Social connectedness is increasingly understood to be a resilience factor that moderates vulnerability to poor physical and mental health. This study examines cognitive and affective processes that support normal socialization and social connectedness, and the impact of schizotypy, in well-functioning college students. In this study, a total of 824 college students completed a series of self-report questionnaires, and structural equation modeling was then employed to identify relationships between cognitive and affective empathy, alexithymia, distress tolerance, social connectedness, and schizotypy. Schizotypy is a trait-like condition, presumed to be genetic in origin, associated with the risk for schizophrenia. Like schizophrenia, schizotypy is thought to have three distinct dimensions or categories, termed positive, negative, and disorganized. Results indicate that the respective dimensions of schizotypy have different pathways to social connectedness, through both direct and indirect effects. Positive schizotypy exerts a counterintuitive positive influence on social connectedness, mediated by positive effects on cognitive empathy, but this is obscured by the high correlations between the schizotypal dimensions and the strong negative influences on empathy and social connectedness of the negative and disorganized dimensions, unless all those intercorrelations are taken into account. Overall, the pathways identified by structural equation modeling strongly support the role of empathy in mediating the impact of schizotypy on social connectedness. Implications for the etiology of social impairments in schizotypy, and for interventions to enhance social connectedness to improve quality of life and reduce health disparities in people at risk for severe mental illness, are discussed.

Even in nonclinical, undergraduate populations, subthreshold psychotic symptoms are related to cigarette smoking, and cigarette smokers are twice as likely to be considered at potentially higher risk for psychosis compared with noncigarette smokers. In summary, there may be a threshold whereby psychotic symptoms confer increased risk for nicotine consumption, with endorsement of a greater number of distressing subthreshold psychotic symptoms increasing the likelihood of cigarette use.

Health disparities associated with severe mental illness (SMI) have become a major public health concern. The disparities are not directly due to the SMI. They involve the same leading causes of premature death as in the general population. The causes of the disparities are therefore suspected to reflect differences in health-related behavior and resilience. As with other problems associated with SMI, studying non-clinical populations at risk for future onset provides important clues about pathways, from vulnerability to unhealthy behavior and compromised resilience, to poor health and reduced quality of life. The purpose of this study was to identify possible pathways in a sample of public university students. Four domains of biosystemic functioning with a priori relevance to SMI-related vulnerability and health disparities were identified. Measures reflecting various well-studied constructs within each domain were factor-analyzed to identify common sources of variance within the domains. Relationships between factors in adjacent domains were identified with linear multiple regression. The results reveal strong relationships between common factors across domains that are consistent with pathways from vulnerability to health disparities, to reduced quality of life. Although the results do not provide dispositive evidence of causal pathways, they serve as a guide for further, larger-scale, longitudinal studies to identify causal processes and the pathways they follow to health consequences.

I n medical school, one of us (NS) was advised by attending psychiatrists to ignore the content of voices and delusions, except to classify the latter as paranoid, grandiose, and so on. Beyond that, it was considered unnecessary to delve into what voices said or what material was contained in the delusions. To do so was a waste of time, as once the presence of hallucinations and/or delusions was established, it was only necessary to determine the presence of other symptoms that would clarify which diagnosis-containing psychosis as a symptom-was correct and, from there, which medications to order. It did not take this author long to question this approach. It was difficult to believe that someone reporting voices telling him to commit suicide was not also experiencing that same urge to do so. Likewise, it seemed that someone with a delusion of being married and having children and a career would also have those same desires. 1 A number of years from then, in the mid-1990s, a book called Cognitive-Behavioral Therapy for Schizophrenia was published (Kingdon, & Turkington, 1994). British authors David Kingdon and Douglas Turkington (cf., Kingdon & Turkington, 2002) described how the content of voices and delusions are important and are used to facilitate treatment efforts. Cognitive behavioral therapy for psychosis (CBTp) helps clients examine the beliefs associated with their voices and delusions by testing their veracity. Other British clinical research groups and clinicians (