
| | - Merete Nordentoft
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Mental Health Services in the Capital Region of Denmark, Mental Health Center Copenhagen, University of Copenhagen, Copenhagen, Denmark
| | - Michele T Pato
- Rutgers University, Robert Wood Johnson Medical School, New Brunswick, NJ, USA
- Rutgers University, New Jersey Medical School, Newark, NJ, USA
| | - Tracey L Petryshen
- Psychiatric and Neurodevelopmental Genetics Unit, Department of Psychiatry and Center for Genomic Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Matti Pirinen
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
- Department of Mathematics and Statistics, University of Helsinki, Helsinki, Finland
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Ann E Pulver
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Thomas G Schulze
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany
- Department of Psychiatry and Behavioral Sciences, SUNY Upstate Medical University, Syracuse, NY, USA
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
- Department of Psychiatry and Behavioral Sciences, The Johns Hopkins University, Baltimore, MD, USA
| | - Jeremy M Silverman
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- James J. Peters VA Medical Center, Bronx, NY, USA
| | - Jordan W Smoller
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Psychiatric and Neurodevelopmental Genetics Unit, Department of Psychiatry and Center for Genomic Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Eli A Stahl
- Division of Psychiatric Genomics, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Program in Medical and Population Genetics, The Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Regeneron Genetics Center, Orange, CA, USA
| | - Debby W Tsuang
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle, WA, USA
- VA Puget Sound Health Care System, Seattle, WA, USA
| | - Elisabet Vilella
- Hospital Universitari Institut Pere Mata, IISPV, Universitat Rovira i Virgili, CIBERSAM, Reus, Spain
| | - Shi-Heng Wang
- College of Public Health, China Medical University, Taichung, Taiwan
| | - Shuhua Xu
- State Key Laboratory of Genetic Engineering and Ministry of Education (MOE) Key Laboratory of Contemporary Anthropology, Collaborative Innovation Center of Genetics and Development, Human Phenome Institute, School of Life Sciences, Fudan University, Shanghai, China
- School of Life Science and Technology, ShanghaiTech University, Shanghai, China
- Center for Excellence in Animal Evolution and Genetics, Chinese Academy of Sciences, Kunming, China
| | - Rolf Adolfsson
- Department of Clinical Sciences, Psychiatry, Umeå University, Umeå, Sweden
| | - Celso Arango
- Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Madrid, Spain
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, Madrid, Spain
| | - Bernhard T Baune
- Department of Psychiatry, University of Münster, Münster, Germany
- The Florey Institute of Neuroscience and Mental Health, University of Melbourne, Parkville, Victoria, Australia
- Department of Psychiatry, Melbourne Medical School, University of Melbourne, Parkville, Victoria, Australia
| | - Sintia Iole Belangero
- Laboratory of Integrative Neuroscience, Universidade Federal de São Paulo, São Paulo, Brazil
- Department of Morphology and Genetics, Laboratorio de Genetica, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Anders D Børglum
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Department of Biomedicine and Centre for Integrative Sequencing (iSEQ), Aarhus University, Aarhus, Denmark
- Center for Genomics and Personalized Medicine, Aarhus, Denmark
| | - David Braff
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- VISN 22, Mental Illness Research, Education and Clinical Center (MIRECC), VA San Diego Healthcare System, San Diego, CA, USA
| | - Elvira Bramon
- Division of Psychiatry, Department of Mental Health Neuroscience, University College London, London, UK
| | - Joseph D Buxbaum
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | - Jorge A Cervilla
- Department of Psychiatry, San Cecilio University Hospital, University of Granada, Granada, Spain
| | - Sven Cichon
- Institute of Medical Genetics and Pathology, University Hospital Basel, Basel, Switzerland
- Department of Biomedicine, University of Basel, Basel, Switzerland
- Institute of Neuroscience and Medicine (INM-1), Research Center Juelich, Juelich, Germany
| | | | - Aiden Corvin
- Neuropsychiatric Genetics Research Group, Department of Psychiatry, Trinity College Dublin, Dublin, Ireland
| | - David Curtis
- UCL Genetics Institute, University College London, London, UK
- Centre for Psychiatry, Queen Mary University London, London, UK
| | - Marta Di Forti
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- National Institute for Health Research (NIHR) Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, UK
- South London and Maudsley NHS Mental Health Foundation Trust, London, UK
| | - Enrico Domenici
- Department of Cellular, Computational and Integrative Biology, University of Trento, Trento, Italy
| | - Hannelore Ehrenreich
- Clinical Neuroscience, Max Planck Institute of Experimental Medicine, Göttingen, Germany
| | - Valentina Escott-Price
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
- Dementia Research Institute, Cardiff University, Cardiff, UK
| | - Tõnu Esko
- Estonian Genome Center, Institute of Genomics, University of Tartu, Tartu, Estonia
- Program in Medical and Population Genetics, The Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Ayman H Fanous
- Department of Psychiatry, Veterans Affairs New York Harbor Healthcare System, New York, NY, USA
- Department of Psychiatry, Phoenix VA Healthcare System, Phoenix, AZ, USA
- Banner-University Medical Center, Phoenix, AZ, USA
| | - Anna Gareeva
- Department of Human Molecular Genetics of the Institute of Biochemistry and Genetics of the Ufa Federal Research Center of the Russian Academy of Sciences (IBG UFRC RAS), Ufa, Russia
- Federal State Educational Institution of Highest Education Bashkir State Medical University of Public Health Ministry of Russian Federation (BSMU), Ufa, Russia
| | - Micha Gawlik
- Department of Psychiatry, Psychosomatics and Psychotherapy, Julius-Maximilians-Universität Würzburg, Würzburg, Germany
| | - Pablo V Gejman
- Center for Psychiatric Genetics, NorthShore University HealthSystem, Evanston, IL, USA
- Department of Psychiatry and Behavioral Neurosciences, The University of Chicago, Chicago, IL, USA
| | - Michael Gill
- Neuropsychiatric Genetics Research Group, Department of Psychiatry, Trinity College Dublin, Dublin, Ireland
| | - Stephen J Glatt
- Psychiatric Genetic Epidemiology and Neurobiology Laboratory (PsychGENe lab), Department of Psychiatry and Behavioral Sciences, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Vera Golimbet
- Mental Health Research Center, Moscow, Russian Federation
| | - Kyung Sue Hong
- Department of Psychiatry, Sungkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Korea
| | - Christina M Hultman
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Steven E Hyman
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Department of Stem Cell and Regenerative Biology, Harvard University, Cambridge, MA, USA
| | - Nakao Iwata
- Department of Psychiatry, Fujita Health University School of Medicine, Toyoake Aichi, Japan
| | - Erik G Jönsson
- Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet and Stockholm Health Care Services, Stockholm Region, Stockholm, Sweden
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - René S Kahn
- University Medical Center Utrecht, Department of Psychiatry, Rudolf Magnus Institute of Neuroscience, Utrecht, The Netherlands
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - James L Kennedy
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Elza Khusnutdinova
- Department of Human Molecular Genetics of the Institute of Biochemistry and Genetics of the Ufa Federal Research Center of the Russian Academy of Sciences (IBG UFRC RAS), Ufa, Russia
- Federal State Educational Institution of Highest Education Bashkir State Medical University of Public Health Ministry of Russian Federation (BSMU), Ufa, Russia
| | - George Kirov
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - James A Knowles
- Department of Psychiatry and Zilkha Neurogenetics Institute, Keck School of Medicine at University of Southern California, Los Angeles, CA, USA
- Department of Cell Biology, State University of New York, Downstate Health Sciences University, New York, NY, USA
| | - Marie-Odile Krebs
- INSERM U1266, Institute of Psychiatry and Neuroscience of Paris, Université de Paris, GHU Paris Psychiatrie & Neurosciences, Paris, France
| | - Claudine Laurent-Levinson
- Faculté de Médecine Sorbonne Université, Groupe de Recherche Clinique no. 15 - Troubles Psychiatriques et Développement (PSYDEV), Department of Child and Adolescent Psychiatry, Hôpital Universitaire de la Pitié-Salpêtrière, Paris, France
- Centre de Référence des Maladies Rares à Expression Psychiatrique, Department of Child and Adolescent Psychiatry, AP-HP Sorbonne Université, Hôpital Universitaire de la Pitié-Salpêtrière, Paris, France
| | - Jimmy Lee
- Department of Psychosis, Institute of Mental Health, Singapore, Singapore
- Neuroscience and Mental Health, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Todd Lencz
- Division of Psychiatry Research, Zucker Hillside Hospital, Glen Oaks, NY, USA
- Institute of Behavioral Science, Feinstein Institutes for Medical Research, Manhasset, NY, USA
- Department of Psychiatry, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - Douglas F Levinson
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA, USA
| | - Qingqin S Li
- Neuroscience Therapeutic Area, Janssen Research and Development, Titusville, NJ, USA
| | - Jianjun Liu
- Human Genetics, Genome Institute of Singapore, A*STAR, Singapore, Singapore
- Department of Medicine, Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore
| | - Anil K Malhotra
- Division of Psychiatry Research, Zucker Hillside Hospital, Glen Oaks, NY, USA
- Institute of Behavioral Science, Feinstein Institutes for Medical Research, Manhasset, NY, USA
- Department of Psychiatry, Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - Dheeraj Malhotra
- Roche Pharma Research and Early Development, Roche Innovation Center Basel, F. Hoffman-La Roche, Basel, Switzerland
| | - Andrew McIntosh
- Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, Royal Edinburgh Hospital, Edinburgh, UK
| | - Andrew McQuillin
- Molecular Psychiatry Laboratory, Division of Psychiatry, University College London, London, UK
| | - Paulo R Menezes
- Department of Preventative Medicine, Faculdade de Medicina FMUSP, University of São Paulo, São Paulo, Brazil
| | - Vera A Morgan
- Neuropsychiatric Epidemiology Research Unit, School of Population and Global Health, University of Western Australia, Perth, Western Australia, Australia
- Centre for Clinical Research in Neuropsychiatry, University of Western Australia, Perth, Western Australia, Australia
| | - Derek W Morris
- Centre for Neuroimaging, Cognition and Genomics (NICOG), National University of Ireland Galway, Galway, Ireland
| | - Bryan J Mowry
- Queensland Brain Institute, University of Queensland, Brisbane, Queensland, Australia
- Queensland Centre for Mental Health Research, University of Queensland, Brisbane, Queensland, Australia
| | - Robin M Murray
- National Institute for Health Research (NIHR) Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, UK
| | | | - Markus M Nöthen
- Institute of Human Genetics, University of Bonn, Bonn, Germany
| | - Roel A Ophoff
- Department of Human Genetics, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
- Center for Neurobehavioral Genetics, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, CA, USA
- Department of Psychiatry, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - Sara A Paciga
- Early Clinical Development, Pfizer Worldwide Research and Development, Groton, CT, USA
| | - Aarno Palotie
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
- Analytic and Translational Genetics Unit, Department of Medicine, Department of Neurology and Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Carlos N Pato
- Rutgers University, Robert Wood Johnson Medical School, New Brunswick, NJ, USA
- Rutgers University, New Jersey Medical School, Newark, NJ, USA
| | - Shengying Qin
- Bio-X Institutes, Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders (Ministry of Education), Collaborative Innovation Center for Brain Science, Shanghai Jiao Tong University, Shanghai, China
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Marcella Rietschel
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Brien P Riley
- Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA
| | - Margarita Rivera
- Department of Biochemistry and Molecular Biology II, Faculty of Pharmacy, University of Granada, Granada, Spain
- Institute of Neurosciences, Biomedical Research Center (CIBM), University of Granada, Granada, Spain
| | - Dan Rujescu
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Meram C Saka
- Department of Psychiatry, School of Medicine, Ankara University, Ankara, Turkey
| | - Alan R Sanders
- Center for Psychiatric Genetics, NorthShore University HealthSystem, Evanston, IL, USA
- Department of Psychiatry and Behavioral Neurosciences, The University of Chicago, Chicago, IL, USA
| | - Sibylle G Schwab
- Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, New South Wales, Australia
- Illawarra Health and Medical Research Institute, Wollongong, New South Wales, Australia
| | - Alessandro Serretti
- Department of Biomedical and Neuromotor Sciences, University of Bologna, Bologna, Italy
| | - Pak C Sham
- Centre for PanorOmic Sciences, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
- State Key Laboratory of Brain and Cognitive Sciences, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
- Department of Psychiatry, LKS Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Yongyong Shi
- Affiliated Hospital of Qingdao University and Biomedical Sciences Institute of Qingdao University (Qingdao Branch of SJTU Bio-X Institutes), Qingdao University, Qingdao, China
- Bio-X Institutes, Key Laboratory for the Genetics of Developmental and Neuropsychiatric Disorders (Ministry of Education), Collaborative Innovation Center for Brain Science, Shanghai Jiao Tong University, Shanghai, China
| | - David St Clair
- Institute of Medical Sciences, University of Aberdeen, Aberdeen, UK
| | | | | | - Ming T Tsuang
- Center for Behavioral Genomics, Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- Institute of Genomic Medicine, University of California San Diego, La Jolla, CA, USA
| | - Jim van Os
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- University Medical Center Utrecht, Department of Psychiatry, Utrecht, The Netherlands
| | - Marquis P Vawter
- Department of Psychiatry and Human Behavior, School of Medicine, University of California Irvine, Irvine, CA, USA
| | | | - Thomas Werge
- Institute of Biological Psychiatry, Mental Health Services, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Center for GeoGenetics, GLOBE Institute, University of Copenhagen, Copenhagen, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Copenhagen, Denmark
| | - Dieter B Wildenauer
- School of Psychiatry and Clinical Neurosciences, University of Western Australia, Perth, Western Australia, Australia
| | - Xin Yu
- Peking University Sixth Hospital, Peking University Institute of Mental Health, Beijing, China
- National Clinical Research Center for Mental Disorders, NHC Key Laboratory of Mental Health (Peking University) and Chinese Academy of Medical Sciences Research Unit, Beijing, China
| | - Weihua Yue
- Peking University Sixth Hospital, Peking University Institute of Mental Health, Beijing, China
- National Clinical Research Center for Mental Disorders, NHC Key Laboratory of Mental Health (Peking University) and Chinese Academy of Medical Sciences Research Unit, Beijing, China
- PKU-IDG/McGovern Institute for Brain Research, Peking University, Beijing, China
| | - Peter A Holmans
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - Andrew J Pocklington
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - Panos Roussos
- Department of Psychiatry, Pamela Sklar Division of Psychiatric Genomics, Friedman Brain Institute, Department of Genetics and Genomic Science and Institute for Data Science and Genomic Technology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Mental Illness Research, Education, and Clinical Center (VISN 2 South), James J. Peters VA Medical Center, New York, NY, USA
| | - Evangelos Vassos
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- National Institute for Health Research (NIHR) Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, London, UK
- Oxford Health NHS Foundation Trust, Oxford, UK
| | - Matthijs Verhage
- Department of Clinical Genetics, Center for Neurogenomics and Cognitive Research, University Medical Center Amsterdam, Amsterdam, The Netherlands
- Department of Functional Genomics, Faculty of Exact Science, Center for Neurogenomics and Cognitive Research, VU University Amsterdam and VU Medical Center, Amsterdam, The Netherlands
| | - Peter M Visscher
- Institute for Molecular Bioscience, University of Queensland, Brisbane, Queensland, Australia
| | - Jian Yang
- Institute for Molecular Bioscience, University of Queensland, Brisbane, Queensland, Australia
- School of Life Sciences, Westlake University, Hangzhou, China
- Westlake Laboratory of Life Sciences and Biomedicine, Hangzhou, China
| | - Danielle Posthuma
- Department of Functional Genomics, Faculty of Exact Science, Center for Neurogenomics and Cognitive Research, VU University Amsterdam and VU Medical Center, Amsterdam, The Netherlands
| | - Ole A Andreassen
- NORMENT Centre, Division of Mental Health and Addiction, University of Oslo, Oslo, Norway
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Kenneth S Kendler
- Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA
| | - Michael J Owen
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - Naomi R Wray
- Institute for Molecular Bioscience, University of Queensland, Brisbane, Queensland, Australia
- Queensland Brain Institute, University of Queensland, Brisbane, Queensland, Australia
| | - Mark J Daly
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA, USA
- Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Institute for Molecular Medicine Finland (FIMM), University of Helsinki, Helsinki, Finland
| | - Hailiang Huang
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Benjamin M Neale
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Patrick F Sullivan
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Genetics, University of North Carolina, Chapel Hill, NC, USA
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA
| | - Stephan Ripke
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin, Berlin, Germany.
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA, USA.
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA.
| | - James T R Walters
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK.
| | - Michael C O'Donovan
- MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK.
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34
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Abstract
The structure of schizophrenia symptoms has a substantial impact on the development of pharmacological and psychosocial interventions. Typically, reflective latent variable models (eg, confirmatory factor analysis) or formative latent variable models (eg, principal component analysis) have been used to examine the structure of schizophrenia symptoms. More recently, network analysis is appearing as a method to examine symptom structure. However, latent variable modeling and network analysis results can lead to different inferences about the nature of symptoms. Given the critical role of correctly identifying symptom structure in schizophrenia treatment and research, we present an introduction to latent variable modeling and network analysis, along with their distinctions and implications for examining the structure of schizophrenia symptoms. We also provide a simulation demonstration highlighting the statistical equivalence between these models and the subsequent importance of an a priori rationale that should help guide model selection.
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Affiliation(s)
- Samuel J Abplanalp
- To whom correspondence should be addressed; VA Greater Los Angeles Healthcare System, MIRECC 210A, Bldg. 210, 11301 Wilshire Blvd, Los Angeles, CA 90073, USA; tel: 317-445-5810, e-mail:
| | - Michael F Green
- Desert Pacific Mental Illness Research, Education and Clinical Center, Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, USA,Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA, USA
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Novacek DM, Wynn JK, Gabrielian S, Glynn SM, Hellemann G, Horan WP, Kern RS, Lee J, Marder SR, Sugar C, Green MF. Examining racial differences in community integration between black and white homeless veterans. Psychiatry Res 2022; 308:114385. [PMID: 34999292 DOI: 10.1016/j.psychres.2021.114385] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2021] [Revised: 11/26/2021] [Accepted: 12/31/2021] [Indexed: 10/19/2022]
Abstract
Black Americans are overrepresented in Veteran and non-Veteran homeless populations. Community integration remains a problem for many Veterans after they obtain housing, and Black Veterans may encounter additional difficulties due to systemic racism. However, no prior study has specifically examined whether there are racial differences in community integration; similarly, no study has considered racial differences in psychosocial correlates of community integration in homeless Veterans. Knowledge of these factors could inform the development of culturally congruent rehabilitative interventions for Black Veterans. Semi-structured clinical interviews were administered to Black (N = 99) and White (N = 49) homeless Veterans to examine relations among psychiatric symptoms, motivation, and community integration domains (e.g., social integration, work productivity, and independent living). There were no significant racial differences in independent living or work productivity. Black Veterans had better social integration with family compared to White Veterans. In addition, psychiatric symptoms were more strongly correlated with social integration for Black than White Veterans. The association between motivation and work productivity was also stronger for Black Veterans. Recovery-oriented interventions could harness family connections and better target psychiatric symptoms to improve community integration for Black Veterans. Work productivity may improve from interventions aimed at enhancing motivation for Black Veterans.
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Affiliation(s)
- Derek M Novacek
- Desert Pacific Mental Illness Research, Education, and Clinical Center, VA Greater Los Angeles Healthcare System, Los Angeles, CA, United States; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, CA, United States.
| | - Jonathan K Wynn
- Desert Pacific Mental Illness Research, Education, and Clinical Center, VA Greater Los Angeles Healthcare System, Los Angeles, CA, United States; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, CA, United States
| | - Sonya Gabrielian
- Desert Pacific Mental Illness Research, Education, and Clinical Center, VA Greater Los Angeles Healthcare System, Los Angeles, CA, United States; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, CA, United States
| | - Shirley M Glynn
- Desert Pacific Mental Illness Research, Education, and Clinical Center, VA Greater Los Angeles Healthcare System, Los Angeles, CA, United States; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, CA, United States
| | - Gerhard Hellemann
- Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL, United States
| | - William P Horan
- Desert Pacific Mental Illness Research, Education, and Clinical Center, VA Greater Los Angeles Healthcare System, Los Angeles, CA, United States; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, CA, United States; VeraSci Inc., Durham, NC, United States
| | - Robert S Kern
- Desert Pacific Mental Illness Research, Education, and Clinical Center, VA Greater Los Angeles Healthcare System, Los Angeles, CA, United States; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, CA, United States
| | - Junghee Lee
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Stephen R Marder
- Desert Pacific Mental Illness Research, Education, and Clinical Center, VA Greater Los Angeles Healthcare System, Los Angeles, CA, United States; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, CA, United States
| | - Catherine Sugar
- Desert Pacific Mental Illness Research, Education, and Clinical Center, VA Greater Los Angeles Healthcare System, Los Angeles, CA, United States; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, CA, United States; Department of Biostatistics, University of California, Los Angeles, CA, United States
| | - Michael F Green
- Desert Pacific Mental Illness Research, Education, and Clinical Center, VA Greater Los Angeles Healthcare System, Los Angeles, CA, United States; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California, Los Angeles, CA, United States
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Green MF, Wynn JK, Gabrielian S, Hellemann G, Horan WP, Kern RS, Lee J, Marder SR, Sugar CA. Motivational and cognitive factors linked to community integration in homeless veterans: study 1 - individuals with psychotic disorders. Psychol Med 2022; 52:169-177. [PMID: 32517838 DOI: 10.1017/s0033291720001889] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Little is known about the determinants of community integration (i.e. recovery) for individuals with a history of homelessness, yet such information is essential to develop targeted interventions. METHODS We recruited homeless Veterans with a history of psychotic disorders and evaluated four domains of correlates of community integration: perception, non-social cognition, social cognition, and motivation. Baseline assessments occurred after participants were engaged in supported housing services but before they received housing, and again after 12 months. Ninety-five homeless Veterans with a history of psychosis were assessed at baseline and 53 returned after 12 months. We examined both cross-sectional and longitudinal relationships with 12-month community integration. RESULTS The strongest longitudinal association was between a baseline motivational measure and social integration at 12 months. We also observed cross-sectional associations at baseline between motivational measures and community integration, including social, work, and independent living. Cross-lagged panel analyses did not suggest causal associations for the motivational measures. Correlations with perception and non-social cognition were weak. One social cognition measure showed a significant longitudinal correlation with independent living at 12 months that was significant for cross-lagged analysis, consistent with a causal relationship and potential treatment target. CONCLUSIONS The relatively selective associations for motivational measures differ from what is typically seen in psychosis, in which all domains are associated with community integration. These findings are presented along with a partner paper (Study 2) to compare findings from this study to an independent sample without a history of psychotic disorders to evaluate the consistency in findings regarding community integration across projects.
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Affiliation(s)
- Michael F Green
- Department of Psychiatry and Biobehavioral Sciences, Jane and Terry Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA90024-1759, USA
- Department of Veterans Affairs, Desert Pacific Mental Illness Research, Education, and Clinical Center, Los Angeles, CA, USA
- VA Research and Enhancement Award Program to Enhance Community Integration in Homeless Veterans, Los Angeles, CA, USA
| | - Jonathan K Wynn
- Department of Psychiatry and Biobehavioral Sciences, Jane and Terry Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA90024-1759, USA
- Department of Veterans Affairs, Desert Pacific Mental Illness Research, Education, and Clinical Center, Los Angeles, CA, USA
- VA Research and Enhancement Award Program to Enhance Community Integration in Homeless Veterans, Los Angeles, CA, USA
| | - Sonya Gabrielian
- Department of Psychiatry and Biobehavioral Sciences, Jane and Terry Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA90024-1759, USA
- Department of Veterans Affairs, Desert Pacific Mental Illness Research, Education, and Clinical Center, Los Angeles, CA, USA
- VA Research and Enhancement Award Program to Enhance Community Integration in Homeless Veterans, Los Angeles, CA, USA
| | - Gerhard Hellemann
- Department of Psychiatry and Biobehavioral Sciences, Jane and Terry Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA90024-1759, USA
- Department of Veterans Affairs, Desert Pacific Mental Illness Research, Education, and Clinical Center, Los Angeles, CA, USA
- VA Research and Enhancement Award Program to Enhance Community Integration in Homeless Veterans, Los Angeles, CA, USA
| | - William P Horan
- Department of Psychiatry and Biobehavioral Sciences, Jane and Terry Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA90024-1759, USA
- Department of Veterans Affairs, Desert Pacific Mental Illness Research, Education, and Clinical Center, Los Angeles, CA, USA
- VA Research and Enhancement Award Program to Enhance Community Integration in Homeless Veterans, Los Angeles, CA, USA
- VeriSci, Durham, North Carolina, USA
| | - Robert S Kern
- Department of Psychiatry and Biobehavioral Sciences, Jane and Terry Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA90024-1759, USA
- Department of Veterans Affairs, Desert Pacific Mental Illness Research, Education, and Clinical Center, Los Angeles, CA, USA
- VA Research and Enhancement Award Program to Enhance Community Integration in Homeless Veterans, Los Angeles, CA, USA
| | - Junghee Lee
- Department of Psychiatry and Biobehavioral Sciences, Jane and Terry Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA90024-1759, USA
- Department of Veterans Affairs, Desert Pacific Mental Illness Research, Education, and Clinical Center, Los Angeles, CA, USA
- VA Research and Enhancement Award Program to Enhance Community Integration in Homeless Veterans, Los Angeles, CA, USA
| | - Stephen R Marder
- Department of Psychiatry and Biobehavioral Sciences, Jane and Terry Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA90024-1759, USA
- Department of Veterans Affairs, Desert Pacific Mental Illness Research, Education, and Clinical Center, Los Angeles, CA, USA
- VA Research and Enhancement Award Program to Enhance Community Integration in Homeless Veterans, Los Angeles, CA, USA
| | - Catherine A Sugar
- Department of Psychiatry and Biobehavioral Sciences, Jane and Terry Semel Institute for Neuroscience and Human Behavior, UCLA, Los Angeles, CA90024-1759, USA
- Department of Veterans Affairs, Desert Pacific Mental Illness Research, Education, and Clinical Center, Los Angeles, CA, USA
- VA Research and Enhancement Award Program to Enhance Community Integration in Homeless Veterans, Los Angeles, CA, USA
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Wynn JK, Gabrielian S, Hellemann G, Horan WP, Kern RS, Lee J, Marder SR, Sugar CA, Green MF. Motivational and cognitive factors linked to community integration in homeless veterans: Study 2 - clinically diverse sample. Psychol Med 2021; 51:2915-2922. [PMID: 32466807 DOI: 10.1017/s0033291720001609] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND In an initial study (Study 1), we found that motivation predicted community integration (i.e. functional recovery) 12 months after receiving housing in formerly homeless Veterans with a psychotic disorder. The current study examined whether the same pattern would be found in a broader, more clinically diverse, homeless Veteran sample without psychosis. METHODS We examined four categories of variables as potential predictors of community integration in non-psychotic Veterans: perception, non-social cognition, social cognition, and motivation at baseline (after participants were engaged in a permanent supported housing program but before receiving housing) and a 12-month follow-up. A total of 82 Veterans had a baseline assessment and 41 returned for testing after 12 months. RESULTS The strongest longitudinal association was between an interview-based measure of motivation (the motivation and pleasure subscale from the Clinical Assessment Interview for Negative Symptoms) at baseline and measures of social integration at 12 months. In addition, cross-lagged panel analyses were consistent with a causal influence of general psychiatric symptoms at baseline driving social integration at 12 months, and reduced expressiveness at baseline driving independent living at 12 months, but there were no significant causal associations with measures of motivation. CONCLUSIONS The findings from this study complement and reinforce those in Veterans with psychosis. Across these two studies, our findings suggest that motivational factors are associated at baseline and at 12 months and are particularly important for understanding and improving community integration in recently-housed Veterans across psychiatric diagnoses.
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Affiliation(s)
- Jonathan K Wynn
- Department of Veterans Affairs, Desert Pacific Mental Illness Research, Education, and Clinical Center, Los Angeles, USA
- Department of Psychiatry and Biobehavioral Sciences, Jane and Terry Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, USA
- VA Research and Enhancement Award Program to Enhance Community Integration in Homeless Veterans
| | - Sonya Gabrielian
- Department of Veterans Affairs, Desert Pacific Mental Illness Research, Education, and Clinical Center, Los Angeles, USA
- Department of Psychiatry and Biobehavioral Sciences, Jane and Terry Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, USA
- VA Research and Enhancement Award Program to Enhance Community Integration in Homeless Veterans
| | - Gerhard Hellemann
- Department of Veterans Affairs, Desert Pacific Mental Illness Research, Education, and Clinical Center, Los Angeles, USA
- Department of Psychiatry and Biobehavioral Sciences, Jane and Terry Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, USA
- VA Research and Enhancement Award Program to Enhance Community Integration in Homeless Veterans
| | - William P Horan
- Department of Veterans Affairs, Desert Pacific Mental Illness Research, Education, and Clinical Center, Los Angeles, USA
- Department of Psychiatry and Biobehavioral Sciences, Jane and Terry Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, USA
- VA Research and Enhancement Award Program to Enhance Community Integration in Homeless Veterans
- VeriSci, Durham, North Carolina, USA
| | - Robert S Kern
- Department of Veterans Affairs, Desert Pacific Mental Illness Research, Education, and Clinical Center, Los Angeles, USA
- Department of Psychiatry and Biobehavioral Sciences, Jane and Terry Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, USA
- VA Research and Enhancement Award Program to Enhance Community Integration in Homeless Veterans
| | - Junghee Lee
- Department of Psychiatry and Biobehavioral Sciences, Jane and Terry Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, USA
- VA Research and Enhancement Award Program to Enhance Community Integration in Homeless Veterans
| | - Stephen R Marder
- Department of Veterans Affairs, Desert Pacific Mental Illness Research, Education, and Clinical Center, Los Angeles, USA
- Department of Psychiatry and Biobehavioral Sciences, Jane and Terry Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, USA
- VA Research and Enhancement Award Program to Enhance Community Integration in Homeless Veterans
| | - Catherine A Sugar
- Department of Veterans Affairs, Desert Pacific Mental Illness Research, Education, and Clinical Center, Los Angeles, USA
- Department of Psychiatry and Biobehavioral Sciences, Jane and Terry Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, USA
- VA Research and Enhancement Award Program to Enhance Community Integration in Homeless Veterans
- Department of Biostatistics, University of California, Los Angeles, USA
| | - Michael F Green
- Department of Veterans Affairs, Desert Pacific Mental Illness Research, Education, and Clinical Center, Los Angeles, USA
- Department of Psychiatry and Biobehavioral Sciences, Jane and Terry Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, USA
- VA Research and Enhancement Award Program to Enhance Community Integration in Homeless Veterans
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Catalano LT, Wynn JK, Lee J, Green MF. A comparison of stages of attention for social and nonsocial stimuli in schizophrenia: An ERP study. Schizophr Res 2021; 238:128-136. [PMID: 34655914 DOI: 10.1016/j.schres.2021.10.008] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2021] [Revised: 10/01/2021] [Accepted: 10/03/2021] [Indexed: 11/13/2022]
Abstract
Social motivation disturbances have been long observed in people with schizophrenia, yet the underlying components that drive these impairments remain unclear. Social attention is one component of social motivation and involves stages of attentional orienting, alerting/sustained attention, and executive control. It is not known at which stage the breakdown in social attention occurs in schizophrenia. The present study examined the allocation of social versus nonsocial attention at multiple stages of processing using event related potential (ERP) components. Electroencephalography from 36 outpatients with schizophrenia and 20 healthy participants was recorded during a dot probe task while viewing social/nonsocial stimuli that assessed: (1) orienting (indexed by the N1pc), (2) sustained attention (Contingent Negative Variation, [CNV]), and (3) executive control of attention during target evaluation (P300). Additionally, we analyzed correlations between the ERPs and participants' reaction times (RT) to the targets. Schizophrenia participants oriented their attention equally to social and nonsocial stimuli (N1pc), showed greater sustained attention to social than nonsocial stimuli (i.e., larger CNV), and exerted greater executive control on social trials (i.e., larger P300) than nonsocial trials, similarly to healthy participants. However, schizophrenia participants showed diminished overall sustained attention (blunted CNV) during the task, compared with healthy participants. Furthermore, greater sustained attention (larger CNV) and greater executive control (larger P300) were associated with improved behavioral performance (faster RTs) for healthy participants, but not schizophrenia participants. Together, these findings suggest there is impaired sustained attention for both social and nonsocial stimuli in schizophrenia, and their attention may not correspond with their behavior.
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Affiliation(s)
- Lauren T Catalano
- Desert Pacific Mental Illness Research, Education and Clinical Center, Veterans Affairs Greater Los Angeles Healthcare System, CA, United States; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA, United States.
| | - Jonathan K Wynn
- Desert Pacific Mental Illness Research, Education and Clinical Center, Veterans Affairs Greater Los Angeles Healthcare System, CA, United States; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA, United States
| | - Junghee Lee
- Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, AL, United States
| | - Michael F Green
- Desert Pacific Mental Illness Research, Education and Clinical Center, Veterans Affairs Greater Los Angeles Healthcare System, CA, United States; Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine at University of California Los Angeles, Los Angeles, CA, United States
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Gabrielian S, Hellemann G, Koosis ER, Green MF, Young AS. Do cognition and other person-level characteristics determine housing outcomes among homeless-experienced adults with serious mental illness? Psychiatr Rehabil J 2021; 44:176-185. [PMID: 33048564 PMCID: PMC8435461 DOI: 10.1037/prj0000457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Objective: Many persons with serious mental illness (SMI) who have experienced homelessness struggle to sustain stable and independent housing. We know little about determinants of this population's housing status. This study aimed to identify person-level determinants of housing status among homeless-experienced veterans with SMI, focused primarily on cognition. Method: We administered cross-sectional surveys and detailed cognitive assessments on a convenience sample of homeless-experienced veterans with SMI (n = 90); we also reviewed these participants' medical records. We captured person-level potential predictors of housing status (demographics, cognition, diagnoses, symptoms, and service utilization) and 2 years of retrospective housing history. Participants' housing status was conceptualized as the setting (stable housing, other sheltered settings, and streets) they lived in for >50% of the past 2 years. We used the chi-square test and analysis of variance to determine how potential predictors differed by housing status. We used recursive partitioning to identify the combination of potential predictors and corresponding scores that best-differentiated participants by housing status. Results: No between-groups differences (p < .05) in cognition, symptoms, or other person-level factors were found among participants grouped by housing status. Recursive partitioning did not yield a stable model to predict housing status from the potential predictor variables. Conclusions and Implications for Practice: These data suggest that clinical interventions addressing studied person-level factors (e.g., cognitive rehabilitation) may not affect housing status for homeless-experienced veterans. As housing is highly influenced by social determinants of health, policies, and practices that affect contextual factors (e.g., affordable housing supply) may be more likely to improve housing status. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
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Affiliation(s)
- Sonya Gabrielian
- Mental Illness Research, Education, and Clinical Center, VA Greater Los Angeles
| | - Gerhard Hellemann
- Mental Illness Research, Education, and Clinical Center, VA Greater Los Angeles
| | - Ella R Koosis
- Mental Illness Research, Education, and Clinical Center, VA Greater Los Angeles
| | - Michael F Green
- Mental Illness Research, Education, and Clinical Center, VA Greater Los Angeles
| | - Alexander S Young
- Mental Illness Research, Education, and Clinical Center, VA Greater Los Angeles
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Zito MF, Subotnik KL, Ventura J, Kern RS, Green MF, Nuechterlein KH. Awareness of illness is associated with better social and nonsocial cognition in recent-onset schizophrenia. Schizophr Res 2021; 231:51-53. [PMID: 33770625 PMCID: PMC10758255 DOI: 10.1016/j.schres.2021.02.020] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 02/17/2021] [Accepted: 02/27/2021] [Indexed: 11/19/2022]
Affiliation(s)
- Michael F Zito
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States of America; Semel Institute for Neuroscience and Human Behavior at UCLA, United States of America.
| | - Kenneth L Subotnik
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States of America; Semel Institute for Neuroscience and Human Behavior at UCLA, United States of America
| | - Joseph Ventura
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States of America; Semel Institute for Neuroscience and Human Behavior at UCLA, United States of America
| | - Robert S Kern
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States of America; Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, United States of America; Semel Institute for Neuroscience and Human Behavior at UCLA, United States of America
| | - Michael F Green
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States of America; Veterans Affairs Greater Los Angeles Healthcare System, Los Angeles, CA, United States of America; Semel Institute for Neuroscience and Human Behavior at UCLA, United States of America
| | - Keith H Nuechterlein
- Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, United States of America; Department of Psychology, University of California Los Angeles, Los Angeles, CA, United States of America; Semel Institute for Neuroscience and Human Behavior at UCLA, United States of America
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Maj M, van Os J, De Hert M, Gaebel W, Galderisi S, Green MF, Guloksuz S, Harvey PD, Jones PB, Malaspina D, McGorry P, Miettunen J, Murray RM, Nuechterlein KH, Peralta V, Thornicroft G, van Winkel R, Ventura J. The clinical characterization of the patient with primary psychosis aimed at personalization of management. World Psychiatry 2021; 20:4-33. [PMID: 33432763 PMCID: PMC7801854 DOI: 10.1002/wps.20809] [Citation(s) in RCA: 123] [Impact Index Per Article: 41.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
The current management of patients with primary psychosis worldwide is often remarkably stereotyped. In almost all cases an antipsychotic medica-tion is prescribed, with second-generation antipsychotics usually preferred to first-generation ones. Cognitive behavioral therapy is rarely used in the vast majority of countries, although there is evidence to support its efficacy. Psychosocial interventions are often provided, especially in chronic cases, but those applied are frequently not validated by research. Evidence-based family interventions and supported employment programs are seldom implemented in ordinary practice. Although the notion that patients with primary psychosis are at increased risk for cardiovascular diseases and diabetes mellitus is widely shared, it is not frequent that appropriate measures be implemented to address this problem. The view that the management of the patient with primary psychosis should be personalized is endorsed by the vast majority of clinicians, but this personalization is lacking or inadequate in most clinical contexts. Although many mental health services would declare themselves "recovery-oriented", it is not common that a focus on empowerment, identity, meaning and resilience is ensured in ordinary practice. The present paper aims to address this situation. It describes systematically the salient domains that should be considered in the characterization of the individual patient with primary psychosis aimed at personalization of management. These include positive and negative symptom dimensions, other psychopathological components, onset and course, neurocognition and social cognition, neurodevelopmental indicators; social functioning, quality of life and unmet needs; clinical staging, antecedent and concomitant psychiatric conditions, physical comorbidities, family history, history of obstetric complications, early and recent environmental exposures, protective factors and resilience, and internalized stigma. For each domain, simple assessment instruments are identified that could be considered for use in clinical practice and included in standardized decision tools. A management of primary psychosis is encouraged which takes into account all the available treatment modalities whose efficacy is supported by research evidence, selects and modulates them in the individual patient on the basis of the clinical characterization, addresses the patient's needs in terms of employment, housing, self-care, social relationships and education, and offers a focus on identity, meaning and resilience.
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Affiliation(s)
- Mario Maj
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy
| | - Jim van Os
- Department of Psychiatry, Brain Centre Rudolf Magnus, University Medical Centre Utrecht, Utrecht, The Netherlands
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Marc De Hert
- University Psychiatric Centre KU Leuven, Kortenberg, Belgium
- Antwerp Health Law and Ethics Chair, University of Antwerp, Antwerp, Belgium
| | - Wolfgang Gaebel
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University Düsseldorf, LVR-Klinikum Düsseldorf, and WHO Collaborating Center on Quality Assurance and Empowerment in Mental Health, Düsseldorf, Germany
| | - Silvana Galderisi
- Department of Psychiatry, University of Campania "L. Vanvitelli", Naples, Italy
| | - Michael F Green
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
- Department of Veterans Affairs, Desert Pacific Mental Illness Research, Education, and Clinical Center, Los Angeles, CA, USA
| | - Sinan Guloksuz
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Philip D Harvey
- Division of Psychology, Department of Psychiatry, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Peter B Jones
- Department of Psychiatry, University of Cambridge and Cambridgeshire & Peterborough NHS Foundation Trust, Cambridge, UK
| | - Dolores Malaspina
- Department of Psychiatry and Neuroscience, Ichan Medical School at Mount Sinai, New York, NY, USA
| | - Patrick McGorry
- Orygen, Parkville, VIC, Australia
- Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia
| | - Jouko Miettunen
- Centre for Life Course Health Research, University of Oulu, Oulu, Finland
- Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Robin M Murray
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Keith H Nuechterlein
- Semel Institute for Neuroscience and Human Behavior, Geffen School of Medicine, and Department of Psychology, University of California Los Angeles, Los Angeles, CA, USA
| | - Victor Peralta
- Mental Health Department, Servicio Navarro de Salud, Instituto de Investigación Sanitaria de Navarra, Pamplona, Spain
| | - Graham Thornicroft
- Centre for Global Mental Health and Centre for Implementation Science, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Ruud van Winkel
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands
- Antwerp Health Law and Ethics Chair, University of Antwerp, Antwerp, Belgium
- University Psychiatric Center KU Leuven, Leuven, Belgium
| | - Joseph Ventura
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
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Reavis EA, Lee J, Altshuler LL, Cohen MS, Engel SA, Glahn DC, Jimenez AM, Narr KL, Nuechterlein KH, Riedel P, Wynn JK, Green MF. Structural and Functional Connectivity of Visual Cortex in Schizophrenia and Bipolar Disorder: A Graph-Theoretic Analysis. ACTA ACUST UNITED AC 2020; 1:sgaa056. [PMID: 33313506 PMCID: PMC7712743 DOI: 10.1093/schizbullopen/sgaa056] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Visual processing abnormalities in schizophrenia (SZ) are poorly understood, yet predict functional outcomes in the disorder. Bipolar disorder (BD) may involve similar visual processing deficits. Converging evidence suggests that visual processing may be relatively normal at early stages of visual processing such as early visual cortex (EVC), but that processing abnormalities may become more pronounced by mid-level visual areas such as lateral occipital cortex (LO). However, little is known about the connectivity of the visual system in SZ and BD. If the flow of information to, from, or within the visual system is disrupted by reduced connectivity, this could help to explain perceptual deficits. In the present study, we performed a targeted analysis of the structural and functional connectivity of the visual system using graph-theoretic metrics in a sample of 48 SZ, 46 BD, and 47 control participants. Specifically, we calculated parallel measures of local efficiency for EVC and LO from both diffusion weighted imaging data (structural) and resting-state (functional) imaging data. We found no structural connectivity differences between the groups. However, there was a significant group difference in functional connectivity and a significant group-by-region interaction driven by reduced LO connectivity in SZ relative to HC, whereas BD was approximately intermediate to the other 2 groups. We replicated this pattern of results using a different brain atlas. These findings support and extend theoretical models of perceptual dysfunction in SZ, providing a framework for further investigation of visual deficits linked to functional outcomes in SZ and related disorders.
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Affiliation(s)
- Eric A Reavis
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA.,Desert Pacific Mental Illness Research, Education, and Clinical Center Greater Los Angeles VA Healthcare System, Los Angeles, CA
| | - Junghee Lee
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA.,Desert Pacific Mental Illness Research, Education, and Clinical Center Greater Los Angeles VA Healthcare System, Los Angeles, CA
| | - Lori L Altshuler
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA
| | - Mark S Cohen
- Department of Psychology, University of California, Los Angeles, Los Angeles, CA.,Departments of Neurology, Radiology, Biomedical Physics, and Bioengineering University of California, Los Angeles, Los Angeles, CA
| | - Stephen A Engel
- Department of Psychology, University of Minnesota, Minneapolis, MN
| | - David C Glahn
- Tommy Fuss Center for Neuropsychiatric Disease Research, Department of Psychiatry Boston Children's Hospital and Harvard Medical School, Boston, MA
| | - Amy M Jimenez
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA.,Desert Pacific Mental Illness Research, Education, and Clinical Center Greater Los Angeles VA Healthcare System, Los Angeles, CA
| | - Katherine L Narr
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA
| | - Keith H Nuechterlein
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA.,Department of Psychology, University of California, Los Angeles, Los Angeles, CA
| | - Philipp Riedel
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA.,Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Medical Faculty, Technische Universität Dresden, Dresden, Germany
| | - Jonathan K Wynn
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA.,Desert Pacific Mental Illness Research, Education, and Clinical Center Greater Los Angeles VA Healthcare System, Los Angeles, CA
| | - Michael F Green
- Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA.,Desert Pacific Mental Illness Research, Education, and Clinical Center Greater Los Angeles VA Healthcare System, Los Angeles, CA
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Oliver LD, Hawco C, Homan P, Lee J, Green MF, Gold JM, DeRosse P, Argyelan M, Malhotra AK, Buchanan RW, Voineskos AN. Social Cognitive Networks and Social Cognitive Performance Across Individuals With Schizophrenia Spectrum Disorders and Healthy Control Participants. Biol Psychiatry Cogn Neurosci Neuroimaging 2020; 6:1202-1214. [PMID: 33579663 DOI: 10.1016/j.bpsc.2020.11.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/22/2020] [Revised: 11/17/2020] [Accepted: 11/30/2020] [Indexed: 11/24/2022]
Abstract
BACKGROUND Schizophrenia spectrum disorders (SSDs) feature social cognitive deficits, although their neural basis remains unclear. Social cognitive performance may relate to neural circuit activation patterns more than to diagnosis, which would have important prognostic and therapeutic implications. The current study aimed to determine how functional connectivity within and between social cognitive networks relates to social cognitive performance across individuals with SSDs and healthy control participants. METHODS Participants with SSDs (n = 164) and healthy control participants (n = 117) completed the Empathic Accuracy task during functional magnetic resonance imaging as well as lower-level (e.g., emotion recognition) and higher-level (e.g., theory of mind) social cognitive measures outside the scanner. Functional connectivity during the Empathic Accuracy task was analyzed using background connectivity and graph theory. Data-driven social cognitive networks were identified across participants. Regression analyses were used to examine network connectivity-performance relationships across individuals. Positive and negative within- and between-network connectivity strengths were also compared in poor versus good social cognitive performers and in SSD versus control groups. RESULTS Three social cognitive networks were identified: motor resonance, affect sharing, and mentalizing. Regression and group-based analyses demonstrated reduced between-network negative connectivity, or segregation, and greater within- and between-network positive connectivity in worse social cognitive performers. There were no significant effects of diagnostic group on within- or between-network connectivity. CONCLUSIONS These findings suggest that the neural circuitry of social cognitive performance may exist dimensionally. Across participants, better social cognitive performance was associated with greater segregation between social cognitive networks, whereas poor versus good performers may compensate via hyperconnectivity within and between social cognitive networks.
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Affiliation(s)
- Lindsay D Oliver
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Colin Hawco
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Philipp Homan
- University Hospital of Psychiatry, University of Zurich, Zurich, Switzerland; Division of Psychiatry Research, Zucker Hillside Hospital, Division of Northwell Health, Glen Oaks, New York; Department of Psychiatry, The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York; Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, New York
| | - Junghee Lee
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles; Department of Veterans Affairs, Desert Pacific Mental Illness Research, Education, and Clinical Center, Los Angeles, California; Department of Psychiatry and Behavioral Neurobiology, School of Medicine, University of Alabama at Birmingham, Birmingham, Alabama
| | - Michael F Green
- Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles; Department of Veterans Affairs, Desert Pacific Mental Illness Research, Education, and Clinical Center, Los Angeles, California
| | - James M Gold
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland
| | - Pamela DeRosse
- Division of Psychiatry Research, Zucker Hillside Hospital, Division of Northwell Health, Glen Oaks, New York; Department of Psychiatry, The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York; Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, New York
| | - Miklos Argyelan
- Division of Psychiatry Research, Zucker Hillside Hospital, Division of Northwell Health, Glen Oaks, New York; Department of Psychiatry, The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York; Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, New York
| | - Anil K Malhotra
- Division of Psychiatry Research, Zucker Hillside Hospital, Division of Northwell Health, Glen Oaks, New York; Department of Psychiatry, The Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, New York; Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, New York
| | - Robert W Buchanan
- Maryland Psychiatric Research Center, Department of Psychiatry, University of Maryland School of Medicine, Baltimore, Maryland
| | - Aristotle N Voineskos
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada; Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.
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Keefe RSE, Green MF, Harvey PD. Requisite Skills and the Meaningful Measurement of Cognition. JAMA Psychiatry 2020; 77:1103-1104. [PMID: 32639514 DOI: 10.1001/jamapsychiatry.2020.1618] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Richard S E Keefe
- Department of Psychiatry and Behavioral Sciences, Duke University Medical Center, Durham, North Carolina
| | - Michael F Green
- Department of Psychiatry and Biobehavioral Sciences, Jane and Terry Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles
| | - Philip D Harvey
- Miller School of Medicine, University of Miami, Miami, Florida.,Research Service, Bruce W. Carter VA Medical Center, Miami, Florida
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Abstract
People with schizophrenia (SZ) exhibit visual processing abnormalities that affect their daily functioning and remediating these deficits might help to improve functioning. Transcranial direct current stimulation (tDCS) is a potential tool for perceptual enhancement for this purpose, though there are no reports of tDCS applied to visual cortex in SZ. In a within-subject, crossover design, we evaluated the effects of tDCS on visual processing in 27 SZ. All patients received anodal, cathodal, or sham stimulation over the central occipital region in 3 visits separated by 1 week. In each visit, a backward masking task and an electroencephalography measure of visual neuroplasticity were administered after tDCS. Neuroplasticity was assessed with visual evoked potentials before and after tetanizing visual high-frequency stimulation. Masking performance was significantly poorer in the anodal and cathodal conditions compared with sham. Both anodal and cathodal stimulation increased the amplitude of P1 but did not change the plasticity index. We found significant plasticity effects of tDCS for only one waveform for one stimulation condition (P2 for anodal tDCS) which did not survive correction for multiple comparisons. The reason for the lack of tDCS stimulation effects on plasticity may be because tDCS was not delivered simultaneously with the tetanizing visual stimulus. The present findings emphasize the need for more research on the relevant parameters for stimulation of visual processing regions in clinical populations.
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Affiliation(s)
- Carol Jahshan
- Mental Illness Research, Education and Clinical Center (MIRECC), VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA.,Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
| | - Jonathan K Wynn
- Mental Illness Research, Education and Clinical Center (MIRECC), VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA.,Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
| | - Brian J Roach
- San Francisco Department of Veterans Affairs Medical Center, San Francisco, CA, USA.,Department of Psychiatry, University of California, San Francisco, CA, USA
| | - Daniel H Mathalon
- San Francisco Department of Veterans Affairs Medical Center, San Francisco, CA, USA.,Department of Psychiatry, University of California, San Francisco, CA, USA
| | - Michael F Green
- Mental Illness Research, Education and Clinical Center (MIRECC), VA Greater Los Angeles Healthcare System, Los Angeles, CA, USA.,Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, CA, USA
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46
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Kern RS, Reddy LF, Cohen AN, Young AS, Green MF. Effects of aerobic exercise on cardiorespiratory fitness and social functioning in veterans 40 to 65 years old with schizophrenia. Psychiatry Res 2020; 291:113258. [PMID: 32763533 DOI: 10.1016/j.psychres.2020.113258] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 06/24/2020] [Accepted: 06/25/2020] [Indexed: 11/26/2022]
Abstract
The usual physical activity level of people with chronic histories of schizophrenia is very low. In this pilot study, we examined the effects of an easy to implement aerobic exercise (AE) program on cardiorespiratory fitness and social functioning in 54 Veterans aged 40-65 years old with schizophrenia. Participants were randomized 2:1 to AE (36 forty-minute sessions conducted 3 times per week over 12 weeks) versus a non-aerobic stretching exercise condition conducted under the same regimen and timeframe. Cardiorespiratory fitness improved significantly within the AE group (p<.0001), and differed significantly from the comparison group (p<.02; Cohen's d=.41). Trend-level improvements were seen in social functioning within the AE group (p<.09) and showed a similar trend level difference in the between-group comparison (p<.06; Cohen's d=.35). Improvements in social functioning were significantly related to gains in cardiorespiratory fitness (r=.42; p<.01). AE effects on other physical and mental health indices were also examined. Overall, the AE intervention was well-tolerated, safe, and showed low rates of attrition after the commencement of training. Our findings indicate it is feasible to improve cardiorespiratory fitness in this clinical population, and there is suggestive evidence that the interventions aimed to do so may also benefit social functioning.
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Affiliation(s)
- Robert S Kern
- UCLA Semel Institute for Neuroscience & Human Behavior, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, Los Angeles, California, United States of America; Department of Veterans Affairs Desert Pacific Mental Illness Research, Education, and Clinical Center, VA Greater Los Angeles Healthcare System, Los Angeles, California, United States of America.
| | - L Felice Reddy
- UCLA Semel Institute for Neuroscience & Human Behavior, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, Los Angeles, California, United States of America
| | - Amy N Cohen
- UCLA Semel Institute for Neuroscience & Human Behavior, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, Los Angeles, California, United States of America; Department of Veterans Affairs Desert Pacific Mental Illness Research, Education, and Clinical Center, VA Greater Los Angeles Healthcare System, Los Angeles, California, United States of America
| | - Alexander S Young
- UCLA Semel Institute for Neuroscience & Human Behavior, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, Los Angeles, California, United States of America; Department of Veterans Affairs Desert Pacific Mental Illness Research, Education, and Clinical Center, VA Greater Los Angeles Healthcare System, Los Angeles, California, United States of America
| | - Michael F Green
- UCLA Semel Institute for Neuroscience & Human Behavior, Department of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, Los Angeles, California, United States of America; Department of Veterans Affairs Desert Pacific Mental Illness Research, Education, and Clinical Center, VA Greater Los Angeles Healthcare System, Los Angeles, California, United States of America
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47
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Catalano LT, Green MF, Wynn JK, Lee J. People with schizophrenia do not show the normal benefits of social versus nonsocial attentional cues. Neuropsychology 2020; 34:620-628. [PMID: 32338943 PMCID: PMC8513804 DOI: 10.1037/neu0000642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
OBJECTIVE Schizophrenia is associated with impairments in social motivation. Social attention has been proposed as an underlying mechanism for social motivation. However, studies in schizophrenia have rarely examined social attention, and none of these studies examined the effects with rapidly presented stimuli. METHOD The current study examined whether individuals with schizophrenia have reduced social attention and whether reduced social attention was related to social motivation deficits (measured with the Clinical Assessment Interview for Negative Symptoms) and decreased social functioning (Role Functioning Scale). Thirty-seven outpatients with schizophrenia and 29 healthy participants completed a gaze cueing task with directional social cues (eye gaze) and nonsocial cues (arrows) at varying stimulus onset asynchronies. RESULTS As predicted, schizophrenia participants had reduced social attention relative to nonsocial attention, compared with healthy participants. Healthy participants were quicker to respond to social cues than nonsocial cues, but schizophrenia participants did not exhibit this same pattern. Schizophrenia participants showed higher accuracy when targets appeared in the same location as a directional cue (i.e., congruency) for nonsocial, but not social, cues. Contrary to expectations, reduced social attention was not significantly correlated with clinically rated social motivation deficits or decreased social functioning in the schizophrenia group. CONCLUSION These findings provide evidence for social attention deficits in schizophrenia, but without a clear mapping of its influence on social motivation. (PsycInfo Database Record (c) 2020 APA, all rights reserved).
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Affiliation(s)
- Lauren T Catalano
- Desert Pacific Mental Illness Research, Education, and Clinical Center
| | - Michael F Green
- Desert Pacific Mental Illness Research, Education, and Clinical Center
| | - Jonathan K Wynn
- Desert Pacific Mental Illness Research, Education, and Clinical Center
| | - Junghee Lee
- Desert Pacific Mental Illness Research, Education, and Clinical Center
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48
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Nahum M, Lee H, Fisher M, Green MF, Hooker CI, Ventura J, Jordan JT, Rose A, Kim SJ, Haut KM, Merzenich MM, Vinogradov S. Online Social Cognition Training in Schizophrenia: A Double-Blind, Randomized, Controlled Multi-Site Clinical Trial. Schizophr Bull 2020; 47:108-117. [PMID: 32614046 PMCID: PMC7825077 DOI: 10.1093/schbul/sbaa085] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
Social cognition (SC), the mental operations underlying social functioning, are impaired in schizophrenia. Their direct link to functional outcome and illness status have made them an important therapeutic target. However, no effective treatment for these deficits is currently applied as a standard of care. To address this need, we have developed SocialVille-an online, plasticity-based training program that targets SC deficits in schizophrenia. Here we report the outcomes of a double-blind, controlled, randomized, multi-site clinical trial of SocialVille. Outpatients with schizophrenia were randomized to complete 40 sessions of either SocialVille (N = 55 completers) or active control (computer games; N = 53 completers) from home. The a priori co-primary outcome measures were a social cognitive composite and a functional capacity outcome (UCSD Performance-based Skills Assessment [UPSA-2]). Secondary outcomes included a virtual functional capacity measure (VRFCAT), social functioning, quality of life, and motivation. Linear mixed models revealed a group × time interaction favoring the treatment group for the social cognitive composite (b = 2.81; P < .001) but not for the UPSA-2 measure. Analysis of secondary outcome measures showed significant group × time effects favoring the treatment group on SC and social functioning, on the virtual functional capacity measure and a motivation subscale, although these latter findings were nonsignificant with FDR correction. These results provide support for the efficacy of a remote, plasticity-based social cognitive training program in improving SC and social functioning in schizophrenia. Such treatments may serve as a cost-effective adjunct to existing psychosocial treatments. Trial Registration: NCT02246426.
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Affiliation(s)
- Mor Nahum
- School of Occupational Therapy, Faculty of Medicine, Hebrew University, Jerusalem, Israel,Department of Research and Development, Posit Science Inc., San Francisco, CA,To whom correspondence should be addressed; School of Occupational Therapy, Faculty of Medicine, The Hebrew University, PO Box 24026, Mount Scopus, Jerusalem, 91240, Israel; tel: +972-54-732-6655, fax: +972-2-5325345, e-mail:
| | - Hyunkyu Lee
- Department of Research and Development, Posit Science Inc., San Francisco, CA
| | - Melissa Fisher
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN
| | - Michael F Green
- VA Greater Los Angeles, Los Angeles, CA,Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA
| | - Christine I Hooker
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL
| | - Joseph Ventura
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA
| | - Joshua T Jordan
- Department of Psychiatry, University of California, San Francisco, CA
| | - Annika Rose
- Department of Research and Development, Posit Science Inc., San Francisco, CA
| | - Sarah-Jane Kim
- Department of Research and Development, Posit Science Inc., San Francisco, CA
| | - Kristen M Haut
- Department of Psychiatry and Behavioral Sciences, Rush University Medical Center, Chicago, IL
| | - Michael M Merzenich
- Department of Research and Development, Posit Science Inc., San Francisco, CA
| | - Sophia Vinogradov
- Department of Psychiatry and Behavioral Sciences, University of Minnesota, Minneapolis, MN
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49
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Bezdicek O, Michalec J, Kališová L, Kufa T, Děchtěrenko F, Chlebovcová M, Havlík F, Green MF, Nuechterlein KH. Profile of cognitive deficits in schizophrenia and factor structure of the Czech MATRICS Consensus Cognitive Battery. Schizophr Res 2020; 218:85-92. [PMID: 32089475 DOI: 10.1016/j.schres.2020.02.004] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2019] [Revised: 01/28/2020] [Accepted: 02/09/2020] [Indexed: 01/10/2023]
Abstract
We aimed to validate the Czech version of the MATRICS Consensus Cognitive Battery (MCCB). The MCCB is a test battery designed to assess cognitive treatment effects in clinical trials of patients with schizophrenia. The valid, reliable and replicable measurement of cognition in schizophrenia is of substantial importance for such clinical trial studies. We performed a psychometric analysis of the MCCB composite and domain scores based on ROC analysis of 67 schizophrenia patients and 67 age- and education-matched healthy controls from a total sample of 220 controls. Also, we correlated MCCB variables with scales measuring psychosocial functioning (Personal and Social Performance scale; PSP). The internal consistency of all 10 tests in the MCCB battery was good (Cronbach's α = 0.85 (95% CI [0.83, 0.88])). The discriminative validity for the detection of neurocognitive dysfunction in schizophrenia based on the area under the curve of MCCB composite T-score was ≥90% (95% CI [0.85, 0.96]) and all MCCB domains showed ps < .001. The MCCB global composite and the Speed of Processing domain score significantly predicted the PSP ratings. A confirmatory factor analysis on the whole control sample (N = 220) showed an optimal fit for a 6-factor in comparison to 1-factor solution. In conclusion, we found high discriminative validity for the Czech MCCB version, similar to the differentiation of schizophrenia versus healthy control groups in the original MCCB studies. We also established the factorial validity of the MCCB and showed that the overall composite of the MCCB predicts psychosocial functioning in the patient group.
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Affiliation(s)
- Ondrej Bezdicek
- Department of Neurology and Centre of Clinical Neuroscience, First Faculty of Medicine and General University Hospital in Prague, Charles University, Czech Republic.
| | - Jiří Michalec
- Department of Psychiatry, First Faculty of Medicine and General University Hospital in Prague, Charles University, Prague, Czech Republic
| | - Lucie Kališová
- Department of Psychiatry, First Faculty of Medicine and General University Hospital in Prague, Charles University, Prague, Czech Republic
| | - Tomáš Kufa
- Department of Psychiatry, First Faculty of Medicine and General University Hospital in Prague, Charles University, Prague, Czech Republic
| | | | - Miriama Chlebovcová
- Department of Psychiatry, First Faculty of Medicine and General University Hospital in Prague, Charles University, Prague, Czech Republic
| | - Filip Havlík
- Department of Neurology and Centre of Clinical Neuroscience, First Faculty of Medicine and General University Hospital in Prague, Charles University, Czech Republic
| | - Michael F Green
- Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA; Department of Veterans Affairs VISN 22 Mental Illness Research, Education, and Clinical Center, Los Angeles, CA, USA.
| | - Keith H Nuechterlein
- Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA; Department of Psychology, University of California Los Angeles, Los Angeles, CA, USA.
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50
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Affiliation(s)
- Michael F Green
- Jane and Terry Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA,Department of Veterans Affairs, Desert Pacific Mental Illness Research, Education, and Clinical Center Los Angeles, CA,VA Research and Enhancement Program to Enhance Community Integration in Homeless Veterans Los Angeles, CA ,To whom correspondence should be addressed; tel: (310) 268-3376;
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