Deficits In Social Functioning Research Articles

White matter organization abnormalities in adults with 47,XXX: a 7 Tesla MRI study

47,XXX (Triple X syndrome) is a sex chromosome aneuploidy characterized by the presence of a supernumerary X chromosome in affected females, and has been associated with a variable cognitive, behavioral, and psychiatric phenotype. Alterations in brain gray matter structure and function have been reported, but less is known about white matter (WM) organization in 47,XXX. Therefore, we conducted 7 T diffusion tensor imaging and characterized fractional anisotropy, mean diffusivity, axial diffusivity, and radial diffusivity of 22 adult women with 47,XXX and 22 age-matched typically developing females using tract-based spatial statistics. Relationships between phenotypic traits and WM organization characteristics in 47,XXX were also investigated. Adults with 47,XXX showed lower axial diffusivity in the body of the corpus callosum and the right superior longitudinal fasciculus. WM organization variability was not associated with IQ and social cognition and social functioning deficits in 47,XXX. Our findings indicate an effect of a supernumerary X chromosome in adult women on axonal integrity of the body of the corpus callosum and the right superior longitudinal fasciculus. These findings provide additional insight into the role of the X chromosome on WM organization. Future research is warranted to explore the clinical significant impact of altered WM organization in 47,XXX.

Unreal that feels real: artificial intelligence-enhanced augmented reality for treating social and occupational dysfunction in post-traumatic stress disorder and anxiety disorders

ABSTRACT Background: Fear- and trauma-related conditions, such as post-traumatic stress disorder (PTSD) and social phobia, often manifest as socially avoidant behaviours, which commonly contribute to social and occupational disability transdiagnostically. While gold-standard treatments (i.e. exposure therapy, psychotropic medications) are effective, they are hindered by high dropout rates and limited impact on real-world functioning. Furthermore, most existing interventions only target symptom reduction, with few addressing avoidance-related deficits in social and occupational functioning. Objectives: This methods paper introduces an innovative augmented reality exposure therapy (ARET) technology designed to address the limitations of traditional interventions for anxiety disorders and PTSD, by directly targeting social and occupational dysfunction through exposure to real-life social contexts. Method: We introduce an ARET system, using artificial intelligence (AI)-driven, augmented reality (AR) technology, that enables exposure to realistic scenarios within the patient's real-world environment, fostering contextual generalization and functional improvement. Featuring holographic three-dimensional humans, precise surface mapping, wireless mobility, and telemedicine capabilities, the software provides customizable exposure scenarios to transform an environment into various spaces (e.g. grocery store, house party) with diverse human characters, as well as flexible AI-driven human interactions tailored to individual needs. Results: We share observations and feedback from the treatment of first responders with PTSD. Patients found the technology easy to use, with immersive realism, active engagement, and strong emotional responses needed for effective exposure therapy. Advances in AI-driven character development and AR hardware accessibility support the wider adoption of ARET by clinicians. Conclusion: By bridging the gap between clinical interventions and real-world functioning, ARET offers a transformative approach to addressing the pervasive impact of psychiatric disorders on social and occupational outcomes.

Humor processing and its relationship with clinical features in patients with first-episode schizophrenia

Humor, a higher-order social cognitive process unique to humans, is commonly impaired in patients with chronic schizophrenia. However, humor processing and its association with the clinical characteristics in the early stage of the illness remain unknown. In this study, we investigated humor processing and its relationship with clinical features in patients with first-episode schizophrenia (FES). We recruited 45 patients with FES and 44 healthy controls matched for age, sex, and education level. The participants completed the Picture Humor Processing Task (HPT-p) and Video Humor Processing Task (HPT-v), which evaluated humor comprehension and appreciation, and a questionnaire assessing their humor styles. Clinical participants also completed clinical and social functioning measurements. Signal detection theory analysis was used to calculate the d' and β values, which represent the detection of humor signals in the comprehension phase and inner criteria of the humor appreciation phase, respectively. In the HPT-p, patients with FES showed a higher false alarm rate (p = 0.048) than healthy controls, whereas the hitting rate, signal recognition ability (d' value), and intrinsic evaluation criterion (β value) were comparable between the two participants groups. In the HPT-v, patients with FES showed lower within-group coherence in the funniness rating (p = 0.023) than healthy controls. In addition, the false alarm rate in the HPT-p and negative symptoms effectively predicted social functioning in patients with FES (R2 = 0.681, p < 0.001). Our results indicate that impairment of humor comprehension in patients with schizophrenia is generated in the first episode and contributes to social functioning deficits, which require early recognition and intervention.

Health-related quality of life in patients with progressive glioblastoma treated with combined bevacizumab and lomustine versus lomustine only: Secondary outcome of the randomized phase III EORTC 26101 study

Abstract Background Progression-free survival, but not overall survival, was prolonged with bevacizumab and lomustine compared to lomustine only in the randomized phase 3 European Organization for Research and Treatment of Cancer (EORTC) 26101 study. Objective To evaluate the impact of treatment on health-related quality of life (HRQoL) in progressive glioblastoma patients participating in the EORTC 26101 study. Methods Patients with progressive glioblastoma, after standard radio-chemotherapy, were 2:1 randomized to either BEV/LOM or LOM. HRQoL was a secondary trial outcome and assessed using the EORTC QLQ-C30 and QLQ-BN20 questionnaires at baseline, and subsequently every 12 weeks. Predefined scales for analysis were global health status (GH), physical functioning, social functioning (SF), motor dysfunction, and communication deficit. The primary endpoint was HRQoL during the last assessment up to week 36. Moreover, time to HRQoL deterioration (TTD) and HRQoL deterioration-free survival (DFS) were calculated. Results Out of 437 patients, 402 (92%) patients had a baseline HRQoL assessment, which dropped to 66% at week 36. During the last assessment up to week 36, no differences were observed for predefined scales, apart from SF being clinically relevant lower in the combination arm (mean 66.0 versus 81.0, p = .001). Of note, the baseline SF score was 66.4 for patients in the combination arm, showing stable SF. Median DFS was significantly longer in the combination arm (12.4 weeks) compared to lomustine alone (6.7 weeks), reflecting the difference in time to progression between arms. TTD, not including progression as an event, was not different between treatment arms (median 13.0 versus 12.9 weeks). Conclusion The addition of bevacizumab to lomustine did not negatively affect HRQoL during the progression-free period.

The effect of phencyclidine-mediated blockade of NMDA receptors in the early postnatal period on glutathione and sulfur amino acid levels in the rat brain as a potential causative factor of schizophrenia-like behavior in adulthood

BackgroundPhencyclidine, an NMDA receptor antagonist, is frequently used to model behavioral and neurochemical changes correlated with schizophrenia in laboratory animals. The present study aimed to examine the effects of repeated administration of phencyclidine during early postnatal development on the contents of glutathione and sulfur-containing amino acids, as well as the activity of antioxidant enzymes in the brain of 12-day-old rats, and schizophrenia-like symptoms in adulthood.MethodsMale Sprague-Dawley pups were administered phencyclidine (10 mg/kg) or saline subcutaneously on the postnatal days p2, p6, p9 and p12. In 12-day-old pups, 4 h after the last dose of phencyclidine, the levels of glutathione, cysteine, methionine, and homocysteine, and the enzymatic activity of superoxide dismutase (SOD), glutathione peroxidase (GPx), and glutathione reductase (GR) were measured in the frontal cortex, hippocampus, and striatum. In 70-72-day-old rats, schizophrenia-like symptoms were assessed using behavioral tests.ResultsBiochemical data showed that perinatal phencyclidine treatment significantly reduced glutathione and cysteine levels in all brain structures studied, methionine was diminished in the striatum, and homocysteine in both the frontal cortex and striatum. GR activity was increased in the frontal cortex while SODactivity was decreased in the hippocampus. Behaviorally, perinatal phencyclidine induced long-term deficits in social and cognitive function and a decrease in locomotor activity assessed as the time of walking. Finally, perinatal treatment with phencyclidine resulted in a significant reduction in body weight gain over time.ConclusionOur research provides further evidence for the usefulness of the phencyclidine-induced neurodevelopmental model of schizophrenia for studying the pathogenesis of schizophrenia.

Advancing the Measurement of Social Functioning in Schizophrenia: Applications of Egocentric Social Network Analysis.

People with schizophrenia face challenges with forming and maintaining social relationships, often resulting in poor social functioning. Commonly used measures of social functioning provide broad information relating to social relationships, but they do not adequately capture information regarding network structure and characteristics of network members. One method that can assess these more detailed aspects of social networks and provide a more comprehensive understanding of social functioning deficits is egocentric social network analysis (SNA). SNA is a scientific discipline that uses principles of network science and graph theory to analyze social relations quantitatively. Even though some types of SNA have been applied in prior schizophrenia studies, its application as a framework to measure social functioning has been extremely limited. Therefore, this article aims to formally introduce SNA and select quantitative SNA metrics, including measures of network composition, structure, homophily, and centrality, to schizophrenia researchers as novel ways of measuring components of social functioning. To demonstrate the application of SNA, we provide illustrative examples of the SNA metrics and graphical diagrams of social networks for two individuals with schizophrenia.

The association between psychopathology, childhood trauma, and emotion processing.

Childhood trauma is highly prevalent and can have a negative impact on the development of socioemotional processes resulting in a higher vulnerability for mental disorders in adulthood. Previous studies have associated the severity of childhood trauma with deficits in social functioning, such as a negative attention bias, suggesting altered social information processing as a mechanism underlying the association between childhood trauma and transdiagnostic psychopathologies. In a cross-sectional setup with a total of 103 participants (26 with major depressive disorder, MDD; 24 with posttraumatic stress disorder, PTSD; 22 with somatic symptom disorder, SDD; and 31 healthy volunteers, HV), this study applied eye tracking in an emotion recognition paradigm. Reaction times, accuracy, and gaze behavior were analyzed for 4 different facial expressions as a function of self-reported childhood trauma and diagnosis. The aim was to investigate to what extent emotion processing is associated with (a) childhood trauma, (b) psychopathology, and (c) respective interacting effects. Patients showed higher reaction times and error rates overall in classifying emotions than HVs, especially for the recognition of anger and fear. Individuals with a diagnosis of PTSD and MDD were particularly slow in their response to these emotions. Higher scores of reported childhood trauma were associated with faster responses for classifying anger and fear and slower initiation of eye movements for SSD, MDD, and HVs for anger. These findings indicate that childhood trauma may contribute to attentional and information-processing biases relevant for social interaction. Identifying individual social deficits offers implications for tailored therapeutic interventions. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

An Exploratory Investigation of Organic Chemicals Detected in Baby Teeth: Differences in Children with and without Autism.

Autism spectrum disorder (ASD) is a behaviorally defined neurodevelopmental disorder characterized by deficits in language, communication, and social function with an estimated prevalence rate of between 1 in 30 and 44 U.S. births. Gene/environment (G × E) interactions are widely regarded as the most probable explanation for idiopathic ASD, especially because some genes are selectively targeted by various environmental xenobiotics. Because deciduous teeth are a likely biomarker of in utero exposure, the present study investigated if the quantity of chemicals found in deciduous teeth differs between children with and without ASD. Twenty-two deciduous teeth from children with ASD and 20 teeth from typically developed children were prepared and analyzed using THE Two-Dimensional Gas Chromatography Time-of-Flight Mass Spectrometer (GC × GC-TOF MS) with ChromaTOF version 23H2 software and Agilent 7890 gas chromatograph. The autism sample had significantly more chemicals in their teeth than the typical developing sample (99.4 vs. 80.7, respectively) (p < 0.0001). The majority of chemicals were identified as phthalates, plasticizers, pesticides, preservatives, or intermediary solvents used in the production of fragranced personal care or cleaning products or flavoring agents in foods. The known toxic analytes reported in this study are likely biomarkers of developmental exposure. Why there were greater concentrations of toxic chemicals in the teeth that came from children with ASD is unclear. A further understanding of the cavalcade of multiple biological system interactions (Interactome) could help with future efforts to reduce risks. Notwithstanding, the avoidance of pesticides, plastics, and scented personal care products may be warranted under the precautionary principle rule.

Face processing in ADHD: A review of the N170 event-related potential.

Attention-deficit hyperactivity disorder (ADHD) is associated with deficits in social functioning, including peer difficulties and poor relationship quality. Little is known, however, about the integrity of foundational sociocognitive abilities that support interpersonal interactions in ADHD. Face processing-a fundamental component of social cognition-has been a popular topic of recent investigations in this area. Researchers have attempted to delineate face processing mechanisms in ADHD to elucidate social deficits often seen in the disorder. Investigating the N170 event-related potential, a neural marker of face processing, has been a popular approach in this endeavour. Here, we present two accounts that offer competing views of how social deficits might arise in those with ADHD. Next, we systematically review and synthesise the literature on the N170 in ADHD to identify whether atypicalities in sociocognitive domains like face processing occur in this patient population. Gaps in the literature are identified and concrete solutions are offered to improve future research in this area. We end by discussing immediate implications for treatment approaches designed to address widely observed social deficits in individuals with ADHD. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Social Interaction in Adolescent Rats with Neonatal Ethanol Exposure: Impact of Sex and CE-123, a Selective Dopamine Reuptake Inhibitor.

Children with fetal alcohol spectrum disorders (FASDs) demonstrate deficits in social functioning that contribute to early withdrawal from school and delinquency, as well as the development of anxiety and depression. Dopamine is involved in reward, motivation, and social behavior. Thus, we evaluated whether neonatal ethanol exposure (in an animal model of FASDs) has an impact on social recognition memory using the three-chamber social novelty discrimination test during early and middle adolescence in male and female rats, and whether the modafinil analog, the novel atypical dopamine reuptake inhibitor CE-123, can modify this effect. Our study shows that male and female rats neonatally exposed to ethanol exhibited sex- and age-dependent deficits in social novelty discrimination in early (male) and middle (female) adolescence. These deficits were specific to the social domain and not simply due to more general deficits in learning and memory because these animals did not exhibit changes in short-term recognition memory in the novel object recognition task. Furthermore, early-adolescent male rats that were neonatally exposed to ethanol did not show changes in the anxiety index but demonstrated an increase in locomotor activity. Chronic treatment with CE-123, however, prevented the appearance of these social deficits. In the hippocampus of adolescent rats, CE-123 increased BDNF and decreased its signal transduction TrkB receptor expression level in ethanol-exposed animals during development, suggesting an increase in neuroplasticity. Thus, selective dopamine reuptake inhibitors, such as CE-123, represent interesting drug candidates for the treatment of deficits in social behavior in adolescent individuals with FASDs.

Are psychotic-like experiences associated with aberrant prosocial decision-making behavior?

Deficits in social functioning and decision-making are well-documented in schizophrenia, but their relationship with positive symptoms and social conflicts is poorly understood. We created a new paradigm based on the Dictator Game (DG) to explore differences in social decision-making between individuals experiencing high levels of psychotic-like experiences (PLEs), particularly hallucinations and delusions, and controls with less PLEs. A large community sample (N = 1,161) completed a DG in an online study whereby extreme groups were built based on the positive subscale of the CAPE. Overall, participants experiencing PLEs did not act less prosocial than controls but showed a somewhat aberrant decision-making behavior, particularly a pattern of behaving more prosocial in fair situations and generally favoring punishment over compensation relative to controls. Mediation analyses suggest that measures of empathy and Machiavellism have predictive power for prosocial behavior beyond group status. The present study raises the possibility that individuals with high levels of PLEs may be less able to adapt their behavior to the situation at hand than controls. These irregularities might be due to deficits in social cognition which may elicit conflict, thus compromising social functioning and possibly contributing to the formation of positive symptoms.

Unraveling the spectrum: overlap, distinctions, and nuances of ADHD and ASD in children.

This review explores the clinical presentation of similarities and differences in Attention-Deficit/Hyperactivity Disorder (ADHD) and Autism Spectrum Disorder (ASD). This paper investigates the deficits in executive function, social function, and emotional intelligence that are seen in both conditions and how the presence of both conditions can exacerbate these deficiencies. Understanding the clinical presentations in these domains is critical to refine diagnostic methods and treatments and improve outcomes for those affected by these neurodevelopmental disorders. The similarities in clinical presentation between ADHD and ASD present a significant diagnostic challenge, with individuals often exhibiting similar behaviors and difficulty navigating the complexities that encompass reacting to their environment. Further research is paramount in gaining more knowledge of the disorders and challenges faced by these individuals, especially those with the presence of both conditions.

Music as a Language

The number of children in western countries diagnosed with Down syndrome (DS), a disease caused by chromosomal abnormalities, is still increasing. The resulting delayed cognitive development also leads to deficits in social functioning in children under 12. Active music therapy (MT), as a natural intervention to achieve therapeutic functions through improvisation, performance, and singing, has been proven to promote the socialization development of children with DS. To get a better idea of the extent of the promotion and exactly what aspects it has improved, I conducted literature reviews and interviews with a music therapist. The results suggest that active MT can stimulate the socialization development of children under 12 with DS in three aspects: language skills, social-emotional development, and prosocial behavior. Although the improvement effect of active MT is better than that of passive MT, it requires the client to have a basis of music theory, that is, it requires higher requirements on the client, so the treatment method should be selected according to the severity of the client's DS or a combination of the two. Hence, future research could be aimed at finding the simplest interventions with sufficient client engagement and verifying the continuation of the effect of active MT.

Supraphysiological testosterone levels from anabolic steroid use and reduced sensitivity to negative facial expressions in men

RationaleAnabolic-androgenic steroids (AAS) are used to improve physical performance and appearance, but have been associated with deficits in social cognitive functioning. Approximately 30% of people who use AAS develop a dependence, increasing the risk for undesired effects.ObjectivesTo assess the relationship between AAS use (current/previous), AAS dependence, and the ability to recognize emotional facial expressions, and investigate the potential mediating role of hormone levels.MethodsIn total 156 male weightlifters, including those with current (n = 45) or previous (n = 34) AAS use and never-using controls (n = 77), completed a facial Emotion Recognition Task (ERT). Participants were presented with faces expressing one out of six emotions (sadness, happiness, fear, anger, disgust, and surprise) and were instructed to indicate which of the six emotions each face displayed. ERT accuracy and response time were recorded and evaluated for association with AAS use status, AAS dependence, and serum reproductive hormone levels. Mediation models were used to evaluate the mediating role of androgens in the relationship between AAS use and ERT performance.ResultsCompared to never-using controls, men currently using AAS exhibited lower recognition accuracy for facial emotional expressions, particularly anger (Cohen’s d = −0.57, pFDR = 0.03) and disgust (d = −0.51, pFDR = 0.05). Those with AAS dependence (n = 47) demonstrated worse recognition of fear relative to men without dependence (d = 0.58, p = 0.03). Recognition of disgust was negatively correlated with serum free testosterone index (FTI); however, FTI did not significantly mediate the association between AAS use and recognition of disgust.ConclusionsOur findings demonstrate impaired facial emotion recognition among men currently using AAS compared to controls. While further studies are needed to investigate potential mechanisms, our analysis did not support a simple mediation effect of serum FTI.

Psychotherapies in opioid use disorder: toward a step-care model

Opioid use disorder (OUD) is characterized by a lack of control in opioid use, resulting in psychological distress and deficits in interpersonal and social functioning. OUD is often associated with psychiatric comorbidities that increase the severity of the disorder. The consequences of OUD are dramatic in terms of increased morbi-mortality. Specific medications and psychotherapies are essential tools not only in the treatment of OUD but also in the prevention of suicide and overdoses. In our review, we assess the different types of psychotherapies (counseling, motivational interviewing, contingency management, cognitive-behavioral therapy, and dialectical-behavior therapy) that are delivered to opioid users, either associated or un-associated with OUD medications and/or medications for psychiatric disabilities. We describe the application of these therapies first to adult opioid users and then to adolescents. This work led us to propose a stepped-care model of psychotherapies for OUD which provided information to assist clinicians in decision-making regarding the selection of psychotherapeutic strategies according to patients’ OUD severity.

46 Exploring Social Cognition Deficits Characterised by Impulsive Responding in Children

Objective:Theory suggests that symptoms of Attention-deficit Hyperactivity Disorder (ADHD; e.g., hyperactivity and impulsivity) may be associated with social cognition deficits characterised by fast but erroneous processing of social cues. Despite this, prior research has provided mixed evidence for (a) deficits in social cognition skills and (b) a link between such deficits and poor social outcomes among children with ADHD. We sought to clarify this ambiguity by (a) exploring variation in social cognition skills across a mixed clinical and normative population and (b) examining the demographic, clinical, and dimensional symptom profiles of children presenting with reduced social cognition skills characterised by fast but erroneous processing.Participants and Methods:Participants were children and adolescents (N = 1,097) aged 4–18 years (M = 9.02, SD = 2.72) assessed using the Paediatric Evaluation of Emotions Relationships and Socialisation (PEERS), a child-direct, ecologically sensitive measure of social cognition. Latent profile analysis of standardised social cognition scores and response times for incorrect encoding of social cues (error-response times) was used to identify social cognition profiles. Differences between each profile in terms of demographics, clinical profiles, symptom dimensions, and social outcomes were explored.Results:Four social cognition profiles were identified. Two profiles were identified as being of particular interest: one which captured typically developing children (TDC; n = 727), and another which was characterised by lower social cognition scores and faster error-response times (impulsive responding; n = 201). The remaining profiles captured the response styles of younger participants (n = 152) and children with more pervasive social cognition deficits (n = 17). Comparison of the two profiles of interest revealed a number of statistically significant differences (p &lt; .05). Compared to the TDC group, the impulsive responding group had: higher SDQ scores for hyperactivity, conduct, emotional, and peer problems; lower IQ and prosocial scores, and; greater parent-perceived social function deficits. Children in this group were also more likely to be male and from a lower SES background. Clinically, 18% of children in the impulsive responding group had an ADHD diagnosis, and 14% had at lease one mental health diagnosis other than ADHD.Conclusions:A large minority of children (~18%) demonstrate social cognition deficits characterised by fast but erroneous processing of social cues. Although the explorative nature of this study does not allow conclusions to be made about the causes of such deficits, it is reasonable to conclude that they are not reducible to clinically significant symptoms of hyperactivity-impulsivity — less than 1/5 of the children in this group had an ADHD diagnosis, and 2/3 of children in this group had no mental health diagnosis at all. Child-direct tools designed to detect individual differences in social cognition skills may be beneficial in identifying individuals who will benefit from social support or interventions aimed at reducing social cognition deficits despite being missed by more traditional screening measures (e.g., clinical diagnoses). Future work should focus on understanding the causal relationships between symptoms of hyperactivity-impulsivity, fast but erroneous processing of social cues, social cognition skills, and social outcomes for this group of children.

A - 131 Social Adjustment and Functioning in Serious Mental Illness Is Predicted by Social Cognition.

Deficits in social cognition (SC) and social functioning (SF) are prominent in schizophrenia. This study used standardized assessments to examine SC and SF to determine if similar deficits are present in persons diagnosed with bipolar disorders. The Awareness of Social Inference Test (TASIT) was used to assess emotion identification and social inference, and the Social Functioning Scale (SFS) to assess SF domains (Social Engagement, Interpersonal Communication, Independent Performance, Independent Competence, Recreation, Prosocial, and Employment). The TASIT and SFS were administered to individuals with schizophrenia (SZ; N = 22), bipolar disorder with psychotic features (BP+; N = 20) or without psychotic features (BP-; N = 21), and healthy controls (HC; N = 22). Mixed model ANOVA examined group differences and multiple regression determined if SC predicted SF. The SZ group showed significantly worse SF compared to all other groups. There was no significant difference between the BP+ and BP-, and both BP groups performed worse than HCs. For multiple regression, the three clinical groups (SZ, BP+, BP-) were combined to yield an overall SMI group (N = 63). TASIT emotion identification and social inference predicted performance on SFS domains of Independent Performance, Independent Competence, Recreation, Prosocial, and SFS total score. Emotion identification was the strongest predictor of the Independent Performance domain in comparison to social inference. Performance on the TASIT predicted performance across several domains of SF in SMI. Differences were present based on the specific SC abilities and SF domains, suggesting SC abilities are more strongly associated with some functional domains but not others, which may help guide clinical decision making.

Relationship between cognitive disengagement syndrome (CDS) (formerly sluggish cognitive tempo) and social functioning in child autism, ADHD, and elementary school samples

Background and aimsNo studies have compared relationships between specific social functioning deficits and cognitive disengagement syndrome/CDS (formerly sluggish cognitive tempo) in autism, ADHD, and general population child samples. MethodsMothers rated 1177 children with autism, 725 with ADHD-Combined, and 307 with ADHD-Inattentive (4–17 years) and 665 elementary school children (6–12 years) on the Pediatric Behavior Scale. ResultsIn all four groups, children with CDS had significantly greater frequencies of rejection by peers than children without CDS, and in the three clinical groups, withdrawn/shy behavior was significantly more prevalent in children with CDS. Low prosocial behavior did not differ between children with and without CDS. CDS contributed significantly and independently to predicting withdrawn/shy behavior and peer rejection, although its contribution was small compared with some other psychological problems. Overall, autism symptoms were the most powerful predictors of withdrawn/shy behavior and peer rejection. Conclusions and implicationsCDS studies sometimes control for ADHD and other psychopathology in multivariate analyses, but autism is usually overlooked. This is a critical oversight because CDS is as common in autism as in ADHD and because social problems, autism symptoms, and CDS are significantly interrelated.

A multivariate cognitive approach to predict social functioning in recent onset psychosis in response to computerized cognitive training

Clinical and neuroimaging data has been increasingly used in recent years to disentangle heterogeneity of treatment response to cognitive training (CT) and predict which individuals may achieve the highest benefits. CT has small to medium effects on improving cognitive and social functioning in recent onset psychosis (ROP) patients, who show the most profound cognitive and social functioning deficits among psychiatric patients. We employed multivariate pattern analysis (MVPA) to investigate the potential of cognitive data to predict social functioning improvement in response to 10 h of CT in patients with ROP. A support vector machine (SVM) classifier was trained on the naturalistic data of the Personalized Prognostic Tools for Early Psychosis Management (PRONIA) study sample to predict functioning in an independent sample of 70 ROP patients using baseline cognitive data. PRONIA is a part of a FP7 EU grant program that involved 7 sites across 5 European countries, designed and conducted with the main aim of identifying (bio)markers associated with an enhanced risk of developing psychosis in order to improve early detection and prognosis. Social functioning was predicted with a balanced accuracy (BAC) of 66.4% (Sensitivity 78.8%; Specificity 54.1%; PPV 60.5%; NPV 74.1%; AUC 0.64; P = 0.01). The most frequently selected cognitive features (mean feature weights > ± 0.2) included the (1) correct number of symbol matchings within the Digit Symbol Substitution Test, (2) the number of distracting stimuli leading to an error within 300 and 200 trials in the Continuous Performance Test and (3) the dynamics of verbal fluency between 15 and 30 s within the Verbal Fluency Test, phonetic part. Next, the SVM classifier generated on the PRONIA sample was applied to the intervention sample, that obtained 54 ROP patients who were randomly assigned to a social cognitive training (SCT) or treatment as usual (TAU) group and dichotomized into good (GF-S ≥ 7) and poor (GF-S < 7) functioning patients based on their level of Global Functioning-Social (GF-S) score at follow-up (FU). By applying the initial PRONIA classifier, using out-of-sample cross-validation (OOCV) to the sample of ROP patients who have undergone the CT intervention, a BAC of 59.3% (Sensitivity 70.4%; Specificity 48.1%; PPV 57.6%; NPV 61.9%; AUC 0.63) was achieved at T0 and a BAC of 64.8% (Sensitivity 66.7%; Specificity 63.0%; PPV 64.3%; NPV 65.4%; AUC 0.66) at FU. After SCT intervention, a significant improvement in predicted social functioning values was observed in the SCT compared to TAU group (P ≤0.05; ES[Cohens' d] = 0.18). Due to a small sample size and modest variance of social functioning of the intervention sample it was not feasible to predict individual response to SCT in the current study. Our findings suggest that the use of baseline cognitive data could provide a robust individual estimate of future social functioning, while prediction of individual response to SCT using cognitive data that can be generated in the routine patient care remains to be addressed in large-scale cognitive training trials.

Associations between social engagement, internalizing symptoms, and delusional ideation in the general population.

Delusions are a hallmark feature of psychotic disorders and lead to significant clinical and functional impairment. Internalizing symptoms-such as symptoms of depression, anxiety, and trauma exposure-are commonly cited to be related to delusions and delusional ideation and are often associated with deficits in social functioning. While emerging studies are investigating the impact of low social engagement on psychotic-like experiences, little work has examined the relationship between social engagement, internalizing symptoms, and delusional ideation, specifically. Using general population data from the Nathan Kline Institute-Rockland (NKI-Rockland) database (N = 526), we examined the relationships between self-reported delusional ideation, internalizing symptoms, and social engagement and tested four indirect effect models to understand how these factors interrelate. Delusional ideation was significantly associated with both increased internalizing symptoms (r = 0.41, p < 0.001) and lower social engagement (r = -0.14, p = 0.001). Within aspects of social engagement, perceived emotional support showed the strongest relationship with delusional ideation (r = -0.17, p < 0.001). Lower social engagement was also significantly associated with increased internalizing symptoms (r = -0.29, p < 0.001). Cross-sectional models suggest that internalizing symptoms have a significant indirect effect on the association between delusional ideation and social engagement. These findings reveal that elevated delusional ideation in the general population is associated with lower social engagement. Elevated internalizing symptoms appear to play a critical role in reducing engagement, possibly exacerbating delusional thinking. Future work should examine the causal and temporal relationships between these factors.