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Janssens JJ, Kiekens G, Jaeken M, Kirtley OJ. A systematic review of interpersonal processes and their measurement within experience sampling studies of self-injurious thoughts and behaviours. Clin Psychol Rev 2024; 113:102467. [PMID: 39084142 DOI: 10.1016/j.cpr.2024.102467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2023] [Revised: 05/27/2024] [Accepted: 07/08/2024] [Indexed: 08/02/2024]
Abstract
Self-injurious thoughts and behaviours (SITBs) are a leading cause of death, and interpersonal processes (IPs) appear to play a role in SITBs. This systematic review synthesises the literature on IPs and SITBs in daily life and addresses four critical questions: (1) Which IPs have been assessed and how, (2) How are differences in IPs between individuals associated with SITBs?, (3) How are differences in IPs within individuals associated with SITBs? and (4) Do IPs relate differently to self-injurious thoughts than behaviours? Our review followed PRISMA guidelines and eligible literature was screened until 25 April 2024. We identified 58 Experience Sampling studies (32.76% daily-diary studies) of which most focused on IPs from major SITBs theories (e.g., thwarted belongingness) but largely used inconsistent operationalizations. Results from 39 studies investigating within-person associations were mixed. Based on 26 studies, whether differences in IPs between individuals relate to SITBs remains unclear. Three studies have investigated whether IPs relate to the transition from thoughts to behaviours, but temporal models are needed to draw firm conclusions. Studies investigating IPs and SITBs in daily life are largely inconclusive. Psychometrically validated measures are warranted, and future daily-life studies would benefit from drawing on ideation-to-action frameworks.
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Affiliation(s)
- Julie J Janssens
- Center for Contextual Psychiatry, KU Leuven, Department of Neuroscience, Campus Gasthuisberg, Herestraat 49 (ON5b), 3000 Leuven, Belgium
| | - Glenn Kiekens
- Center for Contextual Psychiatry, KU Leuven, Department of Neuroscience, Campus Gasthuisberg, Herestraat 49 (ON5b), 3000 Leuven, Belgium; Research Unit of Clinical Psychology, KU Leuven, Leuven, Belgium; Department of Medical and Clinical Psychology, Tilburg University, Tilburg, the Netherlands
| | - Marieke Jaeken
- Center for Contextual Psychiatry, KU Leuven, Department of Neuroscience, Campus Gasthuisberg, Herestraat 49 (ON5b), 3000 Leuven, Belgium
| | - Olivia J Kirtley
- Center for Contextual Psychiatry, KU Leuven, Department of Neuroscience, Campus Gasthuisberg, Herestraat 49 (ON5b), 3000 Leuven, Belgium; Leuven Child and Youth Institute, KU Leuven, Tiensestraat 102, 3000 Leuven, Belgium; Leuven Brain Institute, KU Leuven, Herestraat 49 (ON V), 3000 Leuven, Belgium.
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2
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Fiszdon JM, Bell MD, Fulford D, Roberts DL, Dziura J, Parente L, Nasse A, Choi J. Understanding social situations: study protocol for a randomized controlled trial evaluating a novel social cognitive training versus modified problem-solving training for people with psychosis. Front Psychiatry 2024; 15:1440476. [PMID: 39238934 PMCID: PMC11374757 DOI: 10.3389/fpsyt.2024.1440476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2024] [Accepted: 08/05/2024] [Indexed: 09/07/2024] Open
Abstract
Background Psychotic spectrum disorders (PSD) are associated with poor social function. In this study, we investigate which of two different types of 2-month long training courses is more effective in improving day-to-day interactions and quality of life. Methods/design Participants with psychotic spectrum disorders will be randomly assigned to one of two training courses. Social functioning, everyday activities, social cognition and symptoms will be assessed at multiple timepoints, including baseline, treatment midpoint, end of treatment and 2-month follow-up. One training focuses on how to make good judgments about what other people may be thinking or feeling in social situations, and why people might act in certain ways in different situations. The other training focuses on different strategies for handling everyday problems and stressors. Both trainings are done in one-on-one sessions with a research staff member. There will be 16-20 training sessions, each about 45-60 minutes long. The investigators will ask participants to attend 2 training sessions per week, so the total training time should be about 2 months. Clinical Trials Registration PROSPERO, identifier NCT04557124.
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Affiliation(s)
- Joanna M Fiszdon
- Psychology Department, VA Connecticut Healthcare System, West Haven, CT, United States
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Morris D Bell
- Psychology Department, VA Connecticut Healthcare System, West Haven, CT, United States
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States
| | - Daniel Fulford
- Department of Occupational Therapy and Department of Psychological & Brain Sciences, Boston University, Boston, MA, United States
| | - David L Roberts
- Deparment of Psychiatry, UT Health Sciences Center, University of Texas, San Antonio, TX, United States
| | - James Dziura
- Yale Center for Analytical Sciences and Division of Biostatistics, Yale University School of Public Health, New Haven, CT, United States
| | - Lori Parente
- Psychology Department, VA Connecticut Healthcare System, West Haven, CT, United States
| | - Alexis Nasse
- Psychology Department, VA Connecticut Healthcare System, West Haven, CT, United States
| | - Jimmy Choi
- Olin Neuropsychiatry Research Center, Institute of Living at Harford Healthcare, Hartford, CT, United States
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3
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Turri F, Jones A, Constanty L, Ranjbar S, Drexl K, Miano G, Lepage C, Plessen KJ, Urben S. Self-regulatory control processes in youths: A temporal network analysis approach. JCPP ADVANCES 2024; 4:e12200. [PMID: 38486949 PMCID: PMC10933645 DOI: 10.1002/jcv2.12200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Accepted: 09/11/2023] [Indexed: 03/17/2024] Open
Abstract
Objective This study aimed to better understand the temporal interrelationships among self-control, response inhibition, and anger (i.e., momentary state and rumination) on both the within- and between-person levels in male adolescents. Method We applied temporal network analyses among 62 male adolescents with a wide range of behavioral difficulties. Self-control, momentary anger, and anger rumination were mapped by self-report measures, whereas we measured response inhibition through an ambulatory Go/No-go task (two measures a day-morning and afternoon-over a 9-day period). Results Temporal network analysis, at the within-person level, revealed that morning measures of response inhibition, anger rumination, and self-control were related to the corresponding measure in the afternoon. More efficient response inhibition in the morning was associated with higher self-control in the afternoon. Higher anger rumination in the morning led to higher momentary anger in the afternoon. In a concurrent within-person network, higher momentary anger was reciprocally associated with lower self-control. At the between-person level, higher momentary anger was correlated to higher anger rumination, lower response inhibition, and lower self-control. Discussion This study provides insight into the dynamic interactions among self-control, response inhibition, and anger (momentary state and rumination) in male adolescents, advancing the understanding of self-regulatory control functioning.
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Affiliation(s)
- Fiorella Turri
- Division of Child and Adolescent PsychiatryDepartment of PsychiatryLausanne University Hospital (CHUV)LausanneSwitzerland
| | - Andrew Jones
- School of PsychologyLiverpool John Moores UniversityLiverpoolUK
| | - Lauriane Constanty
- Division of Child and Adolescent PsychiatryDepartment of PsychiatryLausanne University Hospital (CHUV)LausanneSwitzerland
| | - Setareh Ranjbar
- Center of Psychiatric Epidemiology and PsychopathologyDepartment of PsychiatryLausanne University HospitalUniversity of LausannePrillySwitzerland
| | - Konstantin Drexl
- Division of Child and Adolescent PsychiatryDepartment of PsychiatryLausanne University Hospital (CHUV)LausanneSwitzerland
| | - Giorgia Miano
- Division of Child and Adolescent PsychiatryDepartment of PsychiatryLausanne University Hospital (CHUV)LausanneSwitzerland
| | - Caroline Lepage
- Division of Child and Adolescent PsychiatryDepartment of PsychiatryLausanne University Hospital (CHUV)LausanneSwitzerland
| | - Kerstin Jessica Plessen
- Division of Child and Adolescent PsychiatryDepartment of PsychiatryLausanne University Hospital (CHUV)LausanneSwitzerland
- Faculty of Biology and MedicineUniversity of LausanneLausanneSwitzerland
| | - Sébastien Urben
- Division of Child and Adolescent PsychiatryDepartment of PsychiatryLausanne University Hospital (CHUV)LausanneSwitzerland
- Faculty of Biology and MedicineUniversity of LausanneLausanneSwitzerland
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4
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Nepal S, Pillai A, Parrish EM, Holden J, Depp C, Campbell AT, Granholm E. Social Isolation and Serious Mental Illness: The Role of Context-Aware Mobile Interventions. IEEE PERVASIVE COMPUTING 2024; 23:46-56. [PMID: 39092185 PMCID: PMC11290146 DOI: 10.1109/mprv.2024.3377200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/04/2024]
Abstract
Social isolation is a common problem faced by individuals with serious mental illness (SMI), and current intervention approaches have limited effectiveness. This paper presents a blended intervention approach, called mobile Social Interaction Therapy by Exposure (mSITE), to address social isolation in individuals with serious mental illness. The approach combines brief in-person cognitive-behavioral therapy (CBT) with context-triggered mobile CBT interventions that are personalized using mobile sensing data. Our approach targets social behavior and is the first context-aware intervention for improving social outcomes in serious mental illness.
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Affiliation(s)
| | | | - Emma M Parrish
- San Diego State University University of California San Diego San Diego, CA
| | - Jason Holden
- University of California San Diego San Diego, CA, USA
| | - Colin Depp
- University of California San Diego San Diego, CA, USA
| | | | - Eric Granholm
- University of California San Diego San Diego, CA, USA
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5
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Urben S, Constanty L, Lepage C, Rosselet Amoussou J, Durussel J, Turri F, Wouters E, Mürner-Lavanchy I, Plessen KJ. The added value of a micro-level ecological approach when mapping self-regulatory control processes and externalizing symptoms during adolescence: a systematic review. Eur Child Adolesc Psychiatry 2023; 32:2387-2397. [PMID: 35294631 PMCID: PMC10682160 DOI: 10.1007/s00787-022-01972-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/01/2021] [Accepted: 03/03/2022] [Indexed: 11/03/2022]
Abstract
Deficits in self-regulatory control (SRC) represent a core characteristic of externalizing (EXT) symptoms (e.g., rule-breaking behavior or aggressive behaviors) in adolescents. This review aims to specify the added value of ecologically valid assessments at a micro-level when examining the associations between SRC and EXT symptoms in adolescents. This systematic review was reported according to the Preferred Reporting Items for Systematic Review and Meta-Analysis (PRISMA) 2020. The search strategy addressed the added value of (1) naturalistic assessment for the understanding of the relationship between (2) SRC and (3) EXT symptoms in (4) adolescents. We conducted comprehensive searches in bibliographic databases. An additional search was conducted in Google Scholar and supplementary studies were identified through backward and forward citation tracking. Twenty-four studies (n = 4071 adolescents) met the inclusion criteria. The methods used to assess naturalistic aspects included the experience sampling method (ecological momentary- or ambulatory assessment) and the time-course approach (i.e., real-time assessment of SRC processes referring to situations approximating real-life experience where SRC are to be engaged such as in frustrating situations). Micro-level ecological assessments, when mapping the intra-individual relationships between SRC processes and EXT symptoms over time in adolescents within their natural context (i.e., real world) of expression in real time, added a finer-grained observation alongside with a higher ecological validity. Micro-level approaches may enhance the understanding of the complex interplay between SRC and EXT symptoms in adolescence, especially in interventional studies, allowing for the acquisition of endpoints with a higher relevance for everyday functioning.
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Affiliation(s)
- Sébastien Urben
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Lausanne University Hospital (CHUV), University of Lausanne, Lausanne, Switzerland.
| | - Lauriane Constanty
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Lausanne University Hospital (CHUV), University of Lausanne, Lausanne, Switzerland
| | - Caroline Lepage
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Lausanne University Hospital (CHUV), University of Lausanne, Lausanne, Switzerland
| | - Joëlle Rosselet Amoussou
- Psychiatry Library, Education and Research Department, Lausanne University Hospital, University of Lausanne, Lausanne, Switzerland
| | - Julie Durussel
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Lausanne University Hospital (CHUV), University of Lausanne, Lausanne, Switzerland
| | - Fiorella Turri
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Lausanne University Hospital (CHUV), University of Lausanne, Lausanne, Switzerland
| | - Emilie Wouters
- Unit of Child and Adolescent Forensic Psychiatry, Department of Psychiatry, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Ines Mürner-Lavanchy
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Kerstin Jessica Plessen
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Lausanne University Hospital (CHUV), University of Lausanne, Lausanne, Switzerland
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Gooding P, Haddock G, Harris K, Asriah M, Awenat Y, Cook L, Drake RJ, Emsley R, Huggett C, Jones S, Lobban F, Marshall P, Pratt D, Peters S. The interplay between suicidal experiences, psychotic experiences and interpersonal relationships: a qualitative study. BMC Psychiatry 2023; 23:873. [PMID: 38001403 PMCID: PMC10668454 DOI: 10.1186/s12888-023-05164-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 09/04/2023] [Indexed: 11/26/2023] Open
Abstract
BACKGROUND Suicidal thoughts, acts, plans and deaths are considerably more prevalent in people with non-affective psychosis, including schizophrenia, compared to the general population. Social isolation and interpersonal difficulties have been implicated in pathways which underpin suicidal experiences in people with severe mental health problems. However, the interactions between psychotic experiences, such as hallucinations and paranoia, suicidal experiences, and the presence, and indeed, absence of interpersonal relationships is poorly understood and insufficiently explored. The current study sought to contribute to this understanding. METHODS An inductive thematic analysis was conducted on transcripts of 22, individual, semi-structured interviews with adult participants who had both non-affective psychosis and recent suicidal experiences. A purposive sampling strategy was used. Trustworthiness of the analysis was assured with researcher triangulation. RESULTS Participants relayed both positive and negative experiences of interpersonal relationships. A novel conceptual model is presented reflecting a highly complex interplay between a range of different suicidal experiences, psychosis, and aspects of interpersonal relationships. Three themes fed into this interplay, depicting dynamics between perceptions of i. not mattering and mattering, ii. becoming disconnected from other people, and iii. constraints versus freedom associated with sharing suicidal and psychotic experiences with others. CONCLUSION This study revealed a detailed insight into ways in which interpersonal relationships are perceived to interact with psychotic and suicidal experiences in ways that can be both beneficial and challenging. This is important from scientific and clinical perspectives for understanding the complex pathways involved in suicidal experiences. TRIAL REGISTRATION ClinicalTrials.gov (NCT03114917), 14th April 2017. ISRCTN (reference ISRCTN17776666 .); 5th June 2017). Registration was recorded prior to participant recruitment commencing.
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Affiliation(s)
- Patricia Gooding
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Sciences Centre, University of Manchester, Coupland Building 1, Oxford Road, Manchester, M13 9PL, UK.
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK.
| | - Gillian Haddock
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Sciences Centre, University of Manchester, Coupland Building 1, Oxford Road, Manchester, M13 9PL, UK
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Kamelia Harris
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Sciences Centre, University of Manchester, Coupland Building 1, Oxford Road, Manchester, M13 9PL, UK
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Menita Asriah
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Sciences Centre, University of Manchester, Coupland Building 1, Oxford Road, Manchester, M13 9PL, UK
| | - Yvonne Awenat
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Sciences Centre, University of Manchester, Coupland Building 1, Oxford Road, Manchester, M13 9PL, UK
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Leanne Cook
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Sciences Centre, University of Manchester, Coupland Building 1, Oxford Road, Manchester, M13 9PL, UK
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Richard J Drake
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Sciences Centre, University of Manchester, Coupland Building 1, Oxford Road, Manchester, M13 9PL, UK
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Richard Emsley
- Department of Biostatistics and Health Informatics, Institute of Psychiatry, Psychology and Neuroscience, Kings College London, London, UK
| | - Charlotte Huggett
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Sciences Centre, University of Manchester, Coupland Building 1, Oxford Road, Manchester, M13 9PL, UK
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Steven Jones
- Lancashire and South Cumbria, NHS Foundation Trust, Lancashire, UK
- Spectrum Centre for Mental Health Research, Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster, UK
| | - Fiona Lobban
- Lancashire and South Cumbria, NHS Foundation Trust, Lancashire, UK
- Spectrum Centre for Mental Health Research, Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster, UK
| | - Paul Marshall
- Lancashire and South Cumbria, NHS Foundation Trust, Lancashire, UK
- Spectrum Centre for Mental Health Research, Division of Health Research, Faculty of Health and Medicine, Lancaster University, Lancaster, UK
| | - Daniel Pratt
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Sciences Centre, University of Manchester, Coupland Building 1, Oxford Road, Manchester, M13 9PL, UK
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
| | - Sarah Peters
- Division of Psychology and Mental Health, School of Health Sciences, Faculty of Biology, Medicine and Health, Manchester Academic Health Sciences Centre, University of Manchester, Coupland Building 1, Oxford Road, Manchester, M13 9PL, UK
- Greater Manchester Mental Health NHS Foundation Trust, Manchester, UK
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Abel DB, Minor KS. Social pleasure in daily life: A meta-analysis of experience sampling studies in schizophrenia. Schizophr Res 2023; 260:56-64. [PMID: 37625224 DOI: 10.1016/j.schres.2023.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Revised: 06/19/2023] [Accepted: 08/13/2023] [Indexed: 08/27/2023]
Abstract
Social anhedonia is considered a key feature of schizophrenia that leads to impaired social functioning. Although traditional laboratory measures assess non-current social pleasure, researchers have begun using experience sampling methods (ESM) to measure current, or consummatory, experiences of social pleasure in daily life. A recent meta-analysis examined deficits in consummatory social pleasure in schizophrenia and found vast heterogeneity in effect sizes across ESM studies. Thus, this meta-analysis aimed to extend those results by testing moderators of this effect. Meta-analysis of 14 ESM studies suggests those with psychotic disorders exhibit a moderate deficit in consummatory social pleasure compared to healthy controls. Yet, this effect was significantly moderated by the type of measure used to assess social pleasure. Measures that directly assessed positive emotional experience during socialization yielded small effects that failed to reach significance; indirect measures of other social factors related to pleasure yielded large, significant effects. This suggests daily social anhedonia observed in psychotic disorders is not due to reduced experience of positive emotion. Instead, social anhedonia may be driven by other elements of social functioning. Most clinical variables did not influence effects, but there was a trend such that patient groups with lower cognitive functioning exhibited greater pleasure deficits. Inconsistent reporting across studies limited our ability to examine other real-world variables that may contribute to deficits in social pleasure. Yet, results show different ESM items used to measure social pleasure do not assess the same construct. Future research is needed to validate ESM measures and standardize protocols across studies.
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Affiliation(s)
- Danielle B Abel
- Indiana University-Purdue University Indianapolis, 402 N Blackford St, Indianapolis, IN 46202, United States.
| | - Kyle S Minor
- Indiana University-Purdue University Indianapolis, 402 N Blackford St, Indianapolis, IN 46202, United States
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8
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Strauss GP, Raugh IM, Luther L, Walker EF, Mittal VA. Temporal Interactions Between Social Motivation and Behavior In Daily Life Among Individuals at Clinical High-Risk for Psychosis. Schizophr Bull 2023; 49:1150-1160. [PMID: 37467481 PMCID: PMC10483454 DOI: 10.1093/schbul/sbad096] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/21/2023]
Abstract
BACKGROUND AND HYPOTHESES Poor social functioning is common among individuals at clinical high-risk (CHR) for psychosis and is associated with greater likelihood of conversion. Unfortunately, processes contributing to social impairment are unclear, making social functioning difficult to improve via treatment. The current study examined whether abnormalities in social functioning result from aberrant temporal interactions between social motivation and behavior. STUDY DESIGN Participants included 105 individuals at CHR and 62 healthy controls (CN) who completed 6 days of ecological momentary assessment. Multilevel models examined time-lagged interactions between social behavior and motivation. STUDY RESULTS CHR and CN did not differ in social motivation; however, CHR were less likely to interact with family and coworkers and more likely to engage in interactions via phone and text/social media. Autocorrelations indicated that social behavior and motivation were generally consistent across time in CHR and CN groups. Time-lagged analyses indicated that both groups had an increase in social motivation across time when they were alone and a decrease in social motivation across time when they were with others. However, the relative decrease when with others and increase when alone were less robust in CHR than CN, particularly for in-person interactions. Social motivation at time t did not differentially impact social partner or modality at time t+1 in the groups. CONCLUSIONS Findings suggest that social behavior and motivation have different temporal interactions in CHR and CN. Psychosocial interventions may benefit from targeting the frequency of social behavior with specific partners and modalities to change social motivation.
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Affiliation(s)
| | - Ian M Raugh
- Department of Psychology, University of Georgia, Athens, GA, USA
| | - Lauren Luther
- Department of Psychology, University of Georgia, Athens, GA, USA
| | - Elaine F Walker
- Department of Psychology, Emory University, Atlanta, GA, USA
| | - Vijay A Mittal
- Department of Psychology, Northwestern University, Evanston, IL, USA
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9
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Ammerman BA, Jacobucci R. The impact of social connection on near-term suicidal ideation. Psychiatry Res 2023; 326:115338. [PMID: 37453309 DOI: 10.1016/j.psychres.2023.115338] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2023] [Revised: 07/05/2023] [Accepted: 07/06/2023] [Indexed: 07/18/2023]
Abstract
While predominant suicide theories emphasize the role of social connectedness in suicidal thinking, there is a need to better understand (a) how specific aspects of social connection relate to suicidal ideation and (b) the timeframe over which these relationships persist. The current study examined ecological momentary assessment data over a 30-day period from 35 participants with past-year suicidal thoughts or behaviors (mean age = 25.88; 62.9% women; 68.6% White) to address these questions. Results demonstrated that absence of social contact was associated with next timepoint suicidal ideation, even after considering the suicidal ideation autoregressive effect (i.e., concurrent), with effects strongest in the short-term. Findings provide preliminary evidence of the need to assess for the presence of social contact, and for assessments to occur in close proximity (i.e., a few hours), to capture the true dynamics of risk for suicidal ideation. Although needing replication, results suggest importance of just-in-time interventions targeting suicidal ideation.
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Affiliation(s)
- Brooke A Ammerman
- Department of Psychology, University of Notre Dame, 390 Corbett Family Hall, Notre Dame, IN 46656, United States.
| | - Ross Jacobucci
- Department of Psychology, University of Notre Dame, 390 Corbett Family Hall, Notre Dame, IN 46656, United States
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10
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Luther L, Raugh IM, Collins DE, Knippenberg AR, Strauss GP. Negative symptoms in schizophrenia differ across environmental contexts in daily life. J Psychiatr Res 2023; 161:10-18. [PMID: 36893666 PMCID: PMC10149609 DOI: 10.1016/j.jpsychires.2023.02.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 01/23/2023] [Accepted: 02/28/2023] [Indexed: 03/11/2023]
Abstract
A recent environmental theory of negative symptoms posits that environmental contexts (e.g., location, social partner) play a significant-yet often unaccounted for-role in negative symptoms of schizophrenia (SZ). "Gold-standard" clinical rating scales offer limited precision for evaluating how contexts impact symptoms. To overcome some of these limitations, Ecological Momentary Assessment (EMA) was used to determine whether there were state fluctuations in experiential negative symptoms (anhedonia, avolition, and asociality) in SZ across contexts (locations, activities, social interaction partner, social interaction method). Outpatients with SZ (n = 52) and healthy controls (CN: n = 55) completed 8 daily EMA surveys for 6 days assessing negative symptom domains (anhedonia, avolition, and asociality) and contexts. Multilevel modeling demonstrated that negative symptoms varied across location, activity, social interaction partner, and social interaction method. For the majority of contexts, SZ and CN did not report significantly different levels of negative symptoms, with SZ only reporting higher negative symptoms than CN while eating, resting, interacting with a significant other, or being at home. Further, there were several contexts where negative symptoms were similarly reduced (e.g., recreation, most social interactions) or elevated (e.g., using the computer, working, running errands) in each group. Results demonstrate that experiential negative symptoms dynamically change across contexts in SZ. Some contexts may "normalize" experiential negative symptoms in SZ, while other contexts, notably some used to promote functional recovery, may increase experiential negative symptoms.
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Affiliation(s)
- Lauren Luther
- Department of Psychology, University of Georgia, Athens, GA, USA.
| | - Ian M Raugh
- Department of Psychology, University of Georgia, Athens, GA, USA
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11
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Bornheimer LA, Li Verdugo J, Thompson S. Depression Mediates the Relationships between Hallucinations, Delusions, and Social Isolation in First-Episode Psychosis. SOCIAL WORK RESEARCH 2022; 46:332-341. [PMID: 36420428 PMCID: PMC9673164 DOI: 10.1093/swr/svac025] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/15/2021] [Revised: 03/12/2021] [Accepted: 08/12/2022] [Indexed: 06/16/2023]
Abstract
Social isolation is common among individuals with schizophrenia spectrum and other psychotic disorders. Research indicates that social isolation relates to poorer mental health outcomes, depression, and negative symptoms, with less known about its relationship with positive symptoms. This study examined depression as a mediator in the relationships between positive symptoms (i.e., hallucinations and delusions) and social isolation among an early treatment phase sample in the United States. Data were obtained from the Recovery After an Initial Schizophrenia Episode project of the National Institute of Mental Health's Early Treatment Program. Participants (N = 404) included adults between ages 15 and 40 in a first episode of psychosis. Data were analyzed using structural equation modeling in Mplus (Version 8). The study showed that delusions (b = .095, SE = 0.04, p < .05) and hallucinations (b = .076, SE = 0.03, p < .01) were directly related to depression, and that both delusions (b = .129, SE = 0.06, p < .05) and depression (b = .254, SE = 0.09, p < .05) were directly related to social isolation. Findings of this study determined that depression functioned as a mediator in the relationships between positive symptoms and social isolation. Targeting psychosis symptomatology and depression in treatment, improving social skills and social support networks, and considering the role of stigma in social isolation are of great importance in the prevention of poorer mental health outcomes.
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Affiliation(s)
- Lindsay A Bornheimer
- PhD, is an assistant professor, School of Social Work, University of Michigan, 1080 S. University Avenue, Ann Arbor, MI 48109-1106, USA
| | - Juliann Li Verdugo
- MSW, is a project coordinator, is a research assistant, School of Social Work, University of Michigan, Ann Arbor, MI, USA
| | - Sara Thompson
- MSW, is a research assistant, School of Social Work, University of Michigan, Ann Arbor, MI, USA
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12
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Harvey PD, Depp CA, Rizzo AA, Strauss GP, Spelber D, Carpenter LL, Kalin NH, Krystal JH, McDonald WM, Nemeroff CB, Rodriguez CI, Widge AS, Torous J. Technology and Mental Health: State of the Art for Assessment and Treatment. Am J Psychiatry 2022; 179:897-914. [PMID: 36200275 DOI: 10.1176/appi.ajp.21121254] [Citation(s) in RCA: 15] [Impact Index Per Article: 7.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Technology is ubiquitous in society and is now being extensively used in mental health applications. Both assessment and treatment strategies are being developed and deployed at a rapid pace. The authors review the current domains of technology utilization, describe standards for quality evaluation, and forecast future developments. This review examines technology-based assessments of cognition, emotion, functional capacity and everyday functioning, virtual reality approaches to assessment and treatment, ecological momentary assessment, passive measurement strategies including geolocation, movement, and physiological parameters, and technology-based cognitive and functional skills training. There are many technology-based approaches that are evidence based and are supported through the results of systematic reviews and meta-analyses. Other strategies are less well supported by high-quality evidence at present, but there are evaluation standards that are well articulated at this time. There are some clear challenges in selection of applications for specific conditions, but in several areas, including cognitive training, randomized clinical trials are available to support these interventions. Some of these technology-based interventions have been approved by the U.S. Food and Drug administration, which has clear standards for which types of applications, and which claims about them, need to be reviewed by the agency and which are exempt.
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Affiliation(s)
- Philip D Harvey
- Department of Psychiatry, University of Miami Miller School of Medicine, Miami, and Miami VA Medical Center (Harvey); Department of Psychiatry, UC San Diego Medical Center, La Jolla (Depp); USC Institute for Creative Technologies, University of Southern California, Los Angeles (Rizzo); Department of Psychology, University of Georgia, Athens (Strauss); Department of Psychiatry, Dell Medical Center, University of Texas at Austin (Spelber, Nemeroff); Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, R.I. (Carpenter); Department of Psychiatry, University of Wisconsin Medical School, Madison (Kalin); Department of Psychiatry, Yale University School of Medicine, New Haven, Conn. (Krystal); Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta (McDonald); Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford; Veterans Affairs Palo Alto Health Care System, Palo Alto (Rodriguez); Department of Psychiatry and Behavioral Sciences and Medical Discovery Team-Addictions, University of Minnesota, Minneapolis (Widge); Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston (Torous)
| | - Colin A Depp
- Department of Psychiatry, University of Miami Miller School of Medicine, Miami, and Miami VA Medical Center (Harvey); Department of Psychiatry, UC San Diego Medical Center, La Jolla (Depp); USC Institute for Creative Technologies, University of Southern California, Los Angeles (Rizzo); Department of Psychology, University of Georgia, Athens (Strauss); Department of Psychiatry, Dell Medical Center, University of Texas at Austin (Spelber, Nemeroff); Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, R.I. (Carpenter); Department of Psychiatry, University of Wisconsin Medical School, Madison (Kalin); Department of Psychiatry, Yale University School of Medicine, New Haven, Conn. (Krystal); Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta (McDonald); Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford; Veterans Affairs Palo Alto Health Care System, Palo Alto (Rodriguez); Department of Psychiatry and Behavioral Sciences and Medical Discovery Team-Addictions, University of Minnesota, Minneapolis (Widge); Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston (Torous)
| | - Albert A Rizzo
- Department of Psychiatry, University of Miami Miller School of Medicine, Miami, and Miami VA Medical Center (Harvey); Department of Psychiatry, UC San Diego Medical Center, La Jolla (Depp); USC Institute for Creative Technologies, University of Southern California, Los Angeles (Rizzo); Department of Psychology, University of Georgia, Athens (Strauss); Department of Psychiatry, Dell Medical Center, University of Texas at Austin (Spelber, Nemeroff); Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, R.I. (Carpenter); Department of Psychiatry, University of Wisconsin Medical School, Madison (Kalin); Department of Psychiatry, Yale University School of Medicine, New Haven, Conn. (Krystal); Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta (McDonald); Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford; Veterans Affairs Palo Alto Health Care System, Palo Alto (Rodriguez); Department of Psychiatry and Behavioral Sciences and Medical Discovery Team-Addictions, University of Minnesota, Minneapolis (Widge); Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston (Torous)
| | - Gregory P Strauss
- Department of Psychiatry, University of Miami Miller School of Medicine, Miami, and Miami VA Medical Center (Harvey); Department of Psychiatry, UC San Diego Medical Center, La Jolla (Depp); USC Institute for Creative Technologies, University of Southern California, Los Angeles (Rizzo); Department of Psychology, University of Georgia, Athens (Strauss); Department of Psychiatry, Dell Medical Center, University of Texas at Austin (Spelber, Nemeroff); Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, R.I. (Carpenter); Department of Psychiatry, University of Wisconsin Medical School, Madison (Kalin); Department of Psychiatry, Yale University School of Medicine, New Haven, Conn. (Krystal); Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta (McDonald); Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford; Veterans Affairs Palo Alto Health Care System, Palo Alto (Rodriguez); Department of Psychiatry and Behavioral Sciences and Medical Discovery Team-Addictions, University of Minnesota, Minneapolis (Widge); Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston (Torous)
| | - David Spelber
- Department of Psychiatry, University of Miami Miller School of Medicine, Miami, and Miami VA Medical Center (Harvey); Department of Psychiatry, UC San Diego Medical Center, La Jolla (Depp); USC Institute for Creative Technologies, University of Southern California, Los Angeles (Rizzo); Department of Psychology, University of Georgia, Athens (Strauss); Department of Psychiatry, Dell Medical Center, University of Texas at Austin (Spelber, Nemeroff); Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, R.I. (Carpenter); Department of Psychiatry, University of Wisconsin Medical School, Madison (Kalin); Department of Psychiatry, Yale University School of Medicine, New Haven, Conn. (Krystal); Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta (McDonald); Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford; Veterans Affairs Palo Alto Health Care System, Palo Alto (Rodriguez); Department of Psychiatry and Behavioral Sciences and Medical Discovery Team-Addictions, University of Minnesota, Minneapolis (Widge); Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston (Torous)
| | - Linda L Carpenter
- Department of Psychiatry, University of Miami Miller School of Medicine, Miami, and Miami VA Medical Center (Harvey); Department of Psychiatry, UC San Diego Medical Center, La Jolla (Depp); USC Institute for Creative Technologies, University of Southern California, Los Angeles (Rizzo); Department of Psychology, University of Georgia, Athens (Strauss); Department of Psychiatry, Dell Medical Center, University of Texas at Austin (Spelber, Nemeroff); Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, R.I. (Carpenter); Department of Psychiatry, University of Wisconsin Medical School, Madison (Kalin); Department of Psychiatry, Yale University School of Medicine, New Haven, Conn. (Krystal); Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta (McDonald); Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford; Veterans Affairs Palo Alto Health Care System, Palo Alto (Rodriguez); Department of Psychiatry and Behavioral Sciences and Medical Discovery Team-Addictions, University of Minnesota, Minneapolis (Widge); Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston (Torous)
| | - Ned H Kalin
- Department of Psychiatry, University of Miami Miller School of Medicine, Miami, and Miami VA Medical Center (Harvey); Department of Psychiatry, UC San Diego Medical Center, La Jolla (Depp); USC Institute for Creative Technologies, University of Southern California, Los Angeles (Rizzo); Department of Psychology, University of Georgia, Athens (Strauss); Department of Psychiatry, Dell Medical Center, University of Texas at Austin (Spelber, Nemeroff); Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, R.I. (Carpenter); Department of Psychiatry, University of Wisconsin Medical School, Madison (Kalin); Department of Psychiatry, Yale University School of Medicine, New Haven, Conn. (Krystal); Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta (McDonald); Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford; Veterans Affairs Palo Alto Health Care System, Palo Alto (Rodriguez); Department of Psychiatry and Behavioral Sciences and Medical Discovery Team-Addictions, University of Minnesota, Minneapolis (Widge); Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston (Torous)
| | - John H Krystal
- Department of Psychiatry, University of Miami Miller School of Medicine, Miami, and Miami VA Medical Center (Harvey); Department of Psychiatry, UC San Diego Medical Center, La Jolla (Depp); USC Institute for Creative Technologies, University of Southern California, Los Angeles (Rizzo); Department of Psychology, University of Georgia, Athens (Strauss); Department of Psychiatry, Dell Medical Center, University of Texas at Austin (Spelber, Nemeroff); Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, R.I. (Carpenter); Department of Psychiatry, University of Wisconsin Medical School, Madison (Kalin); Department of Psychiatry, Yale University School of Medicine, New Haven, Conn. (Krystal); Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta (McDonald); Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford; Veterans Affairs Palo Alto Health Care System, Palo Alto (Rodriguez); Department of Psychiatry and Behavioral Sciences and Medical Discovery Team-Addictions, University of Minnesota, Minneapolis (Widge); Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston (Torous)
| | - William M McDonald
- Department of Psychiatry, University of Miami Miller School of Medicine, Miami, and Miami VA Medical Center (Harvey); Department of Psychiatry, UC San Diego Medical Center, La Jolla (Depp); USC Institute for Creative Technologies, University of Southern California, Los Angeles (Rizzo); Department of Psychology, University of Georgia, Athens (Strauss); Department of Psychiatry, Dell Medical Center, University of Texas at Austin (Spelber, Nemeroff); Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, R.I. (Carpenter); Department of Psychiatry, University of Wisconsin Medical School, Madison (Kalin); Department of Psychiatry, Yale University School of Medicine, New Haven, Conn. (Krystal); Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta (McDonald); Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford; Veterans Affairs Palo Alto Health Care System, Palo Alto (Rodriguez); Department of Psychiatry and Behavioral Sciences and Medical Discovery Team-Addictions, University of Minnesota, Minneapolis (Widge); Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston (Torous)
| | - Charles B Nemeroff
- Department of Psychiatry, University of Miami Miller School of Medicine, Miami, and Miami VA Medical Center (Harvey); Department of Psychiatry, UC San Diego Medical Center, La Jolla (Depp); USC Institute for Creative Technologies, University of Southern California, Los Angeles (Rizzo); Department of Psychology, University of Georgia, Athens (Strauss); Department of Psychiatry, Dell Medical Center, University of Texas at Austin (Spelber, Nemeroff); Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, R.I. (Carpenter); Department of Psychiatry, University of Wisconsin Medical School, Madison (Kalin); Department of Psychiatry, Yale University School of Medicine, New Haven, Conn. (Krystal); Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta (McDonald); Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford; Veterans Affairs Palo Alto Health Care System, Palo Alto (Rodriguez); Department of Psychiatry and Behavioral Sciences and Medical Discovery Team-Addictions, University of Minnesota, Minneapolis (Widge); Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston (Torous)
| | - Carolyn I Rodriguez
- Department of Psychiatry, University of Miami Miller School of Medicine, Miami, and Miami VA Medical Center (Harvey); Department of Psychiatry, UC San Diego Medical Center, La Jolla (Depp); USC Institute for Creative Technologies, University of Southern California, Los Angeles (Rizzo); Department of Psychology, University of Georgia, Athens (Strauss); Department of Psychiatry, Dell Medical Center, University of Texas at Austin (Spelber, Nemeroff); Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, R.I. (Carpenter); Department of Psychiatry, University of Wisconsin Medical School, Madison (Kalin); Department of Psychiatry, Yale University School of Medicine, New Haven, Conn. (Krystal); Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta (McDonald); Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford; Veterans Affairs Palo Alto Health Care System, Palo Alto (Rodriguez); Department of Psychiatry and Behavioral Sciences and Medical Discovery Team-Addictions, University of Minnesota, Minneapolis (Widge); Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston (Torous)
| | - Alik S Widge
- Department of Psychiatry, University of Miami Miller School of Medicine, Miami, and Miami VA Medical Center (Harvey); Department of Psychiatry, UC San Diego Medical Center, La Jolla (Depp); USC Institute for Creative Technologies, University of Southern California, Los Angeles (Rizzo); Department of Psychology, University of Georgia, Athens (Strauss); Department of Psychiatry, Dell Medical Center, University of Texas at Austin (Spelber, Nemeroff); Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, R.I. (Carpenter); Department of Psychiatry, University of Wisconsin Medical School, Madison (Kalin); Department of Psychiatry, Yale University School of Medicine, New Haven, Conn. (Krystal); Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta (McDonald); Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford; Veterans Affairs Palo Alto Health Care System, Palo Alto (Rodriguez); Department of Psychiatry and Behavioral Sciences and Medical Discovery Team-Addictions, University of Minnesota, Minneapolis (Widge); Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston (Torous)
| | - John Torous
- Department of Psychiatry, University of Miami Miller School of Medicine, Miami, and Miami VA Medical Center (Harvey); Department of Psychiatry, UC San Diego Medical Center, La Jolla (Depp); USC Institute for Creative Technologies, University of Southern California, Los Angeles (Rizzo); Department of Psychology, University of Georgia, Athens (Strauss); Department of Psychiatry, Dell Medical Center, University of Texas at Austin (Spelber, Nemeroff); Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, R.I. (Carpenter); Department of Psychiatry, University of Wisconsin Medical School, Madison (Kalin); Department of Psychiatry, Yale University School of Medicine, New Haven, Conn. (Krystal); Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta (McDonald); Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford; Veterans Affairs Palo Alto Health Care System, Palo Alto (Rodriguez); Department of Psychiatry and Behavioral Sciences and Medical Discovery Team-Addictions, University of Minnesota, Minneapolis (Widge); Department of Psychiatry, Beth Israel Deaconess Medical Center, Boston (Torous)
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13
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Chalker SA, Parrish EM, Cano M, Kelsven S, Moore RC, Granholm E, Pinkham A, Harvey PD, Depp CA. Childhood Trauma Associations With the Interpersonal Psychological Theory of Suicide and Social Cognitive Biases in Psychotic Disorders. J Nerv Ment Dis 2022; 210:432-438. [PMID: 34966112 PMCID: PMC9156551 DOI: 10.1097/nmd.0000000000001462] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT Childhood trauma (CT) is associated with suicidal ideation and behaviors (SI/SB) in people with psychosis. The interpersonal psychological theory of suicide (IPTS) suggests that there are four factors that increase suicide risk: thwarted belongingness, perceived burdensomeness, acquired capacity for suicide, and hopelessness. The IPTS constructs and social cognitive biases are associated with SI/SB in psychotic disorders. However, the role of CT in IPTS constructs and social cognitive biases has not been examined in psychosis. In an outpatient community sample of persons with psychotic disorders (N = 96) assessed with the Childhood Trauma Questionnaire, the aims of this study were to a) evaluate rates of CT in this sample, b) determine the relationship between CT types and lifetime SI/SB, and c) explore the relationship between CT types, IPTS constructs, and social cognitive biases. All participants reported experiencing CT. Emotional abuse was associated with greater SI severity and higher rates of lifetime suicide attempts, as well as with greater perceived burdensomeness and more severe negative social cognitive biases. Other CT types were minimally associated with SI/SB or IPST constructs; hopelessness was not associated. Overall, negative interpersonal beliefs and social cognitive biases may explain how CT increases suicide risk in psychosis.
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Affiliation(s)
- Samantha A. Chalker
- Veterans Affairs San Diego Healthcare System, San Diego, California, USA
- University of California San Diego Department of Psychiatry, San Diego, California, USA
| | - Emma M. Parrish
- San Diego State University / University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, California, USA
| | - Mayra Cano
- University of California San Diego Department of Psychiatry, San Diego, California, USA
| | - Skylar Kelsven
- Veterans Affairs San Diego Healthcare System, San Diego, California, USA
- San Diego State University / University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, California, USA
| | - Raeanne C. Moore
- University of California San Diego Department of Psychiatry, San Diego, California, USA
| | - Eric Granholm
- University of California San Diego Department of Psychiatry, San Diego, California, USA
- San Diego State University / University of California San Diego Joint Doctoral Program in Clinical Psychology, San Diego, California, USA
| | - Amy Pinkham
- School of Behavioral and Brain Sciences, The University of Texas at Dallas, Richardson, TX
| | - Philip D. Harvey
- University of Miller School of Medicine, Miami, FL, USA
- Research Service, Bruce W. Carter VA Medical Center, Miami, FL, USA
| | - Colin A. Depp
- Veterans Affairs San Diego Healthcare System, San Diego, California, USA
- University of California San Diego Department of Psychiatry, San Diego, California, USA
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14
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Miller ML, Raugh IM, Strauss GP, Harvey PD. Remote digital phenotyping in serious mental illness: Focus on negative symptoms, mood symptoms, and self-awareness. Biomark Neuropsychiatry 2022. [DOI: 10.1016/j.bionps.2022.100047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
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15
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Strauss GP, Raugh IM, Zhang L, Luther L, Chapman HC, Allen DN, Kirkpatrick B, Cohen AS. Validation of accelerometry as a digital phenotyping measure of negative symptoms in schizophrenia. SCHIZOPHRENIA (HEIDELBERG, GERMANY) 2022; 8:37. [PMID: 35853890 PMCID: PMC9261099 DOI: 10.1038/s41537-022-00241-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Accepted: 02/24/2022] [Indexed: 05/05/2023]
Abstract
Negative symptoms are commonly assessed via clinical rating scales; however, these measures have several inherent limitations that impact validity and utility for their use in clinical trials. Objective digital phenotyping measures that overcome some of these limitations are now available. The current study evaluated the validity of accelerometry (ACL), a passive digital phenotyping method that involves collecting data on the presence, vigor, and variability of movement. Outpatients with schizophrenia (SZ: n = 50) and demographically matched healthy controls (CN: n = 70) had ACL continuously recorded from a smartphone and smartband for 6 days. Active digital phenotyping assessments, including surveys related to activity context, were also collected via 8 daily surveys throughout the 6 day period. SZ participants had lower scores on phone ACL variables reflecting vigor and variability of movement compared to CN. ACL variables demonstrated convergent validity as indicated by significant correlations with active digital phenotyping self-reports of time spent in goal-directed activities and clinical ratings of negative symptoms. The discriminant validity of ACL was demonstrated by low correlations with clinical rating scale measures of positive, disorganized, and total symptoms. Collectively, findings suggest that ACL is a valid objective measure of negative symptoms that may complement traditional approaches to assessing the construct using clinical rating scales.
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Affiliation(s)
| | - Ian M Raugh
- Department of Psychology, University of Georgia, Athens, GA, USA
| | - Luyu Zhang
- Department of Psychology, University of Georgia, Athens, GA, USA
| | - Lauren Luther
- Department of Psychology, University of Georgia, Athens, GA, USA
| | - Hannah C Chapman
- Department of Psychology, University of Georgia, Athens, GA, USA
| | - Daniel N Allen
- Department of Psychology, University of Nevada, Las Vegas, NV, USA
| | - Brian Kirkpatrick
- Department of Psychiatry and Behavioral Sciences, University of Nevada, Reno School of Medicine, Las Vegas, NV, USA
| | - Alex S Cohen
- Department of Psychology, Louisiana State University, Baton Rouge, LA, USA
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16
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Orth RD, Hur J, Jacome AM, Savage CLG, Grogans SE, Kim YH, Choe EK, Shackman AJ, Blanchard JJ. Understanding the Consequences of Moment-by-Moment Fluctuations in Mood and Social Experience for Paranoid Ideation in Psychotic Disorders. SCHIZOPHRENIA BULLETIN OPEN 2022; 3:sgac064. [PMID: 36387970 PMCID: PMC9642311 DOI: 10.1093/schizbullopen/sgac064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Among individuals with psychotic disorders, paranoid ideation is common and associated with increased impairment, decreased quality of life, and a more pessimistic prognosis. Although accumulating research indicates negative affect is a key precipitant of paranoid ideation, the possible protective role of positive affect has not been examined. Further, despite the interpersonal nature of paranoid ideation, there are limited and inconsistent findings regarding how social context, perceptions, and motivation influence paranoid ideation in real-world contexts. In this pilot study, we used smartphone ecological momentary assessment to understand the relevance of hour-by-hour fluctuations in mood and social experience for paranoid ideation in adults with psychotic disorders. Multilevel modeling results indicated that greater negative affect is associated with higher concurrent levels of paranoid ideation and that it is marginally related to elevated levels of future paranoid ideation. In contrast, positive affect was unrelated to momentary experiences of paranoid ideation. More severe momentary paranoid ideation was also associated with an elevated desire to withdraw from social encounters, irrespective of when with familiar or unfamiliar others. These observations underscore the role of negative affect in promoting paranoid ideation and highlight the contribution of paranoid ideation to the motivation to socially withdraw in psychotic disorders.
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Affiliation(s)
- Ryan D Orth
- Department of Psychology, University of Maryland, College Park, MD, USA
| | - Juyoen Hur
- Department of Psychology, Yonsei University, Seoul, Republic of Korea
| | - Anyela M Jacome
- Department of Psychology, University of Maryland, College Park, MD, USA
| | | | - Shannon E Grogans
- Department of Psychology, University of Maryland, College Park, MD, USA
| | - Young-Ho Kim
- College of Information Studies, University of Maryland, College Park, MD, USA
| | - Eun Kyoung Choe
- College of Information Studies, University of Maryland, College Park, MD, USA
| | - Alexander J Shackman
- Department of Psychology, University of Maryland, College Park, MD, USA
- Neuroscience and Cognitive Science Program, University of Maryland, College Park, MD, USA
- Maryland Neuroimaging Center, University of Maryland, College Park, MD, USA
| | - Jack J Blanchard
- Department of Psychology, University of Maryland, College Park, MD, USA
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17
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Plessen KJ, Constanty L, Ranjbar S, Turri F, Miano G, Lepage C, Urben S. The role of self-regulatory control processes in understanding aggressive ideations and behaviors: An experience sampling method study. Front Psychiatry 2022; 13:1058814. [PMID: 36741583 PMCID: PMC9893502 DOI: 10.3389/fpsyt.2022.1058814] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2022] [Accepted: 12/28/2022] [Indexed: 01/20/2023] Open
Abstract
INTRODUCTION In this study, we aimed to examine the association between aggressive ideations and aggressive behaviors in everyday life, as well as the role of processes related to self-regulatory control (i.e., self-control, ego depletion, and emotional states), using experience sampling methods (ESM). METHODS A total of 62 male adolescents performed a baseline measure of aggression, violent ideations (trait level), and ESM assessments, including four measures per day during nine consecutive days. RESULTS At a state level, aggressive ideations were associated with higher negative emotions during the previous day as well as with lower self-control and stronger anger rumination at the moment. Aggressive behaviors were related to higher anger rumination at the moment and to the manifestation of higher intensity of aggressive ideations derived in the previous measure. Higher self-control was related to a lower probability of aggressive behavior. DISCUSSION This study highlights the temporal link between aggressive ideations and behaviors in everyday life as well as the role of self-control in understanding aggressivity in the lap of time. Furthermore, we observed that expressions of anger (i.e., reactivity, as well as rumination) were central in the understanding of aggressive ideations and behaviors in the everyday life (i.e., at within-person variability at the state level).
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Affiliation(s)
- Kerstin Jessica Plessen
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Lausanne University Hospital (CHUV), Lausanne, Switzerland.,Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
| | - Lauriane Constanty
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Setareh Ranjbar
- Center of Psychiatric Epidemiology and Psychopathology, Department of Psychiatry, Lausanne University Hospital, University of Lausanne, Prilly, Switzerland
| | - Fiorella Turri
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Giorgia Miano
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Caroline Lepage
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Lausanne University Hospital (CHUV), Lausanne, Switzerland
| | - Sébastien Urben
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Lausanne University Hospital (CHUV), Lausanne, Switzerland.,Faculty of Biology and Medicine, University of Lausanne, Lausanne, Switzerland
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18
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Parrish EM, Chalker SA, Cano M, Moore RC, Pinkham AE, Harvey PD, Joiner T, Lieberman A, Granholm E, Depp CA. Ecological momentary assessment of interpersonal theory of suicide constructs in people experiencing psychotic symptoms. J Psychiatr Res 2021; 140:496-503. [PMID: 34157588 PMCID: PMC8621669 DOI: 10.1016/j.jpsychires.2021.06.022] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2021] [Revised: 05/24/2021] [Accepted: 06/13/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND People with psychotic disorders are at an increased risk of suicide, but there is little understanding of suicidal ideation (SI) in this population. The Interpersonal Psychological Theory of Suicide posits that perceived burdensomeness (PB) and thwarted belonginess (TB) contribute to SI. To our knowledge there are no studies using ecological momentary assessment (EMA) to assess these interpersonal risk factors in a sample of individuals with psychotic disorders. This study investigated the validity and variability of PB and TB, and whether SI, EMA-measured psychotic symptoms, mood, and social context relate to PB and TB. METHOD Ninety-six participants with a psychotic disorder, including mood disorders with psychosis completed in-lab assessments of current SI, and then EMA surveys on a smartphone 3×/day for 10 days, answering questions about burdensomeness, belongingness, symptoms (i.e., hearing voices, experiencing suspiciousness), mood (i.e., happy, sad), and social context. RESULTS Burdensomeness varied within-participants less than belongingness (t (95) = -3.74, p=< .001). Participants with SI had higher mean burdensomeness ratings (t (94) = -2.70, p < .01) and lower mean belongingness ratings (t (94) = 3.68, p < .001) than did participants without SI. Being with others, greater psychotic experiences, less happiness, and greater sadness related to greater burdensomeness. SI status, being alone, greater psychotic experiences, less happiness, and greater sadness related to less belongingness. CONCLUSIONS This study examined the real-time influences of SI and psychotic symptoms on burdensomeness and belongingness. Hearing voices, suspiciousness, mood, and SI are related to interpersonal suicide-related risk factors. In this sample, social context had a differential effect on burdensomeness and belongingness.
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Affiliation(s)
- Emma M Parrish
- SDSU/UC San Diego Joint Doctoral Program in Clinical Psychology, San Diego, CA, USA
| | - Samantha A Chalker
- Veterans Affairs San Diego Healthcare System, San Diego, CA, USA; University of California San Diego Department of Psychiatry, San Diego, CA, USA
| | - Mayra Cano
- University of California San Diego Department of Psychiatry, San Diego, CA, USA
| | - Raeanne C Moore
- University of California San Diego Department of Psychiatry, San Diego, CA, USA
| | | | - Philip D Harvey
- University of Miami Miller School of Medicine, Research Service, Bruce W. Carter VA Medical Center, Miami, FL, USA
| | - Thomas Joiner
- Department of Psychology, Florida State University, Tallahassee, FL, USA
| | - Amy Lieberman
- Department of Psychology, Florida State University, Tallahassee, FL, USA
| | - Eric Granholm
- Veterans Affairs San Diego Healthcare System, San Diego, CA, USA; University of California San Diego Department of Psychiatry, San Diego, CA, USA
| | - Colin A Depp
- Veterans Affairs San Diego Healthcare System, San Diego, CA, USA; University of California San Diego Department of Psychiatry, San Diego, CA, USA.
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19
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Quality versus quantity: Determining real-world social functioning deficits in schizophrenia. Psychiatry Res 2021; 301:113980. [PMID: 33979764 PMCID: PMC8206017 DOI: 10.1016/j.psychres.2021.113980] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2020] [Accepted: 04/25/2021] [Indexed: 12/13/2022]
Abstract
Social dysfunction is a hallmark of schizophrenia that is associated with emotional disturbances. Researchers have employed ecological momentary assessment (EMA) to measure social and emotional functioning in people with schizophrenia. Yet, few studies have evaluated quality of real-world social interactions, and it is unclear how interactions impact emotional experiences in this population. Using novel EMA that passively collects audio data, we examined daily social behavior and emotion in schizophrenia (n = 38) and control (n = 36) groups. Contrary to hypotheses, both groups interacted with others at the same rate and exhibited similar levels of positive emotion. However, as expected, the schizophrenia group exhibited significantly less high-quality interactions and reported more negative emotion than controls. Social versus non-social context did not influence experienced emotion in either group. This is the first real-world study to passively assess quality of social interactions in schizophrenia. Although those with schizophrenia did not differ in their number of interactions, they were less likely to engage in substantive, personal conversations. Because high-quality interactions are linked with better social outcomes, this finding has important potential treatment implications. Future research should investigate quality of interactions across different types of social activities to gain a more nuanced understanding of social dysfunction in schizophrenia.
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Abel DB, Minor KS. Social functioning in schizophrenia: Comparing laboratory-based assessment with real-world measures. J Psychiatr Res 2021; 138:500-506. [PMID: 33971484 PMCID: PMC8192459 DOI: 10.1016/j.jpsychires.2021.04.039] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/23/2021] [Revised: 04/19/2021] [Accepted: 04/25/2021] [Indexed: 02/06/2023]
Abstract
Researchers have measured social functioning in schizophrenia using many different strategies. Recent technological advances have made it possible to passively measure behaviors in real-world social situations-allowing for more objective, ecologically valid assessments. Yet, research testing the convergent validity among real-world and laboratory-based social functioning assessment is sparse. The purpose of this study was to test the convergent validity among four social functioning measures: two interview-based rating scales, a self-reported ecological momentary assessment (EMA), and a passive, ambulatory ecological assessment. Data was collected from 36 people with schizophrenia and 33 control participants. Across the entire sample, relationships between interview-based ratings and real-world measures of social functioning only demonstrated small correlations (r's = 0.17-0.19), whereas real-world measures exhibited moderate correlations with one another (r = 0.36). Within groups, real-world measures showed moderate, significant relationships in the control group (r = 0.44) but not in the schizophrenia group (r = 0.27). For those with schizophrenia, the interview-based measures of social functioning were moderately associated with ambulatory ecological assessment (r's = 0.38 and 0.47), but only small associations were observed with self-reported EMA (r's = 0.15 and 0.17). Results suggest social functioning assessments are not highly convergent and likely target different aspects of social functioning. Laboratory-based measures offer global impressions of social functioning whereas real-world measures represent a more nuanced approach. Moreover, ambulatory ecological assessment may most accurately gauge frequency of daily social interactions for those with schizophrenia as it circumvents common pitfalls of self-report and offers a less-biased, in-depth evaluation of social behavior.
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Affiliation(s)
- Danielle B. Abel
- Department of Psychology, Indiana University – Purdue University Indianapolis, LD 124, 402 N Blackford St, Indianapolis, IN, USA 46202
| | - Kyle S. Minor
- Department of Psychology, Indiana University – Purdue University Indianapolis, LD 124, 402 N Blackford St, Indianapolis, IN, USA 46202
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Wright AC, Browne J, Skiest H, Bhiku K, Baker JT, Cather C. The relationship between conventional clinical assessments and momentary assessments of symptoms and functioning in schizophrenia spectrum disorders: A systematic review. Schizophr Res 2021; 232:11-27. [PMID: 34004382 DOI: 10.1016/j.schres.2021.04.010] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2020] [Revised: 04/09/2021] [Accepted: 04/25/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Symptoms and functioning are critical dimensions in those with schizophrenia and are typically measured using validated conventional clinical assessments. Researchers and clinicians have begun to use real-time digital methods, such as ecological momentary assessment (EMA), to assess symptoms and functioning in the moment and outside of traditional hospital and laboratory settings, which may yield more naturalistic data. Although digital methods have advantages, it is unclear whether these momentary assessments capture core aspects of symptoms and functioning. OBJECTIVE This systematic literature review aimed to evaluate the association between conventional clinical and momentary-based assessments of functioning and symptoms in individuals with schizophrenia. METHODS Studies were included if they met the following criteria: (1) written or translated into English; (2) peer-reviewed; (3) included primary quantitative data; (4) 60% of the clinical sample included persons with schizophrenia spectrum disorders; (5) included a clinical assessment of functioning and/or symptoms; (6) included active momentary assessment and/or passive data; and (7) assessed the relationship between the momentary and conventional clinical assessments. RESULTS A total of 49 studies (87 analyses) were included. Conventional clinical assessments of functioning and positive, negative, and depressive symptoms were related to momentary assessments of these symptom domains. Passive data was beneficial for assessing negative symptoms, but research is warranted for other domains. CONCLUSIONS The reviewed studies highlight the utility of EMA methodologies to collect detailed data on symptoms and functioning. Such data is being used to develop more sophisticated models of schizophrenia to enhance our understanding of important mechanisms and develop targeted interventions.
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Affiliation(s)
- Abigail C Wright
- Center of Excellence for Psychosocial and Systemic Research, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA.
| | - Julia Browne
- Center of Excellence for Psychosocial and Systemic Research, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA; Geriatric Research, Education and Clinical Center, Durham VA Health Care System, Durham, NC, USA
| | - Hannah Skiest
- Center of Excellence for Psychosocial and Systemic Research, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Kamila Bhiku
- Center of Excellence for Psychosocial and Systemic Research, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Justin T Baker
- Harvard Medical School, Boston, MA, USA; Institute for Technology in Psychiatry, McLean Hospital, Belmont, MA, USA
| | - Corinne Cather
- Center of Excellence for Psychosocial and Systemic Research, Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
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22
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Castro V. Could technology enable individuals with schizophrenia to access health care? The case of Ecuador. JOURNAL OF ENABLING TECHNOLOGIES 2021. [DOI: 10.1108/jet-01-2021-0002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Purpose
The purpose of this paper is to fill in the gaps in the literature regarding health-care access for individuals with schizophrenia, with a focus on Ecuador, and how technology can enable health-care access during the pandemic.
Design/methodology/approach
To achieve this aim, the author reviewed peer-reviewed articles in English and Spanish (using, among other sources, Medline and ProQuest), the Ecuadorian Constitution, law projects on mental health and suicide and government reports.
Findings
The consensus seems to be that the Ecuadorian health-care system has failed in its constitutional mandate to provide essential care for mentally ill patients, such as those suffering from schizophrenia. The data supporting the use of the internet and smartphone technology for delivering health services during the pandemic are extremely clear, but substantive governmental responses have been lacking.
Research limitations/implications
The major limitation of this study is the lack of data on schizophrenia in Ecuador and the use of technology.
Originality/value
This evaluation of the current literature on the effect of the pandemic on access to health care for patients suffering from mental illness is much-needed and should provide a welcome data source for research, practice and policymaking.
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Durand D, Strassnig MT, Moore RC, Depp CA, Ackerman RA, Pinkham AE, Harvey PD. Self-reported social functioning and social cognition in schizophrenia and bipolar disorder: Using ecological momentary assessment to identify the origin of bias. Schizophr Res 2021; 230:17-23. [PMID: 33667854 PMCID: PMC8222067 DOI: 10.1016/j.schres.2021.02.011] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 02/14/2021] [Accepted: 02/14/2021] [Indexed: 12/20/2022]
Abstract
OBJECTIVES People with schizophrenia (SCZ) and bipolar illness (BPI) generate self-reports of their functioning that diverge from objective information. It has been suggested that these participants do not base such reports on daily experiences, relying on other information. We used ecological momentary assessment (EMA) to sample socially relevant daily activities in SCZ and BPI and related them to self-reported and observer-rated social functioning and social cognitive ability. METHODS 71 people with (BPI) were compared to 102 people with SCZ. Participants were sampled 3 times per day for 30 days with a smartphone-based survey. Each survey asked where they were, with whom they were, what they were doing, and if they were sad. Participants and observers were asked to provide ratings on social functioning and social cognitive abilities at the end of the EMA period. RESULTS There was no association between being home or alone and self-reports of everyday social functioning. In contrast observer ratings were highly correlated with the momentary survey results. Reports of very low levels of sadness were associated with overestimated functioning and participants who were commonly home and alone rated their social functioning as better than participants who were commonly away in the presence of others. IMPLICATIONS Both SCZ and BPI were marked by a disconnect between momentary experiences and self-reports. The largest effect was overestimation of functioning by participants who reported no sadness. Experience appears important, as participants who were routinely home and alone reported better social functioning than participants who spent more time others.
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Affiliation(s)
- Dante Durand
- University of Miami Miller School of Medicine, Miami, FL, United States of America
| | - Martin T Strassnig
- University of Miami Miller School of Medicine, Miami, FL, United States of America
| | - Raeanne C Moore
- UCSD Health Sciences Center, La Jolla, CA, United States of America
| | - Colin A Depp
- UCSD Health Sciences Center, La Jolla, CA, United States of America; San Diego VA Medical Center La Jolla, CA, United States of America
| | - Robert A Ackerman
- University of Texas at Dallas, Richardson, TX, United States of America
| | - Amy E Pinkham
- University of Texas at Dallas, Richardson, TX, United States of America; University of Texas Southwestern Medical Center, Dallas, TX, United States of America
| | - Philip D Harvey
- University of Miami Miller School of Medicine, Miami, FL, United States of America; Bruce W. Carter VA Medical Center, Miami, FL, United States of America.
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Zajenkowska A, Rogoza R, Sasson NJ, Harvey PD, Penn DL, Pinkham AE. Situational context influences the degree of hostile attributions made by individuals with schizophrenia or autism spectrum disorder. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2021; 60:160-176. [PMID: 33650108 DOI: 10.1111/bjc.12283] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2020] [Revised: 01/20/2021] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Previous work has demonstrated that the tendency to make hostile attributions is not a stable trait but varies across different social situations. Therefore, we sought to investigate whether hostile attributions within clinical samples are better understood as a persistent characteristic or one that varies across contexts. METHODS The current analyses investigated patterns of attributions among people diagnosed with schizophrenia (SCZ, n = 271) or autism spectrum disorder (ASD, n = 100) and non-clinical control participants (NCC, n = 233) in an existing data set. RESULTS Results showed that specific relational features in vignettes portraying different social encounters influence the way people make attributions and that variability across contexts is present in both non-clinical and clinical populations. Like non-clinical participants, participants diagnosed with ASD ascribed the greatest hostility to a scene involving an authority figure. In contrast, SCZ participants reported the greatest hostility in response to a scene involving a friend. CONCLUSIONS These findings suggest that salient environmental factors should be considered when assessing social cognitive skills and biases. PRACTITIONER POINTS Hostile attributions should be perceived as situational constructs rather than stable and persistent characteristics. Hostile attributions were most prevalent among persons diagnosed with schizophrenia; however, on average, all participants showed greater hostility for situations involving an authority figure, an acquaintance, or a friend relative to those involving a co-worker or stranger. Psychotherapists and clinicians working with people diagnosed with schizophrenia or autism spectrum disorder could work on identifying situation triggers, which may prompt hostile attributions. Psycho-educational and psychotherapeutic interventions can be altered based on individual triggers of hostile attributions, and attempts can be made to lessen these attributions. Paranoia appears to be linked to hostile attributions regardless of the specific clinical diagnosis and should be considered in the therapeutic process.
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Affiliation(s)
- Anna Zajenkowska
- Insitute of Psychology, Maria Grzegorzewska University, Warsaw, Poland
| | - Radosław Rogoza
- Insitute of Psychology, Cardinal Wyszyński University, Warsaw, Poland
| | - Noah J Sasson
- School of Behavioral and Brain Sciences, The University of Texas at Dallas, Richardson, Texas, USA
| | - Philip D Harvey
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Florida, USA.,Research Service, Miami VA Healthcare System, Miami, Florida, USA
| | - David L Penn
- Department of Psychology and Neuroscience, University of North Carolina-Chapel Hill, Chapel Hill, North Carolina, USA.,School of Behavioural and Health Sciences, Australian Catholic University, Melbourne, Victoria, Australia
| | - Amy E Pinkham
- School of Behavioral and Brain Sciences, The University of Texas at Dallas, Richardson, Texas, USA.,Department of Psychiatry, University of Texas Southwestern Medical School, Dallas, Texas, USA
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25
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Strassnig MT, Harvey PD, Miller ML, Depp CA, Granholm E. Real world sedentary behavior and activity levels in patients with schizophrenia and controls: An ecological momentary assessment study. Ment Health Phys Act 2021; 20:10.1016/j.mhpa.2020.100364. [PMID: 34221125 PMCID: PMC8247127 DOI: 10.1016/j.mhpa.2020.100364] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
BACKGROUND People with schizophrenia often experience poor health, leading to shortened lifespans. The health of people with schizophrenia may be further exacerbated by increased sedentary behavior, which independently predicts health risk in the general population. However, the prevalence and patterns of objectively measured sedentary behavior in schizophrenia have not been studied extensively on a momentary basis. METHODS Activity of 100 patients with schizophrenia was compared to that of healthy controls (HC; n=71) using ecological momentary assessment (EMA). EMA provides real-time, real-world monitoring of behavior. We sampled behavior seven times per day for seven days, quantifying active versus inactive behaviors and four different movement patterns (recumbent, seated, standing, and moving). Due to different employment rates between samples, we focused on surveys completed at home. RESULTS Four of the five most commonly reported activities for participants with schizophrenia involved sitting or lying down. When considering activity during the last hour, participants with schizophrenia were more likely to be sitting or pacing and less likely to be standing than HC. If participants with schizophrenia only did one thing in the last hour, it was more likely to involve sitting and less likely to involve standing compared to HC. DISCUSSION People with schizophrenia were significantly more likely to be seated and less likely to be standing or active during the past hour than HC, despite high frequencies of seated behaviors in the HC as well. The adverse health consequences of sitting for extended periods may be especially relevant for people with schizophrenia and likely contribute to premature mortality in this population.
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Affiliation(s)
| | - Philip D Harvey
- University of Miami Miller School of Medicine, Miami, FL
- Bruce W. Carter VA Medical Center, Miami, FL
| | | | - Colin A Depp
- UCSD Health Sciences Center, La Jolla, CA
- San Diego VA Medical Center La Jolla, CA
| | - Eric Granholm
- UCSD Health Sciences Center, La Jolla, CA
- San Diego VA Medical Center La Jolla, CA
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26
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Depp C, Ehret B, Villa J, Perivoliotis D, Granholm E. A Brief Mobile-Augmented Suicide Prevention Intervention for People With Psychotic Disorders in Transition From Acute to Ongoing Care: Protocol for a Pilot Trial. JMIR Res Protoc 2021; 10:e14378. [PMID: 33555265 PMCID: PMC7899804 DOI: 10.2196/14378] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2019] [Revised: 10/25/2019] [Accepted: 11/26/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND People with serious mental illnesses (SMIs) are at exceptionally high risk for lifetime suicidal ideation and behavior compared with the general population. The transition period between urgent evaluation and ongoing care could provide an important setting for brief suicide-specific interventions for SMIs. To address this concern, this trial, SafeTy and Recovery Therapy (START), involves a brief suicide-specific cognitive behavioral intervention for SMIs that is augmented with mobile phone interactions. OBJECTIVE The primary aim of this pilot trial is to evaluate the feasibility, acceptability, and preliminary effectiveness of the intervention. METHODS A 6-month pilot trial with 70 participants with a diagnosis of bipolar disorder, schizophrenia or schizoaffective disorder, and current active suicidal ideation were randomized to START or START with mobile augmentation. START consists of 4 weekly sessions addressing early warning signs and triggers, symptoms influencing suicidal thinking, and social relationships. Recovery planning is followed by biweekly telephone coaching. START with mobile augmentation includes personalized automated cognitive behavioral therapy scripts that build from in-person content. Participants were evaluated at baseline, 4 weeks (end of in-person sessions), 12 weeks (end of telephone coaching), and 24 weeks. In addition to providing point estimates of feasibility and acceptability, the primary outcome of the trial was the change in severity of suicidal ideation as measured with the Scale for Suicide Ideation (SSI) and secondary outcome included the rate of outpatient engagement. RESULTS The trial is ongoing. Feasibility and acceptability across conditions will be assessed using t tests or Mann-Whitney tests or chi-square tests. The reduction of SSI over time will be assessed using hierarchical linear models. CONCLUSIONS The design considerations and results of this trial may be informative for adapted suicide prevention in psychotic disorders in applied community settings. TRIAL REGISTRATION ClinicalTrials.gov NCT03198364; http://clinicaltrials.gov/ct2/show/NCT03198364. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/14378.
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Affiliation(s)
- Colin Depp
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, United States
- VA San Diego Healthcare System, San Diego, CA, United States
| | - Blaire Ehret
- VA San Diego Healthcare System, San Diego, CA, United States
| | - Jennifer Villa
- Department of Psychology, San Diego State University, San Diego, CA, United States
| | - Dimitri Perivoliotis
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, United States
| | - Eric Granholm
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, United States
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27
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Harvey PD, Miller ML, Moore RC, Depp CA, Parrish EM, Pinkham AE. Capturing Clinical Symptoms with Ecological Momentary Assessment: Convergence of Momentary Reports of Psychotic and Mood Symptoms with Diagnoses and Standard Clinical Assessments. INNOVATIONS IN CLINICAL NEUROSCIENCE 2021; 18:24-30. [PMID: 34150360 PMCID: PMC8195558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Objective: The development and deployment of technology-based assessments of clinical symptoms are increasing. This study used ecological momentary assessment (EMA) to examine clinical symptoms and relates these sampling results to structured clinical ratings. Methods: Three times a day for 30 days, participants with bipolar disorder (n=71; BPI) or schizophrenia (n=102; SCZ) completed surveys assessing five psychosis-related and five mood symptoms, in addition to reporting their location and who they were with at the time of survey completion. Participants also completed Positive and Negative Syndrome Scale (PANSS) interviews with trained raters. Mixed-model repeated-measures (MMRM) analyses examined diagnostic effects and the convergence between clinical ratings and EMA sampling. Results: In total, 12,406 EMA samples were collected, with 80-percent adherence to prompts. EMA-reported psychotic symptoms manifested substantial convergence with equivalent endpoint PANSS items. Patients with SCZ had more severe PANSS and EMA psychotic symptoms. There were no changes in symptom severity scores as a function of the number of previous assessments. Conclusions: EMA surveyed clinical symptoms converged substantially with commonly used clinical rating scales in a large sample, with high adherence. This suggested that remote assessment of clinical symptoms is valid and practical and was not associated with alterations in symptoms as a function of reassessment, with additional benefits of "in the moment" sampling, such as eliminating recall bias and the need for informant reports.
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Affiliation(s)
- Philip D Harvey
- Dr. Harvey is with the University of Miami Miller School of Medicine in Miami, Florida, and Research Service at Bruce W. Carter VA Medical Center in Miami, Florida
- Ms. Miller is with the University of Miami Miller School of Medicine in Miami, Florida
- Dr. Moore is with the Department of Psychiatry at the University of California in La Jolla, California
- Dr. Depp is with the Department of Psychiatry at the University of California in La Jolla, California, and Veterans Affairs San Diego Healthcare System in La Jolla, California
- Ms. Parrish is with the Joint Doctoral Program in Clinical Psychology at San Diego State University /University of California, San Diego
- Dr. Pinkham is with the University of Texas at Dallas in Richardson, Texas, and the UT Southwestern Medical Center in Dallas, Texas
| | - Michelle L Miller
- Dr. Harvey is with the University of Miami Miller School of Medicine in Miami, Florida, and Research Service at Bruce W. Carter VA Medical Center in Miami, Florida
- Ms. Miller is with the University of Miami Miller School of Medicine in Miami, Florida
- Dr. Moore is with the Department of Psychiatry at the University of California in La Jolla, California
- Dr. Depp is with the Department of Psychiatry at the University of California in La Jolla, California, and Veterans Affairs San Diego Healthcare System in La Jolla, California
- Ms. Parrish is with the Joint Doctoral Program in Clinical Psychology at San Diego State University /University of California, San Diego
- Dr. Pinkham is with the University of Texas at Dallas in Richardson, Texas, and the UT Southwestern Medical Center in Dallas, Texas
| | - Raeanne C Moore
- Dr. Harvey is with the University of Miami Miller School of Medicine in Miami, Florida, and Research Service at Bruce W. Carter VA Medical Center in Miami, Florida
- Ms. Miller is with the University of Miami Miller School of Medicine in Miami, Florida
- Dr. Moore is with the Department of Psychiatry at the University of California in La Jolla, California
- Dr. Depp is with the Department of Psychiatry at the University of California in La Jolla, California, and Veterans Affairs San Diego Healthcare System in La Jolla, California
- Ms. Parrish is with the Joint Doctoral Program in Clinical Psychology at San Diego State University /University of California, San Diego
- Dr. Pinkham is with the University of Texas at Dallas in Richardson, Texas, and the UT Southwestern Medical Center in Dallas, Texas
| | - Colin A Depp
- Dr. Harvey is with the University of Miami Miller School of Medicine in Miami, Florida, and Research Service at Bruce W. Carter VA Medical Center in Miami, Florida
- Ms. Miller is with the University of Miami Miller School of Medicine in Miami, Florida
- Dr. Moore is with the Department of Psychiatry at the University of California in La Jolla, California
- Dr. Depp is with the Department of Psychiatry at the University of California in La Jolla, California, and Veterans Affairs San Diego Healthcare System in La Jolla, California
- Ms. Parrish is with the Joint Doctoral Program in Clinical Psychology at San Diego State University /University of California, San Diego
- Dr. Pinkham is with the University of Texas at Dallas in Richardson, Texas, and the UT Southwestern Medical Center in Dallas, Texas
| | - Emma M Parrish
- Dr. Harvey is with the University of Miami Miller School of Medicine in Miami, Florida, and Research Service at Bruce W. Carter VA Medical Center in Miami, Florida
- Ms. Miller is with the University of Miami Miller School of Medicine in Miami, Florida
- Dr. Moore is with the Department of Psychiatry at the University of California in La Jolla, California
- Dr. Depp is with the Department of Psychiatry at the University of California in La Jolla, California, and Veterans Affairs San Diego Healthcare System in La Jolla, California
- Ms. Parrish is with the Joint Doctoral Program in Clinical Psychology at San Diego State University /University of California, San Diego
- Dr. Pinkham is with the University of Texas at Dallas in Richardson, Texas, and the UT Southwestern Medical Center in Dallas, Texas
| | - Amy E Pinkham
- Dr. Harvey is with the University of Miami Miller School of Medicine in Miami, Florida, and Research Service at Bruce W. Carter VA Medical Center in Miami, Florida
- Ms. Miller is with the University of Miami Miller School of Medicine in Miami, Florida
- Dr. Moore is with the Department of Psychiatry at the University of California in La Jolla, California
- Dr. Depp is with the Department of Psychiatry at the University of California in La Jolla, California, and Veterans Affairs San Diego Healthcare System in La Jolla, California
- Ms. Parrish is with the Joint Doctoral Program in Clinical Psychology at San Diego State University /University of California, San Diego
- Dr. Pinkham is with the University of Texas at Dallas in Richardson, Texas, and the UT Southwestern Medical Center in Dallas, Texas
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Yen CF, Liao HY, Lee Y, Hsu ST. Loneliness in patients with schizophrenia. TAIWANESE JOURNAL OF PSYCHIATRY 2021. [DOI: 10.4103/tpsy.tpsy_14_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Gee BL, Han J, Benassi H, Batterham PJ. Suicidal thoughts, suicidal behaviours and self-harm in daily life: A systematic review of ecological momentary assessment studies. Digit Health 2020; 6:2055207620963958. [PMID: 33224516 PMCID: PMC7649887 DOI: 10.1177/2055207620963958] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2019] [Accepted: 09/11/2020] [Indexed: 12/13/2022] Open
Abstract
Background Ecological Momentary Assessments (EMA) offer an approach to understand the daily risk factors of suicide and self-harm of individuals through the use of self-monitoring techniques using mobile technologies. Objectives This systematic review aimed to examine the results of studies on suicidality risk factors and self-harm that used Ecological Momentary Assessments. Methods Pubmed and PsycINFO databases were searched up to April 2020. Bibliographies of eligible studies were hand-searched, and 744 abstracts were screened and double-coded for inclusion. Results The 49 studies using EMA included in the review found associations between daily affect, rumination and interpersonal interactions and daily non-suicidal self-injury (NSSI). Studies also found associations between daily negative affect and positive affect, social support, sleep, and emotions and a person's history of suicide and self-harm. Associations between daily suicide thoughts and self-harm, and psychopathology factors measured at baseline were also observed. Conclusions Research using EMA has the potential to offer clinicians the ability to understand the daily predictors, or risk factors, of suicide and self-harm. However, there are no clear reporting standards for EMA studies on risk factors for suicide. Further research should utilise longitudinal study designs, harmonise datasets and use machine learning techniques to identify patterns of proximal risk factors for suicide behaviours.
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Affiliation(s)
- Brendan Loo Gee
- Centre for Mental Health Research, Australian National University, Acton, Australia.,Australasian Institute of Digital Health, Level 1, 85 Buckhurst Street, South Melbourne, Australia
| | - Jin Han
- Black Dog Institute, University of New South Wales, New South Wales, Australia
| | - Helen Benassi
- Centre for Mental Health Research, Australian National University, Acton, Australia
| | - Philip J Batterham
- Centre for Mental Health Research, Australian National University, Acton, Australia
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Mote J, Fulford D. Ecological momentary assessment of everyday social experiences of people with schizophrenia: A systematic review. Schizophr Res 2020; 216:56-68. [PMID: 31874743 DOI: 10.1016/j.schres.2019.10.021] [Citation(s) in RCA: 62] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2019] [Revised: 08/28/2019] [Accepted: 10/03/2019] [Indexed: 12/22/2022]
Abstract
INTRODUCTION Our goal in the current review was to summarize the existing literature on the utility of ecological momentary assessment (EMA) in assessing the social experiences of people with schizophrenia (SZ). We were further interested in examining the associations between EMA-reported social outcomes and traditional assessments of social functioning. METHODS We conducted a systematic review of EMA studies published between January 1, 1990 and October 31, 2018 from PubMed and PsycINFO electronic databases. We included EMA studies that assessed social experiences (proportion of time spent alone/with others, affective experiences when with others, social stress, factors related to social experiences) in people with SZ. We included studies that examined associations between laboratory-based, self-report, or clinical assessments of functioning with EMA-reported social experiences. RESULTS We identified 22 EMA studies for inclusion in this review. Though heterogeneous in aspects of social experiences assessed, the current literature suggests that people with SZ report more social stress and a preference to be alone when they are with others (nine out of 10 studies). People with SZ report more positive affect when they are with others compared to being alone, and equivalent amounts of positive affect during social experiences as healthy controls (all four studies assessed). Five studies assessed the coherence between functioning assessments and momentary social experiences, with mixed results. CONCLUSION We discuss limitations of the literature and future directions. EMA shows promise in assessing more granular aspects of social experience (including social stress and social pleasure) in people with SZ compared to other methods.
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Affiliation(s)
- Jasmine Mote
- Sargent College of Health and Rehabilitation Sciences, Boston University, 635 Commonwealth Avenue, Boston, MA, 02215, USA.
| | - Daniel Fulford
- Sargent College of Health and Rehabilitation Sciences, Boston University, 635 Commonwealth Avenue, Boston, MA, 02215, USA; Department of Psychological & Brain Sciences, Boston University, 64 Cummington Mall, Boston, MA, 02215, USA
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Kumar P, Tiwari D, Patel V, Vasavada D. A case report on acute and transient psychotic disorder due to coronavirus disease 2019 quarantine. JOURNAL OF MENTAL HEALTH AND HUMAN BEHAVIOUR 2020. [DOI: 10.4103/jmhhb.jmhhb_138_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Mote J, Gard DE, Gonzalez R, Fulford D. How did that interaction make you feel? The relationship between quality of everyday social experiences and emotion in people with and without schizophrenia. PLoS One 2019; 14:e0223003. [PMID: 31568483 PMCID: PMC6768461 DOI: 10.1371/journal.pone.0223003] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2019] [Accepted: 09/11/2019] [Indexed: 12/27/2022] Open
Abstract
People with schizophrenia report positive emotion during social interactions in ecological momentary assessment (EMA) studies; however, few of these studies examine the qualities of social interactions (e.g., intimacy) that may affect emotion experience. In the current EMA study, people with (n = 20) and without schizophrenia (n = 15) answered questions about the quality of their social interactions, including their emotion experiences. We also explored the relationship between EMA-reported social experiences and trait loneliness, negative symptoms, and social functioning. People with and without schizophrenia did not differ in EMA-reported proportion of time spent with others, extent of involvement during social interactions, intimacy of interactions, or average number of social interactions. Both people with and without schizophrenia reported more positive than negative emotion during social experiences. However, people with schizophrenia reported more loneliness, more severe negative symptoms, and impaired social functioning compared to people without schizophrenia. Further, specific qualities of social interactions (intimacy of interaction, involvement during interaction) were related to happiness during interactions only in people without schizophrenia. These results suggest that while people with and without schizophrenia report similar rates of in-the-moment social emotion experiences, the impact of social interaction quality on emotion may differ between groups.
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Affiliation(s)
- Jasmine Mote
- Sargent College of Health & Rehabilitation Sciences, Boston University, Boston, Massachusetts, United States of America
- * E-mail:
| | - David E. Gard
- Department of Psychology, San Francisco State University, San Francisco, California, United States of America
| | - Rachel Gonzalez
- Department of Psychology, San Francisco State University, San Francisco, California, United States of America
| | - Daniel Fulford
- Sargent College of Health & Rehabilitation Sciences, Boston University, Boston, Massachusetts, United States of America
- Department of Psychological & Brain Sciences, Boston University, Boston, Massachusetts, United States of America
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Harvey PD, Deckler E, Jones MT, Jarskog LF, Penn DL, Pinkham AE. Autism symptoms, depression, and active social avoidance in schizophrenia: Association with self-reports and informant assessments of everyday functioning. J Psychiatr Res 2019; 115:36-42. [PMID: 31102902 PMCID: PMC6556410 DOI: 10.1016/j.jpsychires.2019.05.010] [Citation(s) in RCA: 46] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2019] [Revised: 04/01/2019] [Accepted: 05/09/2019] [Indexed: 11/25/2022]
Abstract
Autistic traits are a feature of schizophrenia and has been found to impair social functioning and social cognition. Other influences on social outcomes in schizophrenia include depression and social avoidance. However, challenges in self-assessment of abilities and functioning (i.e., introspective accuracy) and self-assessment bias also contribute to disability. Depression has been studied for its association with introspective accuracy and bias, but autistic traits have not. Participants were 177 patients with schizophrenia who self-reported their everyday functioning and social cognitive ability as well as their depression. All were rated with the PANSS and a separate rater generated all-sources ratings of everyday functioning and social cognitive ability. Correlations between self-reported everyday functioning and social cognitive ability, ratings of everyday functioning and social cognitive ability, and the discrepancies between those ratings were examined for correlations with depression, autistic features and social avoidance. Accuracy was defined by the absolute value of the difference between self-reports and all-sources ratings and bias was defined by the direction of discrepancy (positive vs. negative). There was a statistically significant difference between sources on every measure. Bias was not directional on average, but patients with the lowest levels of depression overestimated their abilities on every measure and those with the highest depression underestimated. Autistic traits were associated with impairments in everyday functioning and underestimation of those impairments, while social avoidance was associated with impaired social functioning and accurate self-assessment. Features of schizophrenia have differential implications for impaired functioning and self-assessment, with autistic features and low levels of depression associated with consistent self-assessment biases.
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Affiliation(s)
- Philip D Harvey
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, USA; Research Service, Miami VA Healthcare System, USA.
| | - Elizabeth Deckler
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Mackenzie T Jones
- Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, USA
| | - L Fredrik Jarskog
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA
| | - David L Penn
- Department of Psychology, University of North Carolina, Chapel Hill, NC, USA; School of Psychology, Australian Catholic University, Melbourne, VIC, Australia
| | - Amy E Pinkham
- School of Behavioral and Brain Sciences, The University of Texas at Dallas, Richardson, TX, USA; Department of Psychiatry, University of Texas Southwestern Medical School, Dallas, TX, USA
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Robertson I, Cheung A, Fan X. Insomnia in patients with schizophrenia: current understanding and treatment options. Prog Neuropsychopharmacol Biol Psychiatry 2019; 92:235-242. [PMID: 30707986 DOI: 10.1016/j.pnpbp.2019.01.016] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/08/2018] [Revised: 01/11/2019] [Accepted: 01/28/2019] [Indexed: 12/21/2022]
Abstract
In patients with schizophrenia, insomnia is a common yet often overlooked comorbidity. With sleep disturbances inextricably linked to increased severity of schizophrenia and worsening clinical outcomes, insomnia is an important therapeutic target within this patient population. Thus, through a review of the current literature, this paper reiterates the important etiological link between these two conditions, while evaluating the safety, efficacy, and limitations of current therapeutic options for the treatment of comorbid insomnia in schizophrenia. Despite the continued use of benzodiazepine receptor agonists (BZRAs) for insomnia, the use of other therapies such as Cognitive Behavioral Therapy for Insomnia (CBT-I) and suvorexant warrants increased consideration. More large-scale clinical trials are needed to assess the efficacy of such therapeutic options in the schizophrenia patient population.
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Affiliation(s)
- Ian Robertson
- Uniformed Services, University of the Health Sciences, School of Medicine, Bethesda, MD, USA
| | - Amy Cheung
- University of Massachusetts, Medical School/UMass Memorial Medical Center, Worcester, MA, USA
| | - Xiaoduo Fan
- University of Massachusetts, Medical School/UMass Memorial Medical Center, Worcester, MA, USA.
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An Overview of the Evidence for Psychological Interventions for Psychosis: Results From Meta-Analyses. CLINICAL PSYCHOLOGY IN EUROPE 2019. [DOI: 10.32872/cpe.v1i1.31407] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Abstract
There are numerous psychological approaches to psychosis that differ in focus, specificity and formats. These include psychodynamic, humanistic, cognitive-behavioural and
third-wave-approaches, psychoeducation, various types of training-based approaches and family interventions.
We briefly describe the main aims and focus of each of these approaches, followed by a review of their evidence-base in regard to improvement in symptoms, relapse and
functioning. We conducted a systematic search for meta-analyses dating to 2017 for each of the approaches reviewed. Where numerous meta-analyses for an approach were available,
we selected the most recent, comprehensive and methodologically sound ones.
We found convincing short- and long-term evidence for cognitive behavioural approaches if the main aim is to reduce symptom distress. Evidence is also strong for psychoeducative
family interventions that include skills training if the main aim is to reduce relapse and rehospitalisation. Acceptance and commitment therapy, mindfulness-based approaches,
meta-cognitive and social skills training, as well as systemic family interventions, were also found to be efficacious, depending on the outcome of interest, but meta-analyses
for these approaches were based on a comparatively lower number of outcome studies and a narrower selection of outcome measures. We found no convincing evidence for
psychodynamic approaches, humanistic approaches or patient-directed psychoeducation (without including the family).
An array of evidence-based psychological therapies is available for psychotic disorders from which clinicians and patients can choose, guided by the strength of the evidence and
depending on the outcome area focused on. Increased effort is needed in terms of dissemination and implementation of these therapies into clinical practice.
Meta-analyses show convincing evidence for CBT if the main target is psychotic symptoms.
Meta-analyses show convincing evidence for family interventions if the main target is relapse.
Effects are promising for ACT, mindfulness-based and systemic approaches, but more research is needed.
The array of effective approaches allows clinicians and patients to select the most appropriate one.
Meta-analyses show convincing evidence for CBT if the main target is psychotic symptoms.
Meta-analyses show convincing evidence for family interventions if the main target is relapse.
Effects are promising for ACT, mindfulness-based and systemic approaches, but more research is needed.
The array of effective approaches allows clinicians and patients to select the most appropriate one.
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Depp CA, Villa J, Schembari BC, Harvey PD, Pinkham A. Social cognition and short-term prediction of suicidal ideation in schizophrenia. Psychiatry Res 2018; 270:13-19. [PMID: 30243127 PMCID: PMC6376982 DOI: 10.1016/j.psychres.2018.09.005] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2018] [Revised: 07/27/2018] [Accepted: 09/03/2018] [Indexed: 02/08/2023]
Abstract
Despite recent research acknowledging social cognition as an important feature of interpersonal functioning in schizophrenia, little work has evaluated the role of social cognition in suicidal ideation and behavior in psychosis. In a short-term longitudinal study, we evaluated the association between concurrent and near term suicidal ideation with social cognition, including emotion recognition and related biases (ER-40; BLERT), attribution biases (AIHQ), and evaluations of trustworthiness (trustworthiness task) in a sample of 179 outpatients with schizophrenia or schizoaffective disorder. Adjusting for severity of positive and general mental health symptoms, greater reactivity to extreme stimuli (trustworthiness measure), BLERT negative affect accuracy, and AIHQ Blame Scores were associated with suicidal ideation at baseline. AIHQ Blame Scores also longitudinally predicted the presence of ideation 2 weeks later and were highest among participants with ideation across the two time points. The present findings provide support that biased interpretations, and, concurrently with ideation, reactivity and selective accuracy to negative stimuli, are associated with suicidal ideation in schizophrenia. Further understanding the role of social cognitive ability and biases on suicidal ideation could contribute to the understanding of social cognition as a treatment target in prevention of suicidal behavior in schizophrenia.
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Affiliation(s)
- Colin A Depp
- Department of Psychiatry, UC San Diego, 9500 Gilman Drive, La Jolla, CA 92093-0664, United States; VA San Diego Healthcare System, San Diego, CA, United States.
| | - Jennifer Villa
- Department of Psychology, San Diego State University, San Diego, CA, United States
| | | | - Philip D Harvey
- Research Service, Bruce W. Carter Veterans Affairs (VA) Medical Center, Miami, FL, United States; Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Amy Pinkham
- School of Behavioral and Brain Sciences, The University of Texas at Dallas, Richardson, TX, United States
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Villa J, Pinkham AE, Kaufmann CN, Granholm E, Harvey PD, Depp CA. Interpersonal beliefs related to suicide and facial emotion processing in psychotic disorders. J Psychiatr Res 2018; 100. [PMID: 29514121 PMCID: PMC5962269 DOI: 10.1016/j.jpsychires.2018.02.016] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Deficits in social cognition are present in psychotic disorders; moreover, maladaptive interpersonal beliefs have been posited to underlie risk of suicidal ideation and behavior. However, the association between social cognition and negative appraisals as potential risk factors for suicidal ideation and behavior in psychotic disorders has not been assessed. In a pilot study, we assessed accuracy and error biases in facial emotion recognition (Penn ER-40), maladaptive interpersonal beliefs as measured by the Interpersonal Needs Questionnaire (INQ), and current suicide ideation and history of past attempts in a sample of 101 outpatients with psychotic disorders (75 schizophrenia/schizoaffective; 26 bipolar disorder). INQ scores were positively associated with history of suicide attempts and current ideation. INQ scores were inversely related with emotion recognition accuracy yet positively correlated with bias toward perceiving anger in neutral expressions. The association between biases pertaining to anger and INQ scores persisted after adjusting for global cognitive ability and were more evident in schizophrenia than in bipolar disorder. The present findings suggest that maladaptive beliefs are associated with a tendency to misperceive neutral stimuli as threatening and are associated with suicidal ideation and behavior. Although better cognitive ability is associated with higher rates of suicide attempts in psychotic disorders, biases in misinterpreting anger in others may be a specific deficit related to formation of maladaptive beliefs about others, which, in turn, are associated with history of suicide attempts.
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Affiliation(s)
- Jennifer Villa
- Department of Psychology, San Diego State University, San Diego, CA, United States
| | - Amy E Pinkham
- School of Behavioral and Brain Sciences, The University of Texas at Dallas, Richardson, TX, United States
| | | | - Eric Granholm
- Department of Psychiatry, UC San Diego, La Jolla, CA, United States
| | - Philip D Harvey
- Research Service, Bruce W. Carter Veterans Affairs (VA) Medical Center, Miami, FL, United States; Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Colin A Depp
- Department of Psychiatry, UC San Diego, La Jolla, CA, United States; VA San Diego Healthcare System, San Diego, CA, United States.
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te Lindert BHW, Itzhacki J, van der Meijden WP, Kringelbach ML, Mendoza J, Van Someren EJW. Bright environmental light ameliorates deficient subjective ‘liking’ in insomnia: an experience sampling study. Sleep 2018; 41:4841627. [DOI: 10.1093/sleep/zsy022] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2017] [Accepted: 02/13/2017] [Indexed: 12/20/2022] Open
Affiliation(s)
- Bart H W te Lindert
- Department of Sleep and Cognition, Netherlands Institute for Neuroscience, Amsterdam, The Netherlands
| | - Jacob Itzhacki
- Department of Sleep and Cognition, Netherlands Institute for Neuroscience, Amsterdam, The Netherlands
- Institute of Cellular and Integrative Neurosciences CNRS-UPR3212, University of Strasbourg, Strasbourg, France
| | - Wisse P van der Meijden
- Department of Sleep and Cognition, Netherlands Institute for Neuroscience, Amsterdam, The Netherlands
- Institute of Cellular and Integrative Neurosciences CNRS-UPR3212, University of Strasbourg, Strasbourg, France
- Center for Chronobiology, Psychiatric Hospital of the University of Basel, Basel, Switzerl
| | - Morten L Kringelbach
- Department of Psychiatry, Warneford Hospital, Oxford, United Kingdom
- Center for Music in the Brain (MIB), Aarhus University, Denmark
| | - Jorge Mendoza
- Institute of Cellular and Integrative Neurosciences CNRS-UPR3212, University of Strasbourg, Strasbourg, France
| | - Eus J W Van Someren
- Department of Sleep and Cognition, Netherlands Institute for Neuroscience, Amsterdam, The Netherlands
- Departments of Integrative Neurophysiology and Psychiatry, Neuroscience Campus Amsterdam, VU University and Medical Center, Amsterdam, the Netherlands
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Suvisaari J, Mantere O, Keinänen J, Mäntylä T, Rikandi E, Lindgren M, Kieseppä T, Raij TT. Is It Possible to Predict the Future in First-Episode Psychosis? Front Psychiatry 2018; 9:580. [PMID: 30483163 PMCID: PMC6243124 DOI: 10.3389/fpsyt.2018.00580] [Citation(s) in RCA: 52] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2018] [Accepted: 10/23/2018] [Indexed: 12/26/2022] Open
Abstract
The outcome of first-episode psychosis (FEP) is highly variable, ranging from early sustained recovery to antipsychotic treatment resistance from the onset of illness. For clinicians, a possibility to predict patient outcomes would be highly valuable for the selection of antipsychotic treatment and in tailoring psychosocial treatments and psychoeducation. This selective review summarizes current knowledge of prognostic markers in FEP. We sought potential outcome predictors from clinical and sociodemographic factors, cognition, brain imaging, genetics, and blood-based biomarkers, and we considered different outcomes, like remission, recovery, physical comorbidities, and suicide risk. Based on the review, it is currently possible to predict the future for FEP patients to some extent. Some clinical features-like the longer duration of untreated psychosis (DUP), poor premorbid adjustment, the insidious mode of onset, the greater severity of negative symptoms, comorbid substance use disorders (SUDs), a history of suicide attempts and suicidal ideation and having non-affective psychosis-are associated with a worse outcome. Of the social and demographic factors, male gender, social disadvantage, neighborhood deprivation, dysfunctional family environment, and ethnicity may be relevant. Treatment non-adherence is a substantial risk factor for relapse, but a small minority of patients with acute onset of FEP and early remission may benefit from antipsychotic discontinuation. Cognitive functioning is associated with functional outcomes. Brain imaging currently has limited utility as an outcome predictor, but this may change with methodological advancements. Polygenic risk scores (PRSs) might be useful as one component of a predictive tool, and pharmacogenetic testing is already available and valuable for patients who have problems in treatment response or with side effects. Most blood-based biomarkers need further validation. None of the currently available predictive markers has adequate sensitivity or specificity used alone. However, personalized treatment of FEP will need predictive tools. We discuss some methodologies, such as machine learning (ML), and tools that could lead to the improved prediction and clinical utility of different prognostic markers in FEP. Combination of different markers in ML models with a user friendly interface, or novel findings from e.g., molecular genetics or neuroimaging, may result in computer-assisted clinical applications in the near future.
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Affiliation(s)
- Jaana Suvisaari
- Mental Health Unit, National Institute for Health and Welfare, Helsinki, Finland
| | - Outi Mantere
- Mental Health Unit, National Institute for Health and Welfare, Helsinki, Finland.,Department of Psychiatry, McGill University, Montreal, QC, Canada.,Bipolar Disorders Clinic, Douglas Mental Health University Institute, Montreal, QC, Canada.,Department of Psychiatry, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Jaakko Keinänen
- Mental Health Unit, National Institute for Health and Welfare, Helsinki, Finland.,Department of Psychiatry, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Teemu Mäntylä
- Mental Health Unit, National Institute for Health and Welfare, Helsinki, Finland.,Department of Neuroscience and Biomedical Engineering, and Advanced Magnetic Imaging Center, Aalto NeuroImaging, Aalto University School of Science, Espoo, Finland.,Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
| | - Eva Rikandi
- Mental Health Unit, National Institute for Health and Welfare, Helsinki, Finland.,Department of Neuroscience and Biomedical Engineering, and Advanced Magnetic Imaging Center, Aalto NeuroImaging, Aalto University School of Science, Espoo, Finland.,Department of Psychology and Logopedics, University of Helsinki, Helsinki, Finland
| | - Maija Lindgren
- Mental Health Unit, National Institute for Health and Welfare, Helsinki, Finland
| | - Tuula Kieseppä
- Mental Health Unit, National Institute for Health and Welfare, Helsinki, Finland.,Department of Psychiatry, Faculty of Medicine, University of Helsinki, Helsinki, Finland
| | - Tuukka T Raij
- Mental Health Unit, National Institute for Health and Welfare, Helsinki, Finland.,Department of Neuroscience and Biomedical Engineering, and Advanced Magnetic Imaging Center, Aalto NeuroImaging, Aalto University School of Science, Espoo, Finland
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Moore RC, Swendsen J, Depp CA. Applications for self-administered mobile cognitive assessments in clinical research: A systematic review. Int J Methods Psychiatr Res 2017; 26:e1562. [PMID: 28370881 PMCID: PMC5623609 DOI: 10.1002/mpr.1562] [Citation(s) in RCA: 72] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2016] [Revised: 12/28/2016] [Accepted: 02/17/2017] [Indexed: 11/09/2022] Open
Abstract
Frequent, brief and repeated self-administered mobile assessments of cognitive function, conducted in everyday life settings, are a promising complementary tool to traditional assessment approaches. Mobile cognitive assessments promote patient-centered care and might enhance capacity to inform individual-level outcomes over time (i.e. detecting subtle declines in cognitive function), as well as in assessing cognition and its correlates in the naturalistic environment. The goal of this systematic review was to assess the feasibility and psychometric properties of mobile cognitive assessments. Through a comprehensive search, we identified 12 articles using self-administered, mobile phone-based cognitive assessments. Studies sampled participants between 1 and 6 times per day for 1-14 days. Samples ranged in age from 14 to 83 years old and were generally healthy populations without cognitive impairment. Working memory was the most frequently-assessed cognitive domain (n = 7), followed by attention/reaction time (n = 4). Seven studies reported adherence, with mean adherence rates of 79.2%. In addition to positive evidence of feasibility, there was general support for high levels of between- and within-person reliability and construct validity. While research has only begun to explore the utility of mobile cognitive assessments, studies to-date indicate they may be a promising complementary tool to traditional assessment methods with potential to improve clinical care and research.
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Affiliation(s)
- Raeanne C Moore
- Department of Psychiatry, University of California, San Diego, California, USA.,VA San Diego Healthcare System, San Diego, California, USA
| | - Joel Swendsen
- National Center for Scientific Research, University of Bordeaux, EPHE, Bordeaux, France
| | - Colin A Depp
- Department of Psychiatry, University of California, San Diego, California, USA.,VA San Diego Healthcare System, San Diego, California, USA
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Moitra E, Gaudiano BA, Davis CH, Ben-Zeev D. Feasibility and acceptability of post-hospitalization ecological momentary assessment in patients with psychotic-spectrum disorders. Compr Psychiatry 2017; 74:204-213. [PMID: 28231480 PMCID: PMC5369417 DOI: 10.1016/j.comppsych.2017.01.018] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Revised: 12/12/2016] [Accepted: 01/30/2017] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Up to 50% of patients with psychotic-spectrum disorders are medication nonadherent. The use of real-time assessment via ecological momentary assessment (EMA) on mobile devices might offer important insights into adherence behaviors that cannot be measured in the clinic. However, existing EMA studies have only studied acutely ill patients during hospitalization or more stable patients in the community. METHODS Feasibility and acceptability of EMA in 65 patients with psychotic-spectrum disorders who were recently discharged from the hospital were assessed. EMA was administered for four weeks via study-provided mobile devices. Feasibility was measured by study recruitment/retention rates, patients' connectivity, and completion rates. Quantitative and qualitative acceptability data were collected. RESULTS Participants completed 28-31% of offered EMA assessments. The only significant predictor of reduced EMA completion was recent cannabis use. EMA completion was maintained from weeks 1 to 3 but significantly dropped at the fourth week. Patient acceptability feedback was generally positive; negative comments related primarily to technological problems. CONCLUSIONS This was the first study to use EMA in recently discharged patients with psychotic-spectrum disorders. EMA is feasible and acceptable in this population, but completion rates were lower than in more stable samples. Future research should consider limiting the assessment period, screening for substance use, and integrating assessment with intervention elements to increase EMA engagement.
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Affiliation(s)
- Ethan Moitra
- Warren Alpert Medical School of Brown University, Providence, RI 02912, USA.
| | - Brandon A Gaudiano
- Warren Alpert Medical School of Brown University, Providence, RI 02912, USA; Butler Hospital, Providence, RI 02906, USA
| | | | - Dror Ben-Zeev
- Department of Psychiatry and Behavioral Sciences. University of Washington, Seattle, WA 98195 USA
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Bonet L, Izquierdo C, Escartí MJ, Sancho JV, Arce D, Blanquer I, Sanjuan J. Use of mobile technologies in patients with psychosis: A systematic review. REVISTA DE PSIQUIATRIA Y SALUD MENTAL 2017; 10:168-178. [PMID: 28258835 DOI: 10.1016/j.rpsm.2017.01.003] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2016] [Revised: 11/15/2016] [Accepted: 01/09/2017] [Indexed: 11/25/2022]
Abstract
There is a growing interest in mobile Health interventions (m-Health) in patients with psychosis. The aim of this study is to conduct a systematic review in order to analysethe current state of research in this area. The search of articles was carried out following the PRISMA criteria, focusing on those studies that used mobile technologies in patients with psychosis during the period from 1990 to 2016. A total of 20 articles were selected from the 431 studies found. Three types of studies are distinguished: 1) Analysis of quality and usability, 2) Improving treatment adherence and reducing hospital admissions, and 3) Analysisof patient symptoms. CONCLUSIONS m-Health interventions are feasible, and are easy to use for patients with psychosis. They evaluate the evolution of psychotic symptoms more efficiently, and improve adherence to treatment, as well as symptoms and hospital admissions. However, a particular strategy does not stand out over the rest, because differences in methodology make them difficult to compare.
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Affiliation(s)
| | | | - Maria Jose Escartí
- Hospital Clínico de Valencia, INCLIVA, Valencia, España; CIBERSAM, España
| | | | - David Arce
- Universidad Politécnica de Valencia, Valencia, España
| | | | - Julio Sanjuan
- Universidad de Valencia, Valencia, España; Hospital Clínico de Valencia, INCLIVA, Valencia, España; CIBERSAM, España.
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Seeman MV. Solitude and schizophrenia. PSYCHOSIS-PSYCHOLOGICAL SOCIAL AND INTEGRATIVE APPROACHES 2016. [DOI: 10.1080/17522439.2016.1264992] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Mary V. Seeman
- Department of Psychiatry, University of Toronto, Toronto, Canada
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