Quality versus quantity: Determining real-world social functioning deficits in schizophrenia

Abel, Danielle B; Salyers, Michelle P.; Wu, Wei; Monette, Mahogany A.; Minor, Kyle S.

doi:10.1016/j.psychres.2021.113980

Cited by 22 publications

(14 citation statements)

References 54 publications

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“…Aside from our results on SAF, our daily diary findings converge with other literature on social interactions in SSDs, lending support to our approach. Specifically, first, we find no group differences in the number of meaningful social interactions experienced, which is supported by recent work demonstrating that clinical status does not predict frequency of social interactions 69,70 . Second, similar to non-SSDs, individuals with SSDs demonstrated similar rates of forecasting more social interactions than they engaged in and also of engaging in more social interactions than what they forecasted, which is similar to a recent finding by Merchant et al 71 (although no control group was used here).…”

Section: Discussionsupporting

confidence: 83%

Social affective forecasting and social anhedonia in schizophrenia-spectrum disorders: a daily diary study

et al. 2022

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Social anhedonia (SA) is a trait-like phenomenon observed across schizophrenia-spectrum disorders (SSDs). While in-the-moment social pleasure experiences are intact in SSDs, anticipatory pleasure experiences may be disrupted. Thus, the prediction of future emotions in social situations, or social affective forecasting (SAF), may play a role in SA. Therefore, we utilized daily diary methods to examine SAF in SSD and the association between SAF and SA in 34 SSD and 43 non-SSD individuals. SAF was calculated as the absolute difference between anticipatory and consummatory ratings of 13 positive and negative emotions for daily social interactions reported across eight days. Results suggest that individuals with SSDs are less accurate in forecasting negative, but not positive emotions, for future social interactions. Further, poorer forecasting accuracy of negative emotions were associated with elevated levels of SA and lower social pleasure. Together, these data suggest that inaccuracies in forecasting negative emotions may be a worthwhile intervention target for reducing SA in SSDs.

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Section: Discussionsupporting

confidence: 83%

Social affective forecasting and social anhedonia in schizophrenia-spectrum disorders: a daily diary study

et al. 2022

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“…These findings aligned with past EAR assessment studies (Manson & Robbins, 2017; Minor et al, 2020) and show that asking people to wear the EAR for extended periods is a viable strategy. Our group has also shown that having participants wear the EAR for 2 days yields enough data to select social interactions, as a recent study found that our strategy resulted in a mean of >6 recorded interactions per week in those with schizophrenia (Abel et al, 2021).…”

Section: Discussionmentioning

confidence: 74%

“…Two-day intervals were selected because this time frame has exhibited good temporal stability (Mehl & Robbins, 2012), convergence with 4-week intervals (Mehl et al, 2012), and provided ample social interactions for use in therapy in our team’s pilot work. Further, a recent assessment study from our group demonstrated that this 2-day recording interval captured an average of >6 social interactions in people with schizophrenia (Abel et al, 2021).…”

Section: Methodsmentioning

confidence: 99%

“…This strategy was implemented to control for effects of the EAR itself (i.e., it allowed us to examine integrating the EAR in therapy rather than general EAR awareness). Although Hawthorne effects could still occur, past studies show that participants acclimate to the EAR after a few hours and report it has minimal effects on behavior (Abel et al, 2021; Mehl et al, 2012; Minor et al, 2018). In total, approximately 2 hr of audio was collected each week, with 5 min recordings at 90 min intervals from 6:00 a.m. to midnight…”

Section: Methodsmentioning

confidence: 99%

“…A methodology that has exhibited great promise for providing observations of real-world social behaviors is the Electronically Activated Recorder (EAR; Abel et al, 2021; Robbins et al, 2018, 2019). The EAR is a computer-based application that can be paired with widely used smartphone technology to collect behavioral samples at preprogrammed intervals using audio recordings (Mehl, 2017; Mehl et al, 2012).…”

Section: Study Objectives and Hypothesesmentioning

confidence: 99%

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Personalizing interventions using real-world interactions: Improving symptoms and social functioning in schizophrenia with tailored metacognitive therapy.

Minor¹,

Marggraf²,

Davis³

et al. 2022

Journal of Consulting and Clinical Psychology

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Objective: When clients' lives are not reflected in therapy, they struggle to apply the skills learned in treatment to everyday situations. In this pilot study, we determined if using clients' real-world interactions in therapy could effectively target metacognitive capacity-yielding improved symptoms and social functioning-by tailoring treatment to focus on issues faced by clients in daily life. Method: Using a randomized controlled trial design, schizophrenia subjects with metacognitive deficits completed 24 sessions of: (a) Standard Metacognitive Reflection and Insight Therapy (MERIT); or (b) Tailored MERIT. Real-world interactions were captured via the Electronically Activated Recorder (EAR), a smartphone application that passively records audio in daily life. All subjects wore the EAR; however, real-world interactions were only used to personalize sessions in Tailored MERIT. Results: Feasibility and acceptability were shown; those in Tailored MERIT wore the EAR 84% of their waking hours and reported minimal burden. When compared to Standard MERIT, Tailored MERIT participants showed large pre-post reductions in negative metacognitive beliefs and disorganized symptoms. Small, but nonsignificant, improvements in social functioning were also observed. Conclusions: Compared to an evidence-based benchmark, we observed that real-world interactions can be used to tailor metacognitive therapy and improve outcomes in schizophrenia. Tailored MERIT has the potential to impact practice by personalizing treatment to account for individual variations in environment and lifestyle-aligning with the Precision Medicine Initiative-in a way that is not possible with current therapy. This is particularly salient in schizophrenia, where limited insight and cognitive deficits often make subjective reporting unreliable.What is the public health significance of this article? This pilot study shows that tailoring a metacognitive intervention to improve social functioning and symptoms is both feasible and acceptable for schizophrenia. Compared to standard metacognitive therapy, our tailored intervention-which uses real-world interactions to personalize therapy sessionsled to reduced negative metacognitive beliefs and disorganized symptoms.

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Emotional Experience of People With Schizophrenia and People at Risk for Psychosis

Riehle,

Straková,

Lincoln

2024

JAMA Psychiatry

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ImportancePsychotic symptoms are associated with subjective reports of aberrant emotion, such as excessive fear or anhedonia, but whether these aberrations reflect aberrant emotional experience of normative stimuli is uncertain both for individuals with schizophrenia and those at risk for psychosis.ObjectiveTo provide a meta-analysis of study samples of emotional experience in individuals with schizophrenia and those at risk for psychosis as assessed in laboratory-based emotion-induction studies.Data SourcesMEDLINE and PsycINFO databases were searched for articles published from January 1986 and Google Scholar citations of a relevant earlier meta-analysis until August 2022. Reference lists were manually searched for additional studies.Study SelectionIncluded studies measured positive or negative emotional experience in response to standardized emotionally evocative stimuli and compared participants diagnosed with schizophrenia or participants at risk for psychosis with healthy controls.Data Extraction and SynthesisThe meta-analysis was registered with PROSPERO and followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses reporting guidelines. Data were extracted by 2 independent coders, and random-effects analyses were conducted.Main Outcomes and MeasuresOutcomes were 3 scales of emotional experience (unipolar positive emotion, unipolar negative emotion, bipolar valence), analyzed separately for pleasant, neutral, and unpleasant stimuli. A meta-analysis was conducted for differences between the 2 clinical groups combined and controls. Subgroup differences (schizophrenia vs at risk) and the influence of several other variables were tested in moderator analyses.ResultsThis systematic review and meta-analysis included data from 111 studies and 6913 participants (schizophrenia: 2848 [41.2%]; at risk: 877 [12.7%]; healthy controls: 3188 [46.1%]). Compared with controls, people with schizophrenia and those at risk for psychosis experienced pleasant stimuli as less positive (unipolar positive: standardized mean difference [SMD] Hedges g = −0.19; P =.001; bipolar valence: SMD Hedges g = −0.28; P &lt;.001) and more negative (Hedges g = 0.52; P &lt;.001), neutral stimuli as more negative (Hedges g = 0.55; P &lt;.001), and unpleasant stimuli as both more positive (unipolar positive: SMD Hedges g = 0.23; P =.005; bipolar valence: Hedges g = 0.12; P =.01) and more negative (Hedges g = 0.22; P &lt;.001). Moderator analyses indicated a less aberrant emotional experience for odors than for visual stimuli (unipolar negative, pleasant z score = −2.97; P =.003; unipolar negative, neutral z score = −2.70; P =.007), an association between higher negative symptoms and diminished positive emotion for pleasant stimuli in schizophrenia (z score = −2.98; P =.003), and that subgroup differences were limited to neutral stimuli.Conclusions and RelevanceResults suggest a pattern of aberrant emotional experience of normative stimuli in schizophrenia and that this already was observable before disorder onset. In particular, the aberrant experience of pleasant stimuli needs to be considered as an intervention target.

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Quality versus quantity: Determining real-world social functioning deficits in schizophrenia

Cited by 22 publications

References 54 publications

Social affective forecasting and social anhedonia in schizophrenia-spectrum disorders: a daily diary study

Social affective forecasting and social anhedonia in schizophrenia-spectrum disorders: a daily diary study

Personalizing interventions using real-world interactions: Improving symptoms and social functioning in schizophrenia with tailored metacognitive therapy.

Emotional Experience of People With Schizophrenia and People at Risk for Psychosis

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