Self-reported Social Functioning Research Articles

Narrative-Derived Indices of Metacognition among People with Schizophrenia: Associations with Self-Reported and Performance-Based Social Functioning.

Metacognitive functioning-which broadly encompasses the mental processes involved in thinking about the thinking of one's self and the thinking of others-is often impaired among individuals living with schizophrenia and may contribute to difficulties in social and interpersonal functioning. Although the majority of studies assessing metacognition among individuals with schizophrenia use standardized, laboratory-based measurements, an increasing number of studies have measured metacognitive capacity using natural language produced by individuals living with mental illness. At the same time, less is known about how language-derived indices of metacognitive function relate to key social outcomes among people with schizophrenia. The primary objective of this study was to employ a validated language coding system (the Metacognition Assessment Scale, Abbreviated; MAS-A) to assess metacognitive functioning from the spoken life narratives of individuals with schizophrenia (n = 32) and community controls (n = 15). Among individuals with schizophrenia, we also examined the associations between language-derived metacognition and measures of self-reported and performance-based social functioning. Our results suggest that most aspects of metacognition in our sample were not significantly diminished in people with schizophrenia compared to community controls. Unexpectedly, the MAS-A subscale related to one's ability to master psychological difficulties was rated higher among individuals with schizophrenia. Further, our results suggest that among people with schizophrenia, higher metacognitive functioning in the domain of self-reflectivity was associated with poorer self-reported social functioning, while a greater metacognitive awareness of other individuals' minds was associated with better scores on aspects of performance-based social functioning. Collectively, these results underscore the utility of assessing metacognitive functioning via life-story narratives to understand social outcomes and highlight possible aspects of resiliency among individuals who have experienced a serious mental illness.

Self-reported functioning among patients with ultra-rare nemaline myopathy or a related disorder in Finland: a pilot study

BackgroundNemaline myopathy (NM) and related disorders (NMr) form a heterogenous group of ultra-rare (1:50,000 live births or less) congenital muscle disorders. To elucidate the self-reported physical, psychological, and social functioning in the daily lives of adult persons with congenital muscle disorders, we designed a survey using items primarily from the Patient Reported Outcomes Measurement Information System, PROMIS®, and conducted a pilot study in patients with NM and NMr in Finland. The items were linked to International Classification of Functioning, Disability and Health (ICF) categories.ResultsIn total, 20 (62.5%) out of 32 invited persons resident in Finland participated in the study; 12 had NM and 8 NMr, 15 were women and 5 men aged 19–75 years. Sixteen (80%) were ambulatory and 4 (20%) NM patients used wheelchairs. The results from the PROMIS measuring system and ICF categories both indicated that non-ambulatory patients of this study faced more challenges in all areas of functioning than ambulatory ones, but the differences were smaller in the domains measuring psychological and social functioning than in physical functioning. In addition, the COVID-19 pandemic adversely affected the functioning of non-ambulatory patients more than that of ambulatory patients. The interindividual differences were, however, noticeable.ConclusionsTo our knowledge, this pilot study is the first comprehensive survey-based study of the physical, psychological, and social functioning of adult persons with nemaline myopathy or related disorders. The results indicate vulnerability of non-ambulatory patients being at higher risk to a decrease in general functioning during global or national exceptional periods. The responses also gave directions for modifying and improving the survey for future studies.

Longitudinal associations between parental early psychological distress and children’s emotional and behavioural problems during early childhood and self-reported social functioning in 11-year-old children born very preterm

ABSTRACT This study examined longitudinal associations between parental psychological distress (stress and depression) when the child was 2 to 4 years and a child’s emotional and behavioural problems at ages 3 to 4, and social functioning (loneliness and social competence) at age 11 in very preterm born children. The participants were Finnish families of 172 very preterm infants (gestational age < 32 weeks and/or birth weight ≤ 1500 g). In girls, higher levels of maternal depression were associated with higher levels of social and emotional loneliness. Furthermore, higher levels of maternal stress and children’s externalizing problems were associated with lower levels of experienced empathy. In boys, higher levels of paternal depression were associated with lower levels of social loneliness and impulsive behaviour. In conclusion, early parental psychological distress is associated with early socioemotional development and the later experienced social functioning in former very preterm infants. The sex of the child moderates these associations.

The pandemic not only increased depression and PTSD in college students, but also changed how they categorize emotions

Objective: In March 2020, the emergence of COVID-19 as a pandemic prompted large scale, social lockdowns internationally. Participants/Method: Here, we compared the mental health symptoms and social functioning of pre-pandemic college students collected during the Spring 2020 semester to those of a pandemic group collected during the Fall 2020 semester. Results: Results reveal that students assessed during the pandemic reported more severe symptoms of posttraumatic stress and depression, yet no difference in anxiety symptoms, relative to students assessed before the pandemic. Furthermore, students assessed during the pandemic conceptualized and categorized their emotions with significantly more neutral emotions and significantly fewer positive emotions, yet no difference in negative emotions, relative to students assessed before the pandemic. Despite these mental health effects, we found no difference between the two groups in self-reported social functioning. Conclusion: Overall, these results suggest young adults’ mental health was significantly impacted by the pandemic, with the potential for long lasting effects.

Context and Expectations Matter: Social, Recreational, and Independent Functioning among Youth with Psychosis in Chennai, India and Montreal, Canada.

Most cross-cultural psychosis research has focused on a limited number of outcomes (generally symptom-related) and perspectives (often clinician-/observer-rated). It is unknown if the purported superior outcomes for psychosis in some low- and middle-income countries extend to patient-reported measures of social, recreational, and independent functioning. Addressing this gap, this study aimed to compare these outcomes in first-episode psychosis at a high-income site and a lower middle-income site. Patients receiving similarly designed early intervention for psychosis in Chennai, India (N = 164) and Montreal, Canada (N = 140) completed the self-reported Social Functioning Scale-Early Intervention, which measures prosocial, recreation, and independence-performance functioning. Their case managers rated expected independence-performance functioning. Both sets of assessments were done at entry and Months 6, 18, and 24. Linear mixed model analyses of differences between sites and over time were conducted, accounting for other pertinent variables, especially negative symptoms. Linear mixed models showed that prosocial, recreation, and independence-performance functioning scores were significantly higher in Montreal than Chennai and did not change over time. Expected independence-performance was also higher in Montreal and increased over time. Negative symptoms and education independently predicted prosocial, recreation, and expected independence-performance functioning. When added to the model, expected independence-performance predicted actual independence-performance and site was no longer significant. At both sites, prosocial and recreation scores were consistently lower (<40%) than independence-performance (40-65%). This is the first cross-cultural investigation of prosocial, recreation, and independent functioning in early psychosis. It demonstrates that these outcomes differ by socio-cultural context. Differing levels of expectations about patients, themselves shaped by cultural, illness, and social determinants, may contribute to cross-cultural variations in functional outcomes. At both sites, social, recreational, and independent functioning were in the low-to-moderate range and there was no improvement over time, underscoring the need for effective interventions specifically designed to impact these outcomes.

Playing Pokemon Go: Increased Life Satisfaction Through More (Positive) Social Interactions.

Pokemon Go (PoGo) is a social mobile game requiring both physical activity and social interaction, and previous research has reported positive effects of PoGo on physical health. However, little research has been conducted on the effects of PoGo on social functioning and life satisfaction, which are important factors for good mental health. The current study investigated the effects of PoGo on life satisfaction and social functioning in participants with and without self-reported diagnoses of mental disorders. Participants were 434 current PoGo players aged 18–69 of diverse genders and nationalities, with a subsample (N = 138) self-reporting diagnoses of various mental disorders with impairments in social functioning. Participants provided retrospective and current self-report measures about their PoGo use, life satisfaction, social functioning (sociality and social ability) and clinical symptom severity. Results showed higher self-reported social functioning and life satisfaction since playing PoGo compared to the time period before playing, which involved a shift from negative to positive ratings. The increases in self-reported life satisfaction and sociality (but not social ability) were more pronounced for the clinical compared to the non-clinical subsample. Results also showed the effect of the social ability change on the life satisfaction change was mediated by the sociality change and moderated by the number of daily in-person player interactions (including strangers). The findings here, using subjective judgements, show that PoGo motivates social interactions and increases life satisfaction, demonstrating that social mobile gaming provides an easy to implement tool to subjectively improve social functioning. This has important implications for populations with social difficulties and reduced social motivation.

Exploring the Relationship Between Loneliness and Social Cognition in Older Age

Abstract. Understanding others is a key component of successful social interactions, and declines in social abilities during later life can lead to social isolation and loneliness. We investigated the relationship between different subcomponents of social cognition and loneliness in a large sample of older adults. We tested perspective-taking and mentalizing skills, alongside self-reported loneliness and social functioning. The results revealed that both loneliness and age correlated significantly with older adults' ability to resist egocentric interference when taking others' perspectives. However, mediation models showed that the effect of loneliness on egocentric tendencies was eliminated when age was accounted for. Therefore, loneliness relates to egocentrism only because egocentric tendencies increase with age, and people experience increasing levels of loneliness and feelings of social isolation with increasing age. Mentalizing and interference from others' perspectives were not influenced by loneliness or age.

Shining a Light on a Hidden Population: Social Functioning and Mental Health in Women Reporting Autistic Traits But Lacking Diagnosis

Female Phenotype Theory (FPT) suggests that autistic women often present with less obvious social impairments than autistic men. We examined the possibility of an exaggerated female phenotype among undiagnosed but probably autistic women. In two nationwide online surveys, we compared self-reported social functioning and mental health between diagnosed autistic women and women without diagnosis who scored ≥ 32 on the Autism Quotient. Compared to diagnosed autistic women, probably autistic women had higher empathy and general social functioning, and were more likely to have received a diagnosis of Borderline Personality Disorder. Autistic women had typically received more mental health diagnoses prior to their ASC diagnosis than autistic men. These findings shed light on the history of misdiagnosis experienced by many autistic women.

Social Problem Solving in Survivors of Pediatric Brain Tumor

Psychosocial late effects among survivors of pediatric brain tumors are common. For school-aged survivors, social skills deficits and isolation present a particular challenge. Social problem-solving is a social skill that is an important determinant of social outcomes and may yield a potential target for intervention. School-aged youth (N = 65) 8-12 years of age (10.59 ± 1.36 years; 55.4% female, 86.2% white) who were 5.23 (SD = 2.44, range 2-10.9) years post-treatment for a brain tumor completed the Attributions and Coping Questionnaire, a measure of social problem-solving that uses vignettes to assess attribution of intent, subsequent emotional response, and imagined behavioral response to an interpersonal problem. Youth also completed self-reports of social functioning (PROMIS Peer Relationships, Self-Perception Profile). A caregiver completed additional measures of child social functioning (NIH Toolbox-Emotion Measures). Survivors attributed unpleasant situations to accidental causes (neutral attribution) and responded in ways that prioritized the friendship (appeasement) or relied on adult intervention. Self-reported social functioning was higher among those who were less likely to avoid challenging social problem-solving situations. Findings identified characteristic social problem-solving approaches among survivors, including a tendency to attribute ambiguous situations to accidental causes and to request adult assistance and/or maintain social relationships. This may indicate a possible avenue for intervention, with a focus on increasing survivors' understanding of the causes of potentially negative peer interactions and reducing their reliance on adults.

An ecological examination of loneliness and social functioning in people with schizophrenia.

Loneliness is associated with a myriad of detrimental outcomes in mental and physical health. Previous studies have found that people with schizophrenia report greater loneliness than controls, and that loneliness is related to depressive symptoms. However, research has been limited, particularly regarding contributions of loneliness to social and occupational functioning. Further, few studies have examined associations between loneliness and daily experience in schizophrenia. Thus, we recruited 35 individuals with schizophrenia and 37 controls. All participants completed the UCLA loneliness scale, symptom assessments, and measures of social and occupational functioning. Additionally, participants with schizophrenia completed an ecological momentary assessment (EMA) protocol that indexed daily social and emotional experiences, including loneliness. Similar to previous reports, we found that those with schizophrenia reported greater loneliness than controls. Further, loneliness was positively associated with depressive and negative symptoms, and negatively associated with self-reported social functioning. Interestingly, loneliness remained a significant predictor of functioning even when controlling for other symptoms, suggesting that severity of depressive and negative symptoms cannot fully explain the relationship between loneliness and functioning. In our EMA analyses, loneliness did not significantly differ when individuals were alone versus with others, underscoring the notion that being alone is not the same as feeling lonely. However, self-reported engagement during social interactions was negatively associated with loneliness, at a trend-level, suggesting that quality of social interactions is a potentially important consideration. Taken together, these findings suggest that loneliness is an important treatment target and provide understanding for how loneliness may manifest in daily life in schizophrenia. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Metta-Based Therapy for Chronic Depression: a Wait List Control Trial

ObjectivesCurrent treatments for chronic depression have focused on reducing interpersonal problems and negative affect, but paid little attention to promoting prosocial motivation and positive affect. Following this treatment focus, the objective of the present study was to examine whether the combination of metta (Loving Kindness) group meditation and subsequent tailored individual therapy focusing on kindness towards oneself and others (metta-based therapy, MBT) shows greater improvements in depressive symptoms than a wait list control group in patients with chronic depression.MethodsForty-eight patients with DSM-5 persistent depressive disorder were randomly assigned to MBT or a wait list control condition. Outcome was assessed after group meditation, after subsequent individual therapy, and at 6-month follow-up. The primary outcome measure was an independent blind rating of depressive symptoms at post-test. Secondary outcome included changes in self-reported depression, behavioral activation, rumination, social functioning, mindfulness, compassion, and clinician-rated emotion regulation.ResultsMixed-design analyses showed significant differences between MBT and WLC in changes from pre- to post-test in clinician-rated and self-rated depression, behavioral activation, rumination, social functioning, mindfulness, and emotion regulation. Most of the changes occurred during group meditation and were associated with large effect sizes. Improvements were maintained at 6-month follow-up.ConclusionsThe results provide preliminary support for the effectiveness of MBT in treating chronic depression.Trial RegistrationISRCTN, ISRCTN97264476.

Symptom trajectories in breast cancer survivors: growth mixture analysis of patient-reported pain, fatigue, insomnia, breast and arm symptoms

Background Variations in symptom development among breast cancer (BC) survivors are understudied. We examined: (Q1) Symptom trajectories of pain, fatigue, insomnia, breast, and arm symptoms in BC survivors, (Q2) possible patterns or cluster-like associations between trajectory classification of different symptoms, and (Q3) characteristics of survivors assigned to high-burden symptom trajectories. Material and methods Participants were 968 women (mean age = 59.6 years) treated for early-stage BC and followed across a three-year postoperative period. As part of routine follow-up procedures, patients reported symptom burden and functioning levels at each hospital visit using the European Organisation for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire (QLQ-C30) and the BC-specific module (QLQ-BR-23). Growth mixture modeling (GMM) analysis was used to differentiate potential subgroups of individuals with similar longitudinal symptom patterns, i.e., symptom trajectories (Q1). With this approach, groups experiencing persistent, highly distressing cancer- and treatment-related late effects (LEs) may be identified. Latent class analysis (LCA) was used for Q2 and logistic regression analysis for Q3. Results GMM identified two relatively parallel trajectories across the tested symptoms: The majority of the sample exhibited a low-burden symptom trajectory (74.4–89.2%) and a minority by a high-burden symptom trajectory (10.8–25.6%). LCA revealed that approximately one in five women (18.8%) were likely to be members of the high-burden symptom trajectory across all tested symptoms. In addition to a high probability of being burdened over time across multiple symptoms, these women were also characterized by poorer self-reported physical and social functioning. Conclusion A substantial minority followed a high-burden symptom trajectory for several years following BC treatment. Associations were found in trajectory classification across symptoms, indicating that cancer-related LEs appear in clusters of multiple concurrent symptoms.

Examining self-reported social functioning, sleep quality, and psychotic-like experiences in college students

Impairments in social and role functioning have been associated with the prodromal phase of psychosis. Additionally, sleep disturbances impacting daily functioning have been detected across the schizophrenia spectrum. Relationships between social functioning, sleep quality, and psychotic-like experiences (PLEs) in undergraduate-level student populations are less understood. The current project aimed to investigate whether self-reported measures of sleep quality would moderate the relationship between social functioning and PLE endorsement in a community sample of 3042 undergraduate student participants between the ages of 18–35. Participants completed the Social Functioning Scale, the Pittsburgh Sleep Quality Index, and the Prodromal Questionnaire, which indexed PLEs. Bivariate correlations revealed significant associations between social functioning, sleep, and PLEs. As expected, poor sleep and poor social functioning were associated with increased endorsement of PLEs. Contrary to expectation, poor sleep quality was associated with better social functioning. In hierarchical multiple regression models, the interaction between social functioning and sleep was not associated with PLE endorsement. Results indicated that both poor sleep and poor social functioning were significantly associated with PLEs when included in the same model. These findings suggest that poor social functioning and disrupted sleep may act additively to influence PLEs, and that they are both important contributors to psychotic symptoms. Due to deleterious effects of poor sleep on physical and emotional health, these findings provide impetus to further investigate relationships between sleep quality, social functioning, and PLEs using such high-resolution methods as actigraphy, mobile sensing, ecological momentary assessment, and neuroimaging.

Preliminary Outcomes of an Ecological Momentary Intervention for Social Functioning in Schizophrenia: Pre-Post Study of the Motivation and Skills Support App.

BackgroundPeople with schizophrenia and other serious mental illnesses often lack access to evidence-based interventions, particularly interventions that target meaningful recovery outcomes such as social functioning and quality of life. Mobile technologies, including smartphone apps, have the potential to provide scalable support that places elements of evidence-based interventions at the palm of patients’ hands.ObjectiveWe aim to develop a smartphone app—called Motivation and Skills Support—to provide targeted social goal support (eg, making new friends and improving existing relationships) for people with schizophrenia enrolled in a stand-alone open trial.MethodsIn this paper, we presented preliminary outcomes of 31 participants who used the Motivation and Skills Support app for 8 weeks, including social functioning pre- to postintervention, and momentary reports of treatment targets (eg, social motivation and appraisals) during the intervention.ResultsThe findings suggest that the intervention improved self-reported social functioning from baseline to treatment termination, particularly in female participants. Gains were not maintained at the 3-month follow-up. Furthermore, increased social functioning was predicted by momentary reports of social appraisals, including perceived social competence and the extent to which social interactions were worth the effort.ConclusionsThe implications of these findings and future directions for addressing social functioning in schizophrenia using mobile technology have been discussed.Trial RegistrationClinicalTrials.gov NCT03404219; https://clinicaltrials.gov/ct2/show/NCT03404219

Association of imbalance between job workload and functional ability with return to work in ARDS survivors

BackgroundInability to return to work (RTW) is common after acute respiratory distress syndrome (ARDS). Mismatch in an individual’s job workload and his or her functional ability, termed work ability imbalance,...

Gender differences in self-reported social functioning of patients with chronic coronary artery disease and affective disorders

Aim. To determine gender differences in self-reported social functioning of patients with comorbidity of affective disorders (ADs) and chronic coronary artery disease. Materials and methods . Self-reported social functioning of 248 cardiological patients (194 men (78.2%) and 54 women (21.8%)) with chronic coronary artery disease (CAD) and ADs was studied using the Social Adaptation Self-evaluation Scale (SASS). The mean age of patients with chronic CAD in men was (57.2 ± 6.5) years, and in women (59.3 ± 7.1), p = 0.04. Qualitative and quantitative indicators were investigated using the Mann – Whitney, Wilcoxon and T-test; χ2 (Pearson›s goodness-of-fit test) was used to estimate the frequencies. Results . ADs were represented by chronic mood disorders (45%), first-time depressive episodes (DEs) 24%, recurrent DEs 24.5%, as well as bipolar II disorder (BD II) 6.5%. ADs in 42.4% of patients were associated with psychosocial stressors (mainly, loss), p = 0.02. Men statistically significantly more often (37.1%, 72/194) than women (16.7%, 9/54) communicated more scarcely with others as a result of projection mechanisms, a high level of hostility, passive aggressiveness and lack of initiative, typical for patients with ADs, p = 0.003. Conclusion. The social functioning of patients with ADs and chronic coronary artery disease was complicated irrespective of gender. Women were single and bereaved of their children more often than men. Due to the low level of communication outside the family and outside of professional activity, most of the patients maintained communication mainly with the family. However, due to ADs, they were not able to feel support from family members and rarely initiated communication with other people (men did it statistically significantly more often than women).

Self-reported social functioning and social cognition in schizophrenia and bipolar disorder: Using ecological momentary assessment to identify the origin of bias

ObjectivesPeople 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. Methods71 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. ResultsThere 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. ImplicationsBoth 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.

Modified CBT for social anxiety and social functioning in young adults with autism spectrum disorder

BackgroundThere is a strong research imperative to investigate effective treatment options for adolescents and adults with autism spectrum disorder (ASD). Elevated social anxiety, difficulties with social functioning and poor mental health have all been identified as core treatment targets for this group. While theoretical models posit a strong bidirectionality between social anxiety and ASD social functioning deficits, few interventions have targeted both domains concurrently. Of the two group interventions previously conducted with adolescents and adults with ASD, significant results have only been observed in either social anxiety or social functioning, and have not generalised to changes in overall mood. The aim of this study was to evaluate the potential benefit, tolerability and acceptability of a group cognitive-behaviour therapy (CBT) intervention in young adults with ASD. Primary treatment outcomes were social anxiety symptoms and social functioning difficulties; secondary outcomes were self-reported mood and overall distress.MethodTen groups of participants completed an eight-week, modified group CBT intervention targeting both social anxiety and social functioning, that included social skills training, exposure tasks and behavioural experiment components. Seventy-eight adolescents and young adults with ASD, without intellectual impairment, aged between 16 and 38 (M = 22.77; SD = 5.31), were recruited from the community, Headspace centres and the Autism Clinic for Translational Research at the Brain and Mind Centre, University of Sydney. Outcomes (social anxiety, social functioning and mood) were measured pre- and post-intervention via self-report questionnaires (administered either online or through the return of hard-copy booklets), and participants were invited to provide anonymous feedback on the intervention (at the mid-point and end of the intervention).ResultsParticipants demonstrated statistically significant improvements on all outcome measures in response to the intervention. Specifically, social anxiety symptoms decreased (p < .001), and specific subdomains of social functioning improved post-intervention, particularly in social motivation (p = .032) and restricted interests and repetitive behaviours (p = .025). Self-reported symptom improvements also generalised to mood (depression, anxiety and stress; p < .05). All improvements demonstrated small effect sizes. Participant feedback was positive and indicated strong satisfaction with the program.LimitationsThe absence of a control group and follow-up measures, reliance on self-report instruments as outcome measures and the exclusion of those with intellectual disability represent significant limitations to this study.ConclusionsThese findings indicate that a group CBT intervention appears to be a beneficial intervention for self-reported social anxiety, social functioning and overall mental health in adolescents and young adults with ASD. The stand-alone nature of the intervention combined with positive participant feedback indicates it was well tolerated, has potential clinical utility and warrants further study in a randomised-controlled, follow-up design.

Social Functioning as a Mediator between Developmental Language Disorder (DLD) and Emotional Problems in Adolescents.

Adolescents with Developmental Language Disorder (DLD) are at risk for increased feelings of anxiety and depression compared to their typically developing (TD) peers. However, the underlying pathways involved in this relationship are unclear. In this initial study of the ‘social mediation hypothesis’, we examine social functioning as a mediator of emotional problems in a cross-sectional sample of adolescents with DLD and age- and sex-matched controls. Preliminary data from twenty-six participants with DLD and 27 participants with typical language development (TLD, 11–17 years) were compared on self- and parent-reported measures of social functioning and emotional outcomes. There was little evidence of group differences in self-reported social functioning and emotional outcomes, but parent-report of SDQ Peer Problems and Emotional Problems in the DLD group was significantly higher than in the TLD group. Parent-reported peer problems mediated parent-reported emotional problems, accounting for 69% of the relationship between DLD status and emotional problems. Parents of adolescents with DLD, but not adolescents themselves, report significantly higher peer and emotional problems compared to TLD peers. The hypotheses generated from these novel data suggest further investigation into adolescents’ perceptions of socioemotional difficulties and friendships should be examined.

Randomized, wait-list-controlled pilot study of app-delivered mindfulness for patients reporting chronic pain.

Chronic pain creates economic burden and exerts profound individual and societal harm. Mobile application (app)-delivered mindfulness meditation may be an important approach to self-management of chronic pain. We examined the feasibility, acceptability, and impact of app-delivered mindfulness meditation on pain cognition and daily functioning among patients reporting chronic pain. We used a longitudinal, randomized, and wait-list-controlled design (NCT03495726) to evaluate changes in self-reported pain severity, pain catastrophizing, and social and physical functioning among participants randomized to 6 weeks of app-delivered mindfulness meditation, compared with participants randomized to a wait-list control group. Although most participants randomized to the mindfulness group used the app at least once, fewer than half adhered to the instructed program. Participants who did not use the app scored higher on the helplessness component of pain catastrophizing at the start of the study and were less likely to have completed 4 years of college. Participants who reported feeling pressured to enroll in the study were also less likely to adhere to the intervention. Compared with participants randomized to wait-list, those in the mindfulness group reported significant improvements in social functioning, even after controlling for pain severity. Participants randomized to the mindfulness intervention also reported significant improvements in helplessness. App usage was not significantly correlated with changes in social functioning or helplessness scores. These results suggest that app-delivered mindfulness meditation is beneficial to patients with chronic pain. Identifying characteristics of patients who were adherent highlights important considerations for clinical settings.