Social Dysfunction In Schizophrenia Research Articles

AI-enhanced analysis of naturalistic social interactions characterizes interaffective impairments in schizophrenia

Social deficits in schizophrenia have been attributed to an impaired attunement to mutual interaction, or “interaffectivity”. While impairments in emotion recognition and facial expressivity in schizophrenia have been consistently reported, findings on mimicry and social synchrony are inconsistent, and previous studies have often lacked ecological validity. To investigate interaffective behavior in dyadic interactions in a real-world-like setting, 20 individuals with schizophrenia and 20 without mental disorder played a cooperative board game with a previously unacquainted healthy control participant. Facial expression analysis was conducted using Affectiva Emotion AI in iMotions 9.3. The contingency and state space distribution of emotional facial expressions was assessed using Mangold INTERACT. Psychotic symptoms, subjective stress, affectivity and game experience were evaluated through questionnaires. Due to a considerable between-group age difference, age-adjusted ANCOVA was performed. Overall, despite an unchanged subjective experience of the social interaction, individuals with schizophrenia exhibited reduced responsiveness to positive affective stimuli. Subjective game experience did not differ between groups. Descriptively, facial expressions in schizophrenia were generally more negative, with increased sadness and decreased joy. Facial mimicry was impaired specifically regarding joyful expressions in schizophrenia, which correlated with blunted affect as measured by the SANS. Dyadic interactions involving persons with schizophrenia were less attracted toward mutual joyful affective states. Only unadjusted for age, in the absence of emotional stimuli from their interaction partner, individuals with schizophrenia showed more angry and sad expressions. These impairments in interaffective processes may contribute to social dysfunction in schizophrenia and provide new avenues for future research.

Disorganized Communication and Social Dysfunction in Schizophrenia: Emerging Concepts and Methods.

In this review, we embrace the emerging field of second-person neuroscience to address disorganization in schizophrenia. We argue that the focus of interest for disorganization is the interpersonal space where shared mental processes ('social mind') occur based on the bio-behavioural synchrony between two (or more) interacting people. We lay out several bio-behavioural measures that can capture the component parts of this process. In particular, we highlight the real-time imaging technology of hyperscanning that enables multi-person analysis of naturalistic social interaction. We illustrate how these measures can be used in empirical studies by posing disorganization as a problem of interpersonal processing. Traditionally, disorganized speech and behaviour have been studied as the product of hidden cognitive processes ('private mind'). A dysfunction in these processes was attributed to the brain afflicted by the illness ('brain-bound mechanisms'). But this approach has contributed to challenges in measuring and quantifying disorganization. Consequently, the single-brain focus has not provided satisfactory clarity or led to effective treatments for persistent social dysfunction in schizophrenia. Social dysfunction is a core feature of schizophrenia. This dysfunction arises from disorganized interpersonal interaction that typifies the social profile of affected individuals. We outline challenges in employing several emerging concepts and methods and how they can be addressed to investigate the mechanisms of social dysfunction in schizophrenia.

The Relevance of Animal Models of Social Isolation and Social Motivation for Understanding Schizophrenia: Review and Future Directions.

Social dysfunction in schizophrenia includes symptoms of withdrawal and deficits in social skills, social cognition, and social motivation. Based on the course of illness, with social withdrawal occurring prior to psychosis onset, it is likely that the severity of social withdrawal/isolation contributes to schizophrenia neuropathology. We review the current literature on social isolation in rodent models and provide a conceptual framework for its relationship to social withdrawal and neural circuit dysfunction in schizophrenia. We next review preclinical tasks of social behavior used in schizophrenia-relevant models and discuss strengths and limitations of existing approaches. Lastly, we consider new effort-based tasks of social motivation and their potential for translational studies in schizophrenia. Social isolation rearing in rats produces profound differences in behavior, pharmacologic sensitivity, and neurochemistry compared to socially reared rats. Rodent models relevant to schizophrenia exhibit deficits in social behavior as measured by social interaction and social preference tests. Newer tasks of effort-based social motivation are being developed in rodents to better model social motivation deficits in neuropsychiatric disorders. While experimenter-imposed social isolation provides a viable experimental model for understanding some biological mechanisms linking social dysfunction to clinical and neural pathology in schizophrenia, it bypasses critical antecedents to social isolation in schizophrenia, notably deficits in social reward and social motivation. Recent efforts at modeling social motivation using effort-based tasks in rodents have the potential to quantify these antecedents, identify models (eg, developmental, genetic) that produce deficits, and advance pharmacological treatments for social motivation.

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

Social dysfunction is a hallmark of schizophrenia that is associated with emotional disturbances. Researchers have employed ecological momentary assessment (EMA) to measure social and emotional functioning in people with schizophrenia. Yet, few studies have evaluated quality of real-world social interactions, and it is unclear how interactions impact emotional experiences in this population. Using novel EMA that passively collects audio data, we examined daily social behavior and emotion in schizophrenia (n = 38) and control (n = 36) groups. Contrary to hypotheses, both groups interacted with others at the same rate and exhibited similar levels of positive emotion. However, as expected, the schizophrenia group exhibited significantly less high-quality interactions and reported more negative emotion than controls. Social versus non-social context did not influence experienced emotion in either group. This is the first real-world study to passively assess quality of social interactions in schizophrenia. Although those with schizophrenia did not differ in their number of interactions, they were less likely to engage in substantive, personal conversations. Because high-quality interactions are linked with better social outcomes, this finding has important potential treatment implications. Future research should investigate quality of interactions across different types of social activities to gain a more nuanced understanding of social dysfunction in schizophrenia.

Anomalous self-experiences are related to general cognition deficits in schizophrenia.

Anomalous self-experiences (ASEs) are prevalent in schizophrenia, but its underpinnings are not completely understood. Given the likely complex substrate of the experience of the self, neurocognitive functions requiring coordinate cerebral activity may relate to ASEs. Moreover, cognitive deficits functioning may be involved in the link between self-experience disturbances and some aspects of social dysfunction in schizophrenia. We have assessed ASEs in 41 schizophrenia patients (11 first episodes) using the Inventory of Psychotic-Like Anomalous Self-Experiences (IPASE), and the general cognition using the Brief Assessment of Cognition in Schizophrenia (BACS). Besides, social cognition was assessed using two complementary tools Meyer, Salovey and Caruso Emotional Intelligence Test (MSCEIT) and GEOPTE (Grupo Español para la Optimización del Tratamiento de la Esquizofrenia). The results revealed that Self-awareness/presence and Somatization IPASE scores were inversely explained by motor speed in the BACS; Consciousness IPASE scores were inversely explained by problem solving performance in the BACS. These data reveal a significant relationship between certain domains of general cognition and anomalous self-experiences, that may be useful in further investigation on the substrates of ASEs.

S55. PRAGMATIC INFERENCES IN SCHIZOPHRENIA: RELATIONSHIP WITH SYMPTOM DOMAINS, THEORY OF MIND AND NEUROCOGNITIVE FUNCTIONS

BackgroundSevere impairment in interpersonal functioning is a common feature of schizophrenia. Deficits in communicative abilities are likely to be among the important factors contributing to social dysfunction in schizophrenia. Difficulties in pragmatic language abilities including understanding intended meaning, beyond explicit and literal content of conversational statements can significantly hamper interpersonal and occupational functioning.An important aspect of pragmatic inference is the ability to derive scalar implicatures (SIs), which are based on linguistic expressions like some, or, often etc. For deriving SIs, one need to go beyond simple semantic and logical level. To date, only a single study has investigated SIs in schizophrenia (Wampers et al 2018). In this study, people with psychosis were less likely to derive SIs than controls. A preliminary analysis of 17 patients with schizophrenia in the same study also showed that better ToM was associated with a higher ability to derive SIsImportantly, the association with schizophrenia and abnormalities in pragmatic infererence might be mediated by clinical features of this illness including formal thought disorder and negative symptoms. Also, difficulties in pragmatic inferences might potentially be secondary to neurocognitive dysfunction rather than being primary deficits. No previous study has investigated clinical and neurocognitive correlates of impairment in ability to derive SIs in schizophrenia.MethodsThe study included 79 patients with schizophrenia-spectrum disorders (66 schizophrenia and 13 schizoaffective disorder) and 49 healthy controls who completed a SI task. SAPS, SANS were also administered. Comprehension of irony, metaphor and faux pas were assessed using verbal story tasks. A subgroup of patients were also administered a comprehensive neuropsychological battery and two ToM tasks (Hinting task and RMET (Reading the Mind from the Eyes).ResultsThere were no significant group difference between schizophrenia and healthy controls for age (F=0.69, p=0.41) and gender (Chi square=2.2, p=0.13). The schizophrenia sample had a shorter duration of education compared to the healthy controls (F=27.2, p<0.001). The patients with schizophrenia had significant impairment in understanding the SIs (F=8.2, p=0.005). Comprension impairment of SIs were significantly associated with SANS negative symptoms (r=-0.29, p= 0.009) but not with SAPS positive formal thought disorder (r=-0.09, p=0.44) and symptoms ratings for hallucinations and delusions. Understanding SIs in schizophrenia was significantly related to better performance in RMET (r=0.34, p=0.036) and irony comprehension (r=-0.38, p=0.001).DiscussionSchizophrenia is associated with significant deficits in understanding pragmatic utterances. These deficits were significantly related to some aspects of social cognition but not neurocognition. Current findings do not support the proposed relationship between formal thought disorder and pragmatic abnormalities in schizophrenia. These findings might have implications in management of social functioning deficits in schizophrenia.

Role of frontal white matter and corpus callosum on social function in schizophrenia

Patients with schizophrenia show severe impairment in social function and have difficulty in their daily social life. Although a recent large-scale multicenter study revealed alterations in white matter microstructures, the association between these anatomical changes and social dysfunction in schizophrenia remains unknown. Therefore, we investigated the association between the white matter integrity of regions of interest and social function in schizophrenia. A total of 149 patients with schizophrenia and 602 healthy comparison subjects (HCS) underwent DTI and completed the Picture Arrangement subtest of the Wechsler Adult Intelligence Scale-Third Edition and the Finance subscale of the University of California, San Diego, Performance-Based Skills Assessment Brief, as social indices of interest. The fractional anisotropy (FA) in the anterior corona radiata and corpus callosum was significantly lower in patients than in HCS, and the radial diffusivity (RD) in the anterior corona radiata and corpus callosum was significantly higher in patients. The Picture Arrangement and Finance scores were both significantly impaired in patients. The effect of the FA of the right anterior corona radiata on the Finance score and the Picture Arrangement score, of the RD of the right anterior corona radiata on the Picture Arrangement score, and of the RD of the corpus callosum on the Picture Arrangement score were significant. In conclusion, our results confirmed the association between structural connectivity in the right frontal white matter and corpus callosum and social function in schizophrenia. These findings may provide a foundation for developing an intervention for functional recovery in schizophrenia.

Working memory and prefrontal/temporal hemodynamic responses during post-task period in patients with schizophrenia: A multi-channel near-infrared spectroscopy study

The relationship between cognitive impairments and social dysfunction in schizophrenia is widely accepted. Neuroimaging studies in patients with schizophrenia have demonstrated abnormal function in the prefrontal region during various neurocognitive tasks. However, studies exploring the neural basis of these cognitive impairments are still limited. Multi-channel near-infrared spectroscopy (NIRS) is a non-invasive functional neuroimaging technique used to detect the spatiotemporal characteristics of brain activity. Previous NIRS studies indicated oxy-hemoglobin (oxy-Hb) increase in patients with schizophrenia during the verbal fluency task (VFT), but to a lesser extent than in healthy participants. Furthermore, aberrant re-increase in the prefrontal region was observed during the post-task period. We hypothesized that prefrontal/temporal oxy-Hb aberrant re-increase during the post-task period was associated with cognitive impairment because oxy-Hb aberrant re-increase represent inadequate suppression of neural activity in the post-task period.We recruited 30 patients with schizophrenia and 30 healthy participants in this study. All participants underwent 52-channel NIRS measurement using the VFT. The patients with schizophrenia showed oxy-Hb aberrant re-increase in prefrontal and temporal regions during the post-task period. Although there was no significant relationship between changes in the oxy-Hb during the task and the scores of the Brief Assessment of Cognition in Schizophrenia (BACS), a significant negative correlation was observed between the oxy-Hb during the post-task period and BACS working memory z-scores (in DLPFC and temporal regions). These results suggest that oxy-Hb re-increase during the post-task period in prefrontal and temporal regions is associated with WM deficits in patients with schizophrenia and NIRS may be a potential biomarker of working memory in chronic schizophrenia.

Oxytocin system dysfunction as a common mechanism underlying metabolic syndrome and psychiatric symptoms in schizophrenia and bipolar disorders.

There is growing interest in using intranasal oxytocin (OT) to treat social dysfunction in schizophrenia and bipolar disorders (i.e., psychotic disorders). While OT treatment results have been mixed, emerging evidence suggests that OT system dysfunction may also play a role in the etiology of metabolic syndrome (MetS), which appears in one-third of individuals with psychotic disorders and associated with increased mortality. Here we examine the evidence for a potential role of the OT system in the shared risk for MetS and psychotic disorders, and its prospects for ameliorating MetS. Using several studies to demonstrate the overlapping neurobiological profiles of metabolic risk factors and psychiatric symptoms, we show that OT system dysfunction may be one common mechanism underlying MetS and psychotic disorders. Given the critical need to better understand metabolic dysregulation in these disorders, future OT trials assessing behavioural and cognitive outcomes should additionally include metabolic risk factor parameters.

Eye and face abnormal processing and social dysfunction in schizophrenia

Eye and face abnormal processing and social dysfunction in schizophrenia

Metacognition and general functioning in patients with schizophrenia and a history of criminal behavior

Metacognitive difficulties have been linked to social dysfunction in schizophrenia. However, research examining the role of metacognition in the social functioning of patients with a history of violence and criminality is very limited. This research is especially important for this group given their relatively poor prognosis and their risk to reoffend, as well as the promising benefits of integrating metacognitive approaches in psychosocial treatments. In this study, the association between metacognition and global social functioning was examined in 79 patients with schizophrenia with a criminal background. We also examined the association of positive, negative and disorganized symptoms with social functioning and the extent to which metacognition mediates this association. The results indicate that poor social functioning is associated with metacognitive difficulties and higher levels of delusions and Conceptual Disorganization. In addition, meditation analyses showed that metacognition accounted for about 11% of the total effect size of the association between delusions and social dysfunction, suggesting that the relationship between delusions and social dysfunction is partially driven by impaired metacognition. These findings underscore the importance of interventions designed to enhance the patients׳ metacognitive capacities, that is, the more proximal capacities linked to poorer social functioning.

Theory of Mind and attachment styles in people with psychotic disorders, their siblings, and controls.

Impaired Theory of Mind (ToM) and insecure (adult) attachment styles have been found in persons with schizophrenia as well as in their healthy siblings. ToM refers to the ability to infer mental states of self and others including beliefs and emotions. Insecure attachment is proposed to underlie impaired ToM, and comprises avoidant (discomfort with close relationships, high value of autonomy) and anxious (separation anxiety, dependency on others) attachment. Insight into the association between attachment style and ToM is clinically relevant, as it enhances our understanding and clinical approach to social dysfunction in schizophrenia. Therefore, we studied the association between insecure attachment styles and ToM in patients with schizophrenia, their siblings, and healthy controls. A total of 111 patients with a diagnosis in the schizophrenia spectrum, 106 non-affected siblings and 63 controls completed the Psychosis Attachment Measure, the Conflicting Beliefs and Emotions, a subsection of the Wechsler Adult Intelligence Scale, and the Childhood Trauma Questionnaire-Short Form. Severity of symptoms was assessed with the Community Assessment of Psychic Experiences and the Positive and Negative Syndrome Scale. After controlling for sex, intelligence, history of trauma and symptom severity, avoidant attachment was significantly associated with cognitive as well as with affective ToM, showing U-shaped associations, indicating better ToM performance for patients with lower or higher levels of avoidant attachment compared to medium levels. Anxious attachment in patients was associated with more problems in cognitive ToM. The results from this study support the idea that an anxious attachment style is associated with worse ToM performance in patients. Results also suggested a potential protective role of higher levels of avoidant attachment on ToM. These findings bear clinical relevance, as activation of (insecure) attachment mechanisms may affect interpersonal relations, as well as therapeutic working alliance. Further clarification is needed, especially on associations between ToM and avoidant attachment.

Social cognition in schizophrenia.

The topic of social cognition has attracted considerable interest in schizophrenia over the last several years. This construct generally refers to the detection, processing, and utilization of social information and, within the field of schizophrenia, includes several skills such as recognizing emotion, understanding the thoughts and intentions of others, and interpreting social cues. Individuals with schizophrenia show significant impairments in social cognition, and these impairments are strongly related to functional outcome. Treating social cognition yields significant improvements in real-world outcomes, including social functioning and social skill. Importantly, social cognitive abilities are linked to specific neural circuits that have been shown to be abnormal in individuals with schizophrenia. Investigations of these neural networks in patients have also demonstrated that brain activation is significantly correlated with social functioning, which suggests that abnormal activation in social cognitive networks may serve as a mechanism for social dysfunction in schizophrenia. Among the many challenges in this area is the issue of measurement. There is disagreement about which tasks best measure social cognition and many existing measures show poor psychometric properties. A recent project, called the Social Cognition Psychometric Evaluation (SCOPE) study, aims to address these problems by providing the field with a well-validated battery of social cognitive tasks that can be used in treatment outcome trials. Research is honing in on the potential mechanisms of social cognitive impairment in patients, and with improved measurement, there is promise for optimizing behavioral and pharmacologic interventions and remediation strategies.

Altered Brain Activation During Action Imitation and Observation in Schizophrenia: A Translational Approach to Investigating Social Dysfunction in Schizophrenia

Social impairments are a key feature of schizophrenia, but their underlying mechanisms are poorly understood. Imitation, a process through which we understand the minds of others, involves the so-called mirror neuron system, a network comprising the inferior parietal lobe, inferior frontal gyrus, and posterior superior temporal sulcus. The authors examined mirror neuron system function in schizophrenia. Sixteen medicated schizophrenia patients and 16 healthy comparison subjects performed an action imitation/observation task during functional MRI. Participants saw a video of a moving hand or spatial cue and were instructed to either execute finger movements associated with the stimulus or simply observe. Activation in the mirror neuron system was measured during imitative versus nonimitative actions and observation of a moving hand versus a moving spatial cue. These contrasts were compared across groups. Activation in the mirror neuron system was less specific for imitation in schizophrenia. Relative to healthy subjects, patients had reduced activity in the posterior superior temporal sulcus during imitation and greater activity in the posterior superior temporal sulcus and inferior parietal lobe during nonimitative action. Patients also showed reduced activity in these regions during action observation. Mirror neuron system activation was related to symptom severity and social functioning in patients and to schizotypal syndrome in comparison subjects. Given the role of the inferior parietal lobe and posterior superior temporal sulcus in imitation and social cognition, impaired imitative ability in schizophrenia may stem from faulty perception of biological motion and transformations from perception to action. These findings extend our understanding of social dysfunction in schizophrenia.

Social dysfunction in schizophrenia: An investigation of the GAF scale's sensitivity to deficits in social cognition

BackgroundSchizophrenia is accompanied by significant impairment in psychosocial functioning, which is only partially explained by clinical symptom severity. Recently, these impairments have been strongly associated with deficits in neurocognition and social cognition. Although the Global Assessment of Function (GAF) scale remains the most widely used measure of psychosocial function in clinical practice, it is unclear whether this instrument is sensitive to changes in cognition, or merely provides a snapshot of symptom severity. To investigate this, we assessed whether variation in GAF score was explained by performance on measures of neurocognitive and social cognition, particularly after variation associated with symptom severity had been accounted for. Methods216 patients with schizophrenia were assessed using the GAF scale, two theory of mind tasks (the ‘Hinting’ task and ‘Reading the Eyes in the Mind’ task), and a neuropsychological battery sensitive to the areas of deficit typically seen in schizophrenia — IQ, episodic memory, working memory and attentional control. ResultsUsing linear regression analysis, symptom severity explained 24% of the variance in GAF scores (F(3, 188)=21.14, p<.001). While neuropsychological performance explained a further 4.7% of variation (r2change=.047, Fchange (1, 187)=12.63, p<.001), social cognition did not explain any further variance in functioning (r2change=.006, Fchange (1, 186)=1.63, p=.20). ConclusionThese data indicate that GAF scores are primarily sensitive to variation in clinical symptoms severity and not at all sensitive to variation in social cognition, an important determinant of real world outcome. Doing so highlights the need to supplement the measurement of psychosocial function using the GAF in clinical practice with functional measures that are more sensitive to deficits in social cognition.

Action blind: Disturbed self-other integration in schizophrenia

Recent research using individual task settings suggests that a major problem in schizophrenia is a dysfunctional theory of mind system leading to false mental state attributions. However, if a more low-level deficit to integrate own and other's actions (action blindness) is present in schizophrenia is still unknown. Using a Social Simon task, we tested if schizophrenia patients have a deficit in self-other integration. Further, we tested for a possible genetic bias of this dysfunction by studying clinically unaffected first-degree relatives of schizophrenia patients. While schizophrenia patients showed no Social Simon effect, we found a reliable Social Simon effect in healthy participants and first-degree relatives of schizophrenia patients. Joint task performance differed statistically between patients and healthy controls. We did not find any differences in the size of the Social Simon effects of relatives and healthy controls. The present findings suggest that schizophrenia patients have severe problems with self-other integration, which may lead to problems in social interactions. Since first-degree relatives of schizophrenia patients showed a reliable Social Simon effect, the evidence for a genetic bias of this social dysfunction in schizophrenia however is weak.

Altered face inversion effect and association between face N170 reduction and social dysfunction in patients with schizophrenia

ObjectiveThere is accumulating evidence that schizophrenics may have deficits in facial recognition, which has been related to disease-specific disturbances in normal social interaction. Neurophysiologically, face inversion results in an amplitude increase of the event-related potential (ERP) component N170. This face inversion effect (FIE) presumably reflects a disruption of face-specific configuration processing. The present study investigated FIE and the associations between social functioning and N170 in patients with schizophrenia. MethodsThe subjects consisted of 15 schizophrenics and 15 controls. Event-related potentials (ERPs) to upright and inverted neutral faces and cars were recorded. The relationships between the Social Functioning Scale (SFS) scores and N170 amplitude to upright faces or cars were also evaluated. ResultsNormal controls exhibited a significant FIE of the N170 amplitude, while schizophrenics showed no FIE. In both normal controls and schizophrenics, no inversion effect was observed for car stimuli. For face stimuli, schizophrenics showed significant bilateral N170 reduction; additionally, in schizophrenics, but not in controls, the SFS was significantly correlated with N170 amplitudes to upright faces. ConclusionsThese results indicate face-specific configuration processing deficits and significant associations between face-N170 reduction and social dysfunction in schizophrenia. SignificanceAbnormal face-specific configuration processing may underlie some of the social dysfunctions in schizophrenia.

The Impact of Impaired “Theory of Mind” on Social Interactions in Schizophrenia

Given the importance of social dysfunction in schizophrenia, many studies have explored how social cognition, and, particularly, Theory of Mind (ToM) may affect patients' social interactions. In the present study, we investigated the impact of ToM deficits on social interactions, taking into account overall neuropsychological functioning as well as clinical and demographic characteristics. We assessed 28 patients with schizophrenia and 30 healthy participants on a series of tasks including tests of ToM, neuropsychological tests focused on functions potentially relevant to ToM and role plays as an indicator of social interactions. Patients performed more poorly than healthy controls across most ToM and some of the neuropsychological tests. Correlations and hierarchical regression analyses indicated the impact of some, but not all, facets of ToM on patients' social interactions, over and above neuropsychological functioning, positive and negative symptom ratings, duration of illness and demographic characteristics. These findings suggest that remediation of ToM deficits in patients with schizophrenia may help to improve their social interactions.

Current pharmacological models of social withdrawal in rats

Social dysfunction in schizophrenia is one of the core negative symptoms, which to date is not adequately addressed by treatment with both typical and atypical antipsychotics. A number of different pharmacological models of social withdrawal are used to mimic social dysfunction in rats, such as amphetamine, N-methyl-D-aspartic acid antagonists, cannabinergic and serotonergic receptor ligands. The purpose of this review is to discuss and compare these models of social withdrawal with a focus on their face, construct and predictive validities. Various techniques and strategies used to observe and analyze rodent social behaviour and other factors that are of relevance to this paradigm have also been examined. After comparing the reports, we are of the opinion that to improve replicability of any given model and its antipsychotic screening potential and the reliability of comparisons made, efforts need to be directed towards cross-laboratory standardization of variables that may confound experimental outcomes and cause discrepancies in results reported. In keeping with an earlier suggestion this may be facilitated through the creation of an online consortium for behavioural neuroscientists to share and compare methodologies, laboratory layouts and perhaps even raw data.

The relationship of social function to depressive and negative symptoms in individuals at clinical high risk for psychosis

Social dysfunction is a hallmark symptom of schizophrenia which commonly precedes the onset of psychosis. It is unclear if social symptoms in clinical high-risk patients reflect depressive symptoms or are a manifestation of negative symptoms. We compared social function scores on the Social Adjustment Scale-Self Report between 56 young people (aged 13-27 years) at clinical high risk for psychosis and 22 healthy controls. The cases were also assessed for depressive and 'prodromal' symptoms (subthreshold positive, negative, disorganized and general symptoms). Poor social function was related to both depressive and negative symptoms, as well as to disorganized and general symptoms. The symptoms were highly intercorrelated but linear regression analysis demonstrated that poor social function was primarily explained by negative symptoms within this cohort, particularly in ethnic minority patients. Although this study demonstrated a relationship between social dysfunction and depressive symptoms in clinical high-risk cases, this association was primarily explained by the relationship of each of these to negative symptoms. In individuals at heightened risk for psychosis, affective changes may be related to a progressive decrease in social interaction and loss of reinforcement of social behaviors. These findings have relevance for potential treatment strategies for social dysfunction in schizophrenia and its risk states and predict that antidepressant drugs, cognitive behavioral therapy and/or social skills training may be effective.