Trajectories of schizotypy and their emotional and social functioning: An 18-month follow-up study

Dynamic interactions among schizotypal traits, affective and prodromal symptoms, social functioning in a large sample of college students: A cross-lagged panel network analysis

OBJECTIVE

Previous studies suggested that schizotypal traits are closely related with affective symptoms and social dysfunction in general population. However, the dynamic interactions among these variables across time remain unclear. This study aimed to investigate this issue using cross-sectional and longitudinal network analysis.

METHODS

A total of 9136 college students completed self-report scales measuring schizotypal traits, anxiety, depression, prodromal risk, and social functioning at timepoint 1 (T1) and six months later. Classical contemporaneous network analysis was used to estimate the associations among all variables at T1, and the cross-lagged panel network analysis was performed to estimate the predictive effects at follow-up. In addition, prodromal high-risk and low-risk subgroups at T1 were identified using Prodromal Questionnaire (PQ-16) to investigate differences on network constructs and edge weights using Network Comparison Tests (NCT).

RESULTS

Contemporaneous network showed that negative dimension of schizotypal traits, anxiety, and depression interacted and were all negatively correlated with social functioning. Of all the nodes in the network, interpersonal features of schizotypal traits was the most centralized. The results of cross-lagged network analysis further verified the predictive effect of personality traits and emotions on social function. In addition, NCT revealed significant difference between prodromal high-risk and low-risk subgroups in network structure and strength of edges connecting schizotypal traits, affective symptoms with prodromal risk, but not in global strength.

CONCLUSIONS

Our findings suggest that schizotypal traits, affective symptoms, and prodromal risk relate to social functioning, both independently and through their dynamic interactions.

Personality and help-seeking for psychological distress: a systematic review and meta-analysis

Introduction

The effective management of depression, anxiety, and other forms of psychological distress depends on individuals' readiness to seek and accept help for their mental suffering. Understanding which personality traits relate to help-seeking can help better tailor mental healthcare to individual needs. However, findings regarding associations of personality traits with help-seeking have been inconsistent.

Methods

This systematic review and meta-analysis focused on English-language research studies on the association of personality (encompassing personality disorders, Five Factor -Big Five- dimensions, and other measures of personality) with depression, anxiety, or unspecified psychological distress in adults aged 18 years and older. Procedures followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The search strategy included two concepts: personality and help-seeking and was carried out on PubMed, Embase, Web of Science, and PsycINFO. Reference tracking and searches on Google Scholar were additionally performed. Sufficiently homogeneous subsections were analyzed by meta-analysis.

Results

A total of 48 studies described in 47 records reported on the association between personality and help-seeking. Nine assessed personality disorders, 29 Five Factor dimensions, and 13 other personality constructs. Twenty-three studies investigated attitudes towards help-seeking while 25 studies investigated help-seeking behaviors. Of the studies investigating behavior, three used external observations, the rest relied on self-reports/clinician-administered questionnaires. Evidence highlighted a dissociation between attitudes and behavior for schizotypal and borderline personality disorders, and neuroticism, which displayed negative help-seeking attitudes but more help-seeking behavior. By contrast, paranoid, schizoid and obsessive-compulsive personality disorders related to both negative help-seeking attitudes and behavior across studies. Limited evidence linked extraversion to social support seeking and conscientiousness to care seeking behaviors. Meta-analyses on the Five Factor dimensions and help-seeking attitudes supported robust negative associations with neuroticism, as well as positive associations with agreeableness, albeit less reliably. Other personality traits mostly corroborated the above relationships, while also contributing new perspectives, such as help-seeking behavior's negative associations with reality weakness and cynicism, and positive associations with abasement and rigidity.

Discussion

Future research should investigate help-seeking behavior using external observations and longitudinal designs. Assessing personality in clinical settings can help identify populations at risk of keeping to themselves when mentally distressed.

Anhedonia Across and Beyond the Schizophrenia Spectrum

Anhedonia refers to the diminished ability to experience pleasure, and is a core feature of schizophrenia (SCZ). The neurocognitive and neural correlates of anhedonia remain elusive. Based on several influential theoretical models for negative symptoms, this selective review proposed four important neurocognitive domains, which may unveil the neurobiological mechanisms of anhedonia. The authors critically reviewed the current evidence regarding value representation of reward, prospection, emotion-behavior decoupling, and belief updating in the Chinese setting, covering both behavioral and neuroimaging research. We observed a limited application of the transdiagnostic approach in previous studies on the four domains, and the lack of adequate measures to tap into the expressivity deficit in SCZ. Despite many behavioral paradigms for these four domains utilized both social and non-social stimuli, previous studies seldom focused on the social-versus-non-social differentiation. We further advocated several important directions for future research.

Executively-mediated language skills are related to performance-based social functioning in the early psychosis spectrum

Social impairment is a core deficit in psychotic spectrum disorders (PSDs). Prior work shows that language abnormalities can predict psychosis onset and are related to social outcomes in PSDs. Few studies have investigated nuanced relationships between language/verbal abilities and social functioning in the early psychosis spectrum, including at-risk (schizotypy) and first episode of psychosis (FEP) individuals. This study aimed to examine the relationship to between language/verbal performance and performance-based and examiner-rated social functioning. We also aimed to replicate prior models that demonstrate neurocognition is related to social functioning through negative symptoms and social cognition. Low schizotypy (n = 42), high schizotypy (n = 44), and FEP (n = 15) participants completed a battery of language/verbal, social cognition, and social functioning measures. Regression analyses revealed that Proverb Test performance was uniquely and significantly associated with performance-based but not examiner-rated social functioning. Other language/verbal measures were not significantly related to social functioning. In mediational analyses, language/verbal performance was indirectly related to social functioning through negative traits, and also through social cognition. Findings extend support for negative symptom and social cognitive intervention in the early psychosis spectrum, and uniquely suggest that executively-mediated language skills may be an additional target to improve social functioning.

Predicting subclinical psychotic-like experiences on a continuum using machine learning

Previous studies applying machine learning methods to psychosis have primarily been concerned with the binary classification of chronic schizophrenia patients and healthy controls. The aim of this study was to use electroencephalographic (EEG) data and pattern recognition to predict subclinical psychotic-like experiences on a continuum between these two extremes in otherwise healthy people. We applied two different approaches to an auditory oddball regularity learning task obtained from N = 73 participants: A feature extraction and selection routine incorporating behavioural measures, event-related potential components and effective connectivity parameters; Regularisation of spatiotemporal maps of event-related potentials. Using the latter approach, optimal performance was achieved using the response to frequent, predictable sounds. Features within the P50 and P200 time windows had the greatest contribution toward lower Prodromal Questionnaire (PQ) scores and the N100 time window contributed most to higher PQ scores. As a proof-of-concept, these findings demonstrate that EEG data alone are predictive of individual psychotic-like experiences in healthy people. Our findings are in keeping with the mounting evidence for altered sensory responses in schizophrenia, as well as the notion that psychosis may exist on a continuum expanding into the non-clinical population.

The effect of effort-reward imbalance on brain structure and resting-state functional connectivity in individuals with high levels of schizotypal traits

INTRODUCTION

Effort-reward imbalance (ERI) is a typical psychosocial stress. Schizotypal traits are attenuated features of schizophrenia in the general population. According to the diathesis-stress model, schizotypal traits and psychosocial stress contribute to the onset of schizophrenia. However, few studies examined the effects of these factors on brain alterations. This study aimed to examine relationships between ERI, schizotypal traits and brain structures and functions.

METHODS

We recruited 37 (13 male, 24 female) participants with high levels of schizotypal traits and 36 (12 male, 24 female) participants with low levels of schizotypal traits by the Schizotypal Personality Questionnaire (SPQ). The Chinese school version of the effort-reward imbalance questionnaire (C-ERI-S) was used to measure ERI. We conducted the voxel-based morphometry (VBM) and whole brain resting-state functional connectivity (rsFC) analysis using reward or stress-related regions as seeds.

RESULTS

Participants with high levels of schizotypal traits were more likely to perceive ERI. The severity of ERI was correlated with grey matter volume (GMV) reduction of the left pallidum and altered rsFC among the prefrontal, striatum and cerebellum in participants with high levels of schizotypal traits.

CONCLUSION

ERI is associated with GMV reduction and altered rsFC in individuals with high levels of schizotypal traits.

Applying network analysis to investigate the links between dimensional schizotypy and cognitive and affective empathy

BACKGROUND

Although impairment in empathy has been reported in schizophrenia spectrum disorders, little is known about the relationship between empathy and schizotypal traits. This study examines this relationship by applying network analysis to a large sample collected at 18-months follow-up in a longitudinal dataset.

METHODS

One thousand four hundred and eighty-six college students were recruited and completed a set of self-reported questionnaires on empathy, schizotypy, depression, anxiety and stress. Networks were constructed by taking the subscale scores of these measures as nodes and partial correlations between each pair of nodes as edges. Network Comparison Tests were performed to investigate the differences between individuals with high and low schizotypy.

RESULTS

Cognitive and affective empathy were strongly connected with negative schizotypy in the network. Physical and social anhedonia showed high centrality measured by strength, closeness and betweenness while anxiety and stress showed high expected influence. Predictability ranged from 22.4% (personal distress) to 79.9% (anxiety) with an average of 54.4%. Compared with the low schizotypy group, the high schizotypy group showed higher global strength (S = 0.813, p < 0.05) and significant differences in network structure (M = 0.531, p < 0.001) and strength of edges connecting empathy with schizotypy (adjusted ps < 0.05).

LIMITATIONS

Only self-rating scales were used, and disorganized schizotypy was not included.

CONCLUSIONS

Our findings suggest that the cognitive and affective components of empathy and dimensions of schizotypy are closely related in the general population and their network interactions may play an important role in individuals with high schizotypy.

Role for Positive Schizotypy and Hallucination Proneness in Semantic Processing

Semantic processing underpins the organization of verbal information for both storage and retrieval. Deficits in semantic processing are associated with both the risk for and symptoms presented in schizophrenia. However, studies are mixed and could reflect the confounding effects of medication and symptom heterogeneity. Therefore, we considered whether two risk phenotypes, positive schizotypy and hallucinatory predisposition, present in the general population were associated with differential responding profiles for a semantic processing task. One hundred and eighty-three participants completed the Schizotypal Personality Questionnaire, Launay-Slade Hallucination Scale, National Adult Reading Test, a handedness measure, and a computerized semantic relatedness judgment task. Pairs of words were related through their dominant or subordinate meanings, or unrelated. Participants were divided into four groups using a mean split on cognitive-perceptual (positive) schizotypy and hallucination proneness. Significant differences between groups were found for reaction time on the semantic relatedness task, with the high cognitive-perceptual schizotypy groups responding significantly slower to all word pairs compared to their low scoring counterparts. There was some evidence that high hallucination proneness was associated with significantly faster reaction times which may reflect disinhibitive processes, however additional support is required. The results suggest that these two components of psychosis risk are associated with different patterns of responding to semantic processing. More diffuse activation of semantic information appeared to be associated with positive schizotypy, while those predisposed to hallucinations appeared to respond quicker. These results have significant implications in the re-conceptualization of hallucination proneness as distinct from positive schizotypy. Additional research is required to investigate the association between psychotic-like experiences separate from personality variables such as positive schizotypy and semantic processing.

A systematic review and narrative synthesis of data-driven studies in schizophrenia symptoms and cognitive deficits

To tackle the phenotypic heterogeneity of schizophrenia, data-driven methods are often applied to identify subtypes of its symptoms and cognitive deficits. However, a systematic review on this topic is lacking. The objective of this review was to summarize the evidence obtained from longitudinal and cross-sectional data-driven studies in positive and negative symptoms and cognitive deficits in patients with schizophrenia spectrum disorders, their unaffected siblings and healthy controls or individuals from general population. Additionally, we aimed to highlight methodological gaps across studies and point out future directions to optimize the translatability of evidence from data-driven studies. A systematic review was performed through searching PsycINFO, PubMed, PsycTESTS, PsycARTICLES, SCOPUS, EMBASE and Web of Science electronic databases. Both longitudinal and cross-sectional studies published from 2008 to 2019, which reported at least two statistically derived clusters or trajectories were included. Two reviewers independently screened and extracted the data. In this review, 53 studies (19 longitudinal and 34 cross-sectional) that conducted among 17,822 patients, 8729 unaffected siblings and 5520 controls or general population were included. Most longitudinal studies found four trajectories that characterized by stability, progressive deterioration, relapsing and progressive amelioration of symptoms and cognitive function. Cross-sectional studies commonly identified three clusters with low, intermediate (mixed) and high psychotic symptoms and cognitive profiles. Moreover, identified subgroups were predicted by numerous genetic, sociodemographic and clinical factors. Our findings indicate that schizophrenia symptoms and cognitive deficits are heterogeneous, although methodological limitations across studies are observed. Identified clusters and trajectories along with their predictors may be used to base the implementation of personalized treatment and develop a risk prediction model for high-risk individuals with prodromal symptoms.

Network structure of anticipatory pleasure and risk features: Evidence from a large college sample

Investigating the relationship between anticipatory pleasure deficits and risk features of mental disorders not only theoretically benefits the understanding of anhedonia, but could also facilitate early detection and intervention of mental disorders. Using network analysis, the present study examined the pattern of relationship between anticipatory pleasure and risk features of schizophrenia spectrum, depressive, anxiety, autism spectrum, and obsessive-compulsive disorders in a large sample of college students (n = 2152). It was found that interpersonal features of schizotypal personality traits and poor social skills of autistic traits showed strong correlation with low social anticipatory pleasure. Depressive symptoms severity was weakly associated with reduced abstract anticipatory pleasure, while obsessive-compulsive traits were weakly associated with high contextual anticipatory pleasure. No significant correlation was found between anxiety symptoms severity and anticipatory pleasure. Social anticipatory pleasure had the highest strength centrality among all anticipatory pleasure components, while interpersonal features of schizotypal personality traits had the highest strength centrality in the whole network. Our findings suggest that impaired anticipatory pleasure, especially social anticipatory pleasure, is a particular feature of schizotypal personality traits and autistic traits. Our findings may have implications for intervention in that the social component may be a target to improve anhedonia in individuals with schizotypal and autistic traits, while interpersonal features may be a key treatment target given that it was central to the relationship between anticipatory pleasure and risk features.

Associations of psychotic-like experiences, related symptoms, and working memory with functioning

This study examined the association of spatial working memory and attenuated psychotic-like experiences and related symptoms with social and role functioning. Findings from this study suggest that symptom dimensions and working memory impairment were associated with diminished functioning across a variety of domains. Specifically, negative symptoms and working memory impairment were inversely associated with both social and role functioning, whereas positive and disorganized symptoms showed inverse associations with social functioning only. Symptom dimensions did not moderate cognitive and functional variables, although working memory and attenuated clinical symptoms had an additive effect on functioning. Post-hoc analyses examining symptom dimensions simultaneously showed negative symptoms to be the variable most strongly predictive of overall functioning. These findings suggest that even in a non-clinical sample, sub-threshold psychosis symptoms and cognition may influence people’s social and role functioning.

Cognitive Functioning and Schizotypy: A Four-Years Study

Although there is ample evidence from cross-sectional studies indicating cognitive deficits in high schizotypal individuals that resemble the cognitive profile of schizophrenia-spectrum patients, there is still lack of evidence by longitudinal/follow-up studies. The present study included assessments of schizotypal traits and a wide range of cognitive functions at two time points (baseline and 4-years assessments) in order to examine (a) their stability over time, (b) the predictive value of baseline schizotypy on cognition at follow-up and (c) differences in cognition between the two time points in high negative schizotypal and control individuals. Only high negative schizotypal individuals were compared with controls due to the limited number of participants falling in the other schizotypal groups at follow-up. Seventy participants (mean age: 36.17; 70% females) were assessed at baseline and follow-up. Schizotypal traits were evaluated with the Schizotypal Personality Questionnaire. We found that schizotypal traits decreased over time, except in a sub-group of participants ("schizotypy congruent") that includes individuals who consistently meet normative criteria of inclusion in either a schizotypal or control group. In these individuals, negative schizotypy and aspects of cognitive-perceptual and disorganized schizotypy remained stable. The stability of cognitive functioning also varied over time: response inhibition, aspects of cued attention switching, set-shifting and phonemic/semantic verbal fluency improved at follow-up. High negative schizotypy at baseline predicted poorer response inhibition and semantic switching at follow-up while high disorganized schizotypy predicted poorer semantic processing and complex processing speed/set-shifting. The between-group analyses revealed that response inhibition, set-shifting and complex processing speed/set-shifting were poorer in negative schizotypals compared with controls at both time points, while maintaining set and semantic switching were poorer only at follow-up. Taken together, the findings show differential stability of the schizotypal traits over time and indicate that different aspects of schizotypy predict a different pattern of neuropsychological task performance during a 4-years time window. These results are of significant use in the formulation of targeted early-intervention strategies for high-risk populations.

Vulnerability to Psychosis, Ideas of Reference and Evaluation with an Implicit Test

BACKGROUND

Ideas of reference (IRs) are observed in the general population on the continuum of the psychotic phenotype (as a type of psychotic-like experiences, PLE). The instruments usually used to evaluate IRs show some problems: They depend on the cooperation of the participant, comprehension of items, social desirability, etc. Aims: The Testal emotional counting Stroop (TECS) was developed for the purpose of improving evaluation of individuals vulnerable to psychosis and its relationship with ideas of reference. The TECS (two versions) was applied as an implicit evaluation instrument for IRs and related processes for early identification of persons vulnerable to psychosis and to test the possible influence of emotional symptomatology.

METHOD

A total of 160 participants (67.5% women) from the general population were selected (Mean (M) = 24.12 years, standard deviation (SD) = 5.28), 48 vulnerable and 112 non-vulnerable.

RESULTS

Vulnerability to psychosis was related to greater latency in response to referential stimuli. Version 4 of the TECS showed a slight advantage in identifying more latency in response to referential stimuli among participants with vulnerability to psychosis (Cohen's d = 1.08). Emotional symptomatology (especially stress), and IQ (premorbid) mediated the relationship between vulnerability and IR response latency.

CONCLUSIONS

The application of the implicit Testal emotional counting Stroop test (TECS) is useful for evaluating processes related to vulnerability to psychosis, as demonstrated by the increased latency of response to referential stimuli.

Latent profile analysis of psychosis liability in a community-derived sample of adolescents: Links with mental health difficulties, suicidal ideation, bipolar-like experiences and psychotic-like experiences

AIM

The main goal of the present study was to explore the latent structure of schizotypy as an indicator of psychosis liability, in a community-derived sample of adolescents. Links to mental health difficulties, prosocial behaviour, suicidal ideation, bipolar-like experiences and psychotic-like experiences (PLEs) (severity and distress) were compared across schizotypy latent profiles.

METHOD

The present research included 1588 adolescents selected by a stratified random cluster sampling. The Oviedo Schizotypy Assessment Questionnaire (ESQUIZO-Q), The Paykel Suicide Scale (PSS), The Strengths and Difficulties Questionnaire (SDQ), The Prodromal Questionnaire-Brief (PQ-B), The Mood Disorder Questionnaire (MDQ), The Penn Matrix Reasoning Test (PMRT), The Family Affluence Scale-II (FAS-II), and The Oviedo Infrequency Scale (INF-OV) were used.

RESULTS

Using latent profile analysis four latent classes (LC) were identified: "Positive schizotypy" (14.1%, n = 224), "Low schizotypy" (51.9%, n = 825), "Social Disorganization schizotypy" (27.2%, n = 432), and "High schizotypy" (6.7%, n = 107). The "High schizotypy" class scored higher on several psychometric indicators of psychopathology (ie, mental health difficulties, suicide ideation, bipolar-like experiences and PLEs) relative to the other three LC.

CONCLUSION

Four groups of adolescents with different patterns of schizotypal traits and different clinical-pathological meaning were found. Deficits found across schizotypy latent profiles, resembling those found in patients with psychosis and ultra-high risk samples. The identification of homogeneous subgroups of adolescents potentially at risk for psychosis may help us in the prevention of psychotic-spectrum disorders and mental health problems.

Childhood maltreatment impacts the early stage of facial emotion processing in young adults with negative schizotypy

Childhood maltreatment (CM) is a factor of risk for psychosis and is associated with alterations in facial emotion processing.Negative symptoms of schizophrenia-spectrum disorders are associated with deficits in facial emotion processing, but research findings on schizotypy are mixed. This study examined the early stage of facial emotion processing in young adults with high levels of negative schizotypy (NS) and explored the impact of childhood maltreatment. On the basis of the Social and Physical Anhedonia subscales of the Chapman Psychosis-Proneness Scales, a total of 74 high-NS and 52 low-NS individuals were recruited to complete the Childhood Trauma Questionnaire and the dot-probe task. The P100 and N170 components of event-related potentials were measured to assess the processing of four facial expressions of emotion. The high-NS group showed significantly reduced P100 amplitudes for all facial expressions. Angry and fearful expressions elicited larger N170 amplitudes than disgusted and happy expressions. Happy expressions elicited shorter N170 latencies than disgusted expressions. Compared to the high-NS group without CM, the high-NS group with CM had a longer latency of P100. Individuals with high NS, compared to individuals with low NS, have impaired fundamental visual processing, but intact processing of facial figurations. Childhood maltreatment may be a factor responsible for the pathological state of the visual pathway in high NS group.

Examining the structure of ideas of reference in clinical and community samples

AIMS

This study addresses the psychometric properties of a Spanish validation of the REF scale of ideas of reference (IRs) in detecting and following at-risk mental states and psychosis.

METHODS

A total of 9447 participants were distributed in three groups: 676 patients with various diagnoses-154 with psychotic disorders, 6291 youths aged 11 to 20, and 2480 adult participants aged 21 to 84.

RESULTS

Youths had higher scores than adults on IRs, observing a progressive decrease and stabilization in the twenties. Exploratory factor analysis provided a structure for the overall IRs score, with five first-order dimensions and one second-order dimension. Confirmatory factor analysis supported the structure with excellent fit. The REF scale was invariant across sex and samples. The internal consistency of the complete scale was excellent and acceptable across the five first-order factors. Strong relationships were found with the positive dimension of the community assessment of psychic experience-42, as well as with aberrant salience. Low and moderate relationships were found with public self-consciousness, anxiety, and depression. Youths and patients diagnosed with schizophrenia and other psychotic disorders had a high mean IRs frequency. Male sex, greater age (among the adults), and the "causal explanations", "Songs, newspapers, books" and "laughing and commenting" REF subscales showed predictive power in the diagnostic categories of schizophrenia and other psychotic disorders.

CONCLUSIONS

The results provide satisfactory that the REF scale could be used to study psychosis.

Perspectives on Machine Learning for Classification of Schizotypy Using fMRI Data

Functional magnetic resonance imaging is capable of estimating functional activation and connectivity in the human brain, and lately there has been increased interest in the use of these functional modalities combined with machine learning for identification of psychiatric traits. While these methods bear great potential for early diagnosis and better understanding of disease processes, there are wide ranges of processing choices and pitfalls that may severely hamper interpretation and generalization performance unless carefully considered. In this perspective article, we aim to motivate the use of machine learning schizotypy research. To this end, we describe common data processing steps while commenting on best practices and procedures. First, we introduce the important role of schizotypy to motivate the importance of reliable classification, and summarize existing machine learning literature on schizotypy. Then, we describe procedures for extraction of features based on fMRI data, including statistical parametric mapping, parcellation, complex network analysis, and decomposition methods, as well as classification with a special focus on support vector classification and deep learning. We provide more detailed descriptions and software as supplementary material. Finally, we present current challenges in machine learning for classification of schizotypy and comment on future trends and perspectives.

Negative Schizotypy and Altered Functional Connectivity During Facial Emotion Processing

BACKGROUND

Impairment in facial emotion perception is an important domain of social cognition deficits in schizophrenia. Although impaired facial emotion perception has been found in individuals with negative schizotypy (NS), little is known about the corresponding change in brain functional connectivity.

METHODS

Sixty-four participants were classified into a high NS group (n = 34) and a low NS group (n = 30) based on their total scores on the Chapman scales for physical and social anhedonia. All participants undertook a facial emotion discrimination functional imaging task that consisted of four emotional valences (angry, fear, happy, and neutral). For univariate analysis, the signal change at the bilateral amygdala was compared for each emotional contrast using SPSS (P < .05). For the functional connectivity analysis, we calculated the beta-series functional connectivity of the bilateral amygdala with the medial prefrontal cortex (mPFC) and compared the group differences in SPM12 (P < .05, small volume family-wise error correction).

RESULTS

No significant differences were found between the high and low NS groups in accuracy and reaction time in the facial emotion discrimination task. The high NS group showed reduced brain activations at the amygdala under fearful and neutral conditions. Reduced functional connectivity between the amygdala and the mPFC/dorsal anterior cingulate cortex under the happy and fearful conditions in the high NS group was also found.

CONCLUSIONS

Our findings suggest that the individuals with high NS showed altered brain activity and functional connectivity at the amygdala during facial emotion processing and provide new evidence for understanding social cognition deficits in at-risk individuals.