Social Disconnection Research Articles

Amplification of Positivity Treatment for Anxiety and Depression: A Randomized Experimental Therapeutics Trial Targeting Social Reward Sensitivity to Enhance Social Connectedness

BackgroundSocial disconnection is common and causes significant impairment in anxiety and depressive disorders, and it does not respond sufficiently to available treatments. The positive valence system supports social bond formation and maintenance but is often hyporesponsive in people with anxiety or depression. We conducted an experimental therapeutics trial to test the hypothesis that targeting positive valence processes through cognitive and behavioral strategies would enhance responsivity to social rewards, a core mechanism underlying social connectedness. MethodsSixty-eight adults who endorsed clinically elevated anxiety and/or depression with social impairment were randomized 1:1:1 to 5 (n = 23) or 10 (n = 22) sessions of amplification of positivity (AMP) treatment or waitlist (n = 23). Pre- to posttreatment change in striatal activity (primary outcome) during social reward anticipation was measured using functional magnetic resonance imaging, and reactivity to a social affiliation task (secondary) and self-reported social connectedness (exploratory) were examined. Primary analyses compared AMP (doses combined) versus waitlist. A second aim was to compare the effects of different doses. ResultsAMP engaged the hypothesized treatment target, leading to greater striatal activation during anticipation of social rewards versus waitlist (d = 1.01 [95% CI = 0.42–1.61]; largest striatal volume). AMP yielded larger improvements in positive affect and approach behavior during the affiliation task (but not other outcomes) and social connectedness. Larger striatal and social connectedness increases were observed for 5-session versus 10-session AMP (d range = 0.08–1.03). ConclusionsTeaching people with anxiety or depression strategies to increase positive thoughts, behaviors, and emotions enhances activity in brain regions that govern social reward processing and promotes social connectedness. Social reward sensitivity may be a transdiagnostic target for remediating social disconnection.

Social infrastructures and older adults' webs of care: COVID‐19 as spatial breach

AbstractThis paper argues that the spatial restrictions and social distancing measures which older adults experienced during COVID‐19 can be interpreted as a spatial breach in their webs of care, impacting their ability to connect socially with others through formal and informal social infrastructures. Drawing on a qualitative study of 50 older adults in Singapore (which is part of a wider mixed‐methods project consisting of 1199 participants), the paper shows how spatial breaches manifest as tension points in the older adults' webs of care. The paper highlights the paradoxical and ageist impacts of vulnerability tropes that emphasise the alleged universal vulnerability of older adults to the coronavirus. It provides further insights on why some tension points in the older adults' webs of care become resolved through adjustments while others remain unresolved. This analysis furthers our understanding of how older adults cope with the social disconnection that may happen during spatial breaches, especially when it is due to the choices of others to withdraw socially. Conceptually, the paper demonstrates how care assemblages and social infrastructures work in tandem to modulate the older adults' webs of care dynamically. The paper situates social infrastructures as key resource components in the webs of care of older adults, functioning as formal or informal platforms through which they access material, financial or emotional resources. Importantly, the paper shows how particular social infrastructures may become prominent or recede in one's webs of care as the person's care assemblages dynamically adjust to personal circumstances and relationships. In doing so, the paper bridges hitherto distinct literatures on how social infrastructures and assemblages are used to understand social life.

Patient Experience With Absolute Voice Rest Following Phonomicrosurgery: A Qualitative Study.

Voice rest is commonly recommended following phonomicrosurgery to minimize vocal fold scarring, but associated quality of life (QoL) is low resulting in poor compliance. This study aimed to explore patients' experiences with voice rest following phonomicrosurgery to identify facilitators and barriers. This qualitative study used prospective, typical case technique for purposive sampling of consecutive patients who underwent voice rest following phonomicrosurgery for benign vocal fold lesions. Participants were enrolled at a single tertiary Laryngology center located at Unity Health Toronto - St. Michael's Hospital from 2020 to 2022. Semi-structured virtual interviews were conducted 4 weeks following patients' surgery. All interview transcripts were transcribed verbatim and underwent thematic analysis. Participant recruitment was stopped once thematic saturation was achieved. Twenty participants were recruited and 4 withdrew due to scheduling conflicts. Sixteen participants completed interviews, all of whom reported minimal impact of postoperative voice rest on QoL. The participants attributed their success to facilitators such as notifying close contacts of their situation beforehand and adopting nonverbal forms of communication. No participant endorsed a negative attitude toward voice rest. Understanding the rationale for voice rest and the consequences of noncompliance were reported to be effective in encouraging compliance. Overall, the participants tolerated voice rest well owing to facilitators such as early preparation, lifestyle modifications, and understanding the rationale for voice rest. Social disconnect and work demands were barriers of voice rest. Moving forward, facilitators and barriers should be addressed in efforts to optimize the voice rest experience for future patient populations. 4 Laryngoscope, 134:361-366, 2024.

Going it alone: Examining interpersonal sensitivity and hostility as mediators of the link between perfectionism and social disconnection.

Perfectionism is linked to a variety of mental health conditions in university students. The Perfectionism Social Disconnection Model posits that perfectionistic individuals exhibit off-putting interpersonal behaviors (i.e., rejection sensitivity and hostility), which lead to social disconnection, and in turn contribute to psychological distress. Although several longitudinal studies have found that social disconnection mediates the link between perfectionistic traits and psychological distress, less is known about how perfectionism leads to social disconnection. The present study aimed to address this gap. A sample of 877 university students completed one survey a month for three consecutive months. Our random-intercept cross-lagged panel model results showed significant positive associations between the random intercepts of socially prescribed and self-oriented perfectionism with rejection sensitivity, hostility, and loneliness, with stronger associations for socially prescribed perfectionism. In addition, the random intercept of other-oriented perfectionism showed positive associations with hostility but not rejection sensitivity or loneliness. Moreover, almost all cross-lagged paths were nonsignificant. Collectively, these findings indicate that although perfectionistic traits may be associated with rejection sensitivity and hostility to varying degrees at the between-person level, these behaviors may not cause social disconnection at the within-person level.

Grief participation rights and the social support hierarchy: Exploring the communicative role of the bereaved in a social support interaction

This article explores how bereaved individuals co-construct social support and social norms in the social interaction of 14 bereavement group meetings in Denmark. To study this, we used a discourse analytical approach focusing on how the participants position their social supporters. The results show that the participants designate, uphold, and presuppose two hierarchical positions to bereaved and non-bereaved supporters with different abilities to understand them. Based on this finding, the concepts of “grief participation rights” and “social support hierarchy” are proposed to supplement existing notions of “rights to grieve” and “grief hierarchy.” These concepts suggest that non-bereaved supporters are not accorded the same participatory rights in social support conversations as bereaved individuals who have suffered a similar loss as the speaker. The concepts are discussed in relation to effective social support and in the context of research on social disconnection in grief.

Social Withdrawal, Loneliness, and Health in Schizophrenia: Psychological and Neural Mechanisms.

Some of the most debilitating aspects of schizophrenia and other serious mental illnesses (SMI) are the impairments in social perception, motivation, and behavior that frequently accompany these conditions. These impairments may ultimately lead to chronic social disconnection (ie, social withdrawal, objective isolation, and perceived social isolation or loneliness), which may contribute to the poor cardiometabolic health and early mortality commonly observed in SMI. However, the psychological and neurobiological mechanisms underlying relationships between impairments in social perception and motivation and social isolation and loneliness in SMI remain incompletely understood. A narrative, selective review of studies on social withdrawal, isolation, loneliness, and health in SMI. We describe some of what is known and hypothesized about the psychological and neurobiological mechanisms of social disconnection in the general population, and how these mechanisms may contribute to social isolation and loneliness, and their consequences, in individuals with SMI. A synthesis of evolutionary and cognitive theories with the "social homeostasis" model of social isolation and loneliness represents one testable framework for understanding the dynamic cognitive and biological correlates, as well as the health consequences, of social disconnection in SMI. The development of such an understanding may provide the basis for novel approaches for preventing or treating both functional disability and poor physical health that diminish the quality and length of life for many individuals with these conditions.

Psychic Pain Among Men: Factor Structure, Psychosocial Correlates, and Mediation of Social Connectedness and Suicidal Ideation.

The Psychic Pain Scale (PPS) measures a form of mental pain involving overwhelming negative affect and loss of self-control. Understanding psychic pain among men is needed to advance efforts for preventing male suicide. The present study examined the factor structure and psychosocial correlates of the PPS among 621 online help-seeking men. Confirmatory factor analysis indicated a higher-order factor comprising affect deluge and loss of control factors. Psychic pain evinced significant associations with general psychological distress, r = 0.64; perceived social support, r = -0.43; social connectedness, r = -0.55; and suicidal ideation, r = 0.65 (all p 's < 0.001)-the latter three remained significant after controlling for general distress. Psychic pain also mediated the association between social disconnection and suicidal ideation (standardized indirect effect = -0.14 [-0.21, -0.09]), after controlling for social support and distress. Findings support the PPS as a promising measure for investigating psychic pain among men and indicate psychic pain as a link between social disconnection and suicidal ideation.

Does disseminating (mis)information restore social connection during a global pandemic?

AbstractThe COVID‐19 pandemic impeded social interaction, negatively affecting well‐being worldwide. To slow virus spread, practices were enacted to minimize face‐to‐face contact, leading to increased social disconnection. As people turned increasingly to online environments (e.g., social media) to fulfill needs for inclusion and belonging, misinformation regarding COVID‐19 simultaneously ran rampant. The purpose of the current study was to examine whether impeded social inclusion may have contributed to the spread of misinformation. We recruited a sample of adult social media users in the United States (N = 431) and randomly assigned them to be either included, ostracized (i.e., ignored), or rejected (i.e., to receive explicitly negative attention). Participants subsequently rated their willingness to share COVID‐19 claims via social media (in fact, all claims were false). Participants learned that sharing some claims would likely lead to high expected engagement from others on social media (e.g., “likes”), whereas some claims would likely lead to little expected engagement. While information sharing was low in our sample, participants were more willing to share claims that they believed would lead to higher levels of engagement—consistent with the idea that sharing information is motivated not only by the desire to educate others but also to elicit social connection. However, this behavioral intention was no more common among participants who had been momentarily ostracized or rejected online than among participants who had been included. Future research should continue to explore the link between social exclusion and the motivation to disseminate (mis)information beyond a pandemic‐related context.

Relationship Between Unmet Social Needs and Care Access in a Veteran Cohort

BackgroundThe association between unmet social needs (e.g., food insecurity) and adverse health outcomes is well-established, especially for patients with and at risk for cardiovascular disease (CVD). This has motivated healthcare systems to focus on unmet social needs. Yet, little is known about the mechanisms by which unmet social needs impact health, which limits healthcare-based intervention design and evaluation. One conceptual framework posits that unmet social needs may impact health by limiting care access, but this remains understudied.ObjectiveExamine the relationship between unmet social needs and care access.DesignCross-sectional study design using survey data on unmet needs merged with administrative data from the Veterans Health Administration (VA) Corporate Data Warehouse (September 2019–March 2021) and multivariable models to predict care access outcomes. Pooled and separate rural and urban logistic regression models were utilized with adjustments from sociodemographics, region, and comorbidity.SubjectsA national stratified random sample of VA-enrolled Veterans with and at risk for CVD who responded to the survey.Main MeasuresNo-show appointments were defined dichotomously as patients with one or more missed outpatient visits. Medication non-adherence was measured as proportion of days covered and defined dichotomously as adherence less than 80%.Key ResultsGreater burden of unmet social needs was associated with significantly higher odds of no-show appointments (OR = 3.27, 95% CI = 2.43, 4.39) and medication non-adherence (OR = 1.59, 95% CI = 1.19, 2.13), with similar associations observed for rural and urban Veterans. Social disconnection and legal needs were especially strong predictors of care access measures.ConclusionsFindings suggest that unmet social needs may adversely impact care access. Findings also point to specific unmet social needs that may be especially impactful and thus might be prioritized for interventions, in particular social disconnection and legal needs.

The taboo of mental health problems, stigma and fear of disclosure among Asian international students: implications for help-seeking, guidance and support

ABSTRACT The current study explored the experiences of Asian International Students (AISs) in terms of mental health, disclosure and help-seeking within Higher Education in Scotland, UK. A qualitative study using individual semi-structured interviews with AISs (n = 20) was used and an inductive thematic approach to analysis was conducted. Three major themes were developed: (1) Negative beliefs, stigma and fear of judgment, (2) Adaptation and acculturation difficulties and (3) Barriers in communication, social disconnection and loneliness. Supporting AISs involves challenging negative judgements surrounding mental health, increasing mental health literacy and addressing barriers that may inhibit disclosure and help-seeking behaviour. The need for culturally sensitive mental health practitioners and awareness of diverse understandings of mental health issues is essential to improving support for AISs.

Home Visitation Program Staff Attitudes and Intentions Towards Using Digital Technology to Educate Families About Preventing Early Childhood Obesity: A Qualitative Study.

Home visitation programs that reach families of young children offer a unique opportunity for large-scale early childhood obesity prevention efforts. The objective of this qualitative research was to determine stakeholder attitudes, subjective norms, perceived ease of use and usefulness, behavioral control, and behavioral intentions towards utilizing technology in a home visitation program targeting early childhood obesity prevention. Staff from the Florida Maternal, Infant, and Early Childhood Home Visiting Program (n = 27) were interviewed individually by a trained research assistant using a semi-structured script based on constructs from the Technology Acceptance Model and Theory of Planned Behavior. Demographic and technology use information were collected. Interviews were recorded and transcribed verbatim, with data extracted and coded by two trained researchers using a theoretical thematic analysis approach. Most of the home visiting staff (78%) were white and non-Hispanic and employed for an average of 5years with the program. Most staff (85%) indicated they were currently using videoconferencing for home visits. Themes and subthemes emerged, including positive attitudes towards technology as a flexible and time-efficient program alternative for childhood obesity prevention with recommendations to keep content short, at a low literacy level, and available in more than one language for ease of use. Participants recommended developing training tutorials to improve program implementation. Internet access and potential social disconnect were cited as concerns for using technology. Overall, home visitation staff had positive attitudes and intentions for using technology in home visiting programs with families for early childhood obesity prevention.

Social cognitive bias increases loneliness both directly and by decreasing social connection in patients with schizophrenia.

While considerable emphasis has been put on investigating the mechanisms that drive reduced social connection in patients with schizophrenia (SCZ), recent studies have increasingly focused on the issue of loneliness in SCZ. As both social cognitive bias and self-reported empathy predict loneliness in non-clinical populations, the current study aims to examine the relationship between loneliness, reduced social connection and social cognitive biases, and self-reported empathy in SCZ. Ninety-three adult SCZ and sixty-six matched healthy individuals completed a battery of questionnaires measuring loneliness and social connection (Revised-UCLA Loneliness Scale, Lubben-Social Network Scale, Social Disconnectedness Scale), cognitive biases (Ambiguous Intentions Hostility Questionnaire, Davos Assessment of Cognitive Biases Scale, Cognitive Biases Questionnaire for psychosis) and self-reported empathy (Interpersonal Reactivity Index). Significant predictors of loneliness in SCZ were entered into two latent variables ("Social Threat Bias", "Social Connection"), and structural equation modeling was used to explore the direct and indirect relationships between Social Threat Bias, symptoms. and loneliness in SCZ. Patients reported higher levels of loneliness, cognitive biases and personal distress compared to controls. Furthermore, SCZ reported less social connection and perspective taking compared to controls. Structural equation modeling revealed that Social Threat Bias was linked to increased loneliness in SCZ both directly and indirectly via decreased social connection. Negative symptoms were directly linked with loneliness, while the association between affective symptoms and loneliness was mediated via Social Threat Bias. The results of the current study suggest that social threat bias should be considered while planning the interventions aimed to reduce loneliness in schizophrenia.

Intimate Partner Violence Survivors' Daily Experiences of Social Disconnection, Substance Use, and Sex with Secondary Partners.

Women who have experienced intimate partner violence (IPV) are disproportionately likely to engage in sexual risk behavior, including sex with a secondary partner (i.e., sex partners outside their primary relationship). Social disconnection has been identified as a social determinant of health that may enhance understanding of sex with a secondary partner. This study extends past research by using an intensive longitudinal design consisting of multiple daily assessments to examine event-level associations between women IPV survivors' social disconnection and sex with a secondary partner concurrently (i.e., during the same aggregated assessment) and temporally (i.e., social disconnection during one assessment predicting sex with a secondary partner in a subsequent assessment) over a 14-day period, in consideration of physical, psychological, and sexual IPV, and alcohol and drug use. Participants (N = 244) were recruited from New England through 2017. Results from multilevel logistic regression models indicate that women who experienced greater social disconnection on average were more likely to report sex with a secondary partner. However, after including IPV and substance use in the model, the strength of this relationship was attenuated. Sexual IPV emerged as a between-person predictor of sex with a secondary partner in temporally lagged models. Results provide insight into the relationships between daily social disconnection and sex with a secondary partner among IPV survivors, particularly regarding the effects of substance use and IPV both concurrently and temporally. Taken together, findings emphasize the importance of social connection for women's well-being and highlight the need for interventions that enhance interpersonal connectedness.

"And you feel like you're suffocating … how the fuck am I going to get out of all this?" Drivers and experiences of suicidal ideation in the Australian construction industry.

This research was designed to generate understandings of drivers and experiences of suicidal ideation and distress among Australian Construction Industry (ACI) workers, as well as what helped during these experiences. Fifteen participants, from a variety of ACI or closely associated roles, with an average age of 45 years (29-66), engaged in individual, semi-structured interviews. Interviews were audio-recorded with consent and analyzed using descriptive thematic analysis. Eight themes relating to what may drive the presence of suicidal ideation and distress were identified; 1) challenges of working within the ACI, 2) relationship and family issues, 3) social disconnection, 4) personal financial hardship, 5) perceived lack of support, 6) alcohol and drug use, 7) child custody/access and legal issues, and 8) experience of mental health challenges, trauma, or a significant adverse life event. Four themes relating to experience and expression of suicidal ideation and distress were identified: 1) suicidal thoughts, 2) impaired thinking, 3) observable expressions of suicidal distress, and 4) lack of observable expressions of suicidal distress. Six themes relating to what helped during experiences and well as what can be done by the ACI to help mitigate experiences, were identified: 1) presence of colleague and managerial support, 2) MATES in Construction, 3) engagement with non-work activities and social support, 4) personal skills and knowledge relating to suicide and mental health, 5) high level industry integration and engagement with support programs, and 6) work hours and expectations changes. Findings highlight several industry and personal related challenges that may drive experiences, with many potentially mitigatable by ACI changes and focused prevention strategies. Participant suicidal thought descriptions align with previously identified constructs deemed central in suicidal trajectories. While findings highlight several observable expressions of suicidal ideation and distress, challenges associated with identifying and assisting individuals in the ACI who may be struggling were also reported. Several factors that helped ACI workers during their experiences, as well as what the ACI can do to mitigate future experiences, were identified. Recommendations are made based on these findings, encouraging a more supportive work environment, as well as continued development and increased awareness of support and education systems.

Feeling Alone in one's Grief: Investigating Social Cognitions in Adaption to Bereavement using the German Version of the Oxford Grief-Social Disconnection Scale

BackgroundSocial support would be expected to influence grief processes positively. However, inconsistent empirical findings suggest the existence of moderating variables that determine whether social contact attenuates grief-related distress. The Oxford Grief-Social Disconnection Scale (OG-SD) measures the subjective experience of social disconnection, i.e. a perceived change in the social self that may diminish the rewarding features of authentic social interaction. The aim of this study was to validate the German version of the OG-SD and to investigate its association with grief severity and perceived social support. MethodGerman bereaved adults responded to an online-survey, containing the translated OG-SD and measures of grief severity (ICG), grief-specific avoidance, depressive and posttraumatic stress symptoms and perceived social support (PSS). In this sample of 341 participants (34±15 years; 81% female), the average time since loss was 6.8 (±8.8) years. Item analyses and confirmatory factor analysis (CFA) were conducted. Concerning construct validity, correlations between the OG-SD and the other measures were assessed and an independent sample t test compared OG-SD scores of candidates for probable prolonged grief ‘caseness’ (PGD) and non-candidates. ResultsThe OG-SD showed excellent internal consistency (α = 0.94). A CFA replicated the original factorial structure. Higher OG-SD scores were associated with higher grief severity (ICG; r = 0.61, p < .01) and less perceived social support (PSS; r = −0.52, p < .01). Persons with probable PGD scored significantly higher on the OG-SD than the remaining sample (t[239,20] = 9.39, p < .001, d = 1.11). ConclusionThe German version of the OG-SD showed good psychometric properties. Our findings demonstrate a strong cross-sectional association between social disconnection, grief severity, and a perceived lack of adequate social support. Future longitudinal studies are needed to establish the dynamic relationship between these constructs, e.g., whether social disconnection is a correlate or a risk factor for PGD.

Racial and Gender Differences in Medical Student Burnout: A 2021 National Survey

ObjectiveTo measure racial and gender differences in medical student burnout and identify possible contributing factors. Patients and MethodsElectronic surveys were distributed to medical students at 9 US medical schools from December 27, 2020, through January 17, 2021. Questions covered demographic characteristics, stressors contributing to burnout, and the 2-item Maslach Burnout Inventory. ResultsOf 5500 invited students, 1178 (21%) responded (mean age, 25.3 years; 61% identified as female). Fifty-seven percent of respondents identified as White, 26% as Asian, and 5% as Black. Overall, 75.6% of students met the criteria for burnout. Women reported more burnout (78% vs 72%; P=.049). There were no differences in burnout prevalence by race. Students commonly reported that lack of sleep (42%), decreased engagement in hobbies or self-care (41%), stress about grades (37%), feeling socially disconnected (36%), and lack of exercise (35%) contributed to burnout. Compared with students of other races, Black students reported that their feelings of burnout were affected significantly more by lack of sleep and poor diet, and Asian students more by stress about grades, residency, and publishing pressure (all P<.05). Female students were more affected than male students by stress about grades, poor diet, and feelings of social disconnectedness and inadequacy (all P<.05). ConclusionBurnout (75.6%) was higher than historical norms, and female students reported higher burnout than male students. There was no difference in burnout prevalence by race. There were racial and gender differences in self-identified contributors of burnout. Additional research is needed to confirm whether stressors were contributors to or consequences of burnout, as well as how to address them.

A 50-state survey study of thoughts of suicide and social isolation among older adults in the United States

BackgroundWe aimed to characterize the prevalence of social disconnection and thoughts of suicide among older adults in the United States, and examine the association between them in a large naturalistic study. MethodsWe analyzed data from 6 waves of a fifty-state non-probability survey among US adults conducted between February and December 2021. The internet-based survey collected the PHQ-9, as well as multiple measures of social connectedness. We applied multiple logistic regression to analyze the association between presence of thoughts of suicide and social disconnection. Exploratory analysis, using generalized random forests, examined heterogeneity of effects across sociodemographic groups. ResultsOf 16,164 survey respondents age 65 and older, mean age was 70.9 (SD 5.0); the cohort was 61.4 % female and 29.6 % male; 2.0 % Asian, 6.7 % Black, 2.2 % Hispanic, and 86.8 % White. A total of 1144 (7.1 %) reported thoughts of suicide at least several days in the prior 2 week period. In models adjusted for sociodemographic features, households with 3 or more additional members (adjusted OR 1.73, 95 % CI 1.28–2.33) and lack of social supports, particularly emotional supports (adjusted OR 2.60, 95 % CI 2.09–3.23), were independently associated with greater likelihood of reporting such thoughts, as was greater reported loneliness (adjusted OR 1.75, 95 % CI 1.64–1.87). The effects of emotional support varied significantly across sociodemographic groups. ConclusionsThoughts of suicide are common among older adults in the US, and associated with lack of social support, but not with living alone. Trial registrationNA.

Prenatal Stress Exposure Amplifies Effect of Maternal Suicidal Ideation on Early Childhood Behavioral Trajectories.

The inutero environment influences fetal development and may predispose to disease later in life. This study examines whether maternal suicidal ideation during pregnancy is associated with children's behavioral trajectories across early childhood, and whether prenatal maternal traumatic stress accelerates the trajectories. The study included mother-child dyads (N = 331, 51.1% boys) from the longitudinal Stress In Pregnancy study; 31.1% (n = 103) mothers were Exposed to Superstorm Sandy. During their second trimester, 12.4% (n = 41) women reported suicidal ideation during pregnancy. Mothers completed the Behavior Assessment Scale for Children-2 annually from ages 2- to 6-years-old to assess multiple behavioral domains. Hierarchical linear modeling estimated within-person longitudinal trajectories of clinical behaviors, and between-person effects of maternal suicidal ideation and disaster-related stressin utero on changes in child behavior. For children exposed to both risks, Atypical behaviors (i.e., unusual behaviors, social disconnection) increased linearly across early childhood. Exposure to Superstorm Sandy and maternal suicidal ideation were independently associated with non-linear increases in Anxiety severity and maternal suicidal ideation during pregnancy was associated with a linear increase in Attention problems across early childhood. Maternal suicidal ideation during pregnancy is associated with increased risk for a range of behavioral and emotional difficulties in early childhood and the trajectory of atypical behaviors was amplified by disaster-related traumatic stress. Findings highlight the need for health professionals to screen for suicidal ideation among their pregnant patients. Pregnant women who experience severe stress may require additional monitoring and support to reduce risk for poorer early childhood outcomes.

Review of Major Social Determinants of Health in Schizophrenia-Spectrum Disorders: II. Assessments.

Social determinants of health (SDoHs) impact the development and course of schizophrenia-spectrum psychotic disorders (SSPDs). Yet, we found no published scholarly reviews of psychometric properties and pragmatic utility of SDoH assessments among people with SSPDs. We aim to review those aspects of SDoH assessments. PsychInfo, PubMed, and Google Scholar databases were examined to obtain data on reliability, validity, administration process, strengths, and limitations of the measures for SDoHs identified in a paired scoping review. SDoHs were assessed using different approaches including self-reports, interviews, rating scales, and review of public databases. Of the major SDoHs, early-life adversities, social disconnection, racism, social fragmentation, and food insecurity had measures with satisfactory psychometric properties. Internal consistency reliabilities-evaluated in the general population for 13 measures of early-life adversities, social disconnection, racism, social fragmentation, and food insecurity-ranged from poor to excellent (0.68-0.96). The number of items varied from 1 to more than 100 and administration time ranged from less than 5 minutes to over an hour. Measures of urbanicity, low socioeconomic status, immigration status, homelessness/housing instability, and incarceration were based on public records or targeted sampling. Although the reported assessments of SDoHs show promise, there is a need to develop and test brief but validated screening measures suitable for clinical application. Novel assessment tools, including objective assessments at individual and community levels utilizing new technology, and sophisticated psychometric evaluations for reliability, validity, and sensitivity to change with effective interventions are recommended, and suggestions for training curricula are offered.

Loneliness is associated with a greater self-reference effect in episodic memory when compared against a close friend.

Loneliness describes a negative experience associated with perceived social disconnection. Despite the clear links between loneliness and mental and physical health, relatively little is known about how loneliness affects cognition. In this study, we tested the effect of loneliness on cognitive distance between the self and others, using a task in which participants completed a surprise memory task for adjectives implicitly encoded in relation to the self, a close friend or a celebrity. We assessed item memory sensitivity, metacognitive sensitivity, metacognitive efficiency and source memory for positive and negative words. In addition, participants reported their trait loneliness and depression. Results revealed an overall self-referential advantage compared with both friend and celebrity encoded items. Likewise, a friend-referential advantage was identified compared to celebrity-encoded items. Individuals who experienced more loneliness showed a greater self-referential bias in comparison to words encoded in relation to a close friend, and a smaller friend-referential bias in comparison to words encoded in relation to celebrity. These findings suggest that loneliness is reflected in a greater cognitive distance between the self and close friends in relation to memory biases. The results have important implications for understanding the social contextual effects on memory and the cognitive ramifications of loneliness.