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Item Do People With Schizophrenia Enjoy Social Activities as Much as Everyone Else? A Meta-analysis of Consummatory Social Pleasure(Oxford University Press, 2023) Abel, Danielle B.; Rand, Kevin L.; Salyers, Michelle P.; Myers, Evan J.; Mickens, Jessica L.; Minor, Kyle S.; Psychology, School of ScienceBackground: The "emotion paradox" of schizophrenia suggests people with schizophrenia demonstrate deficits when reporting anticipated and retrospective pleasure; yet, in-the-moment, consummatory pleasure is largely intact. It is uncertain how these findings extend to social situations. This meta-analysis aimed to (1) determine the mean difference in consummatory social pleasure between people with schizophrenia and healthy controls, and (2) examine moderators of this effect, including study design and clinical characteristics of participants. Design: A literature search using PsycINFO, Web of Science, Pubmed, and EMBASE databases was conducted. Studies measuring consummatory social pleasure using experience sampling methods and laboratory social simulations were included. Random effects meta-analyses were conducted using Hedge's g. Results: Meta-analysis of 26 studies suggests people with schizophrenia exhibited a small, significant deficit in consummatory social pleasure (g = -0.38, 90% CI [-0.53, -0.22]). There was significant heterogeneity in effect sizes; magnitude was moderated by study design and type of measure used to assess social pleasure. Conclusions: Overall, people with schizophrenia seem to exhibit less consummatory social pleasure than controls. However, this deficit is smaller than in studies of anticipated and retrospective pleasure. Thus, consummatory social pleasure may not be quite as impaired in people with schizophrenia as traditional anhedonia research suggests. Moreover, pleasure deficits observed in people with schizophrenia may result from differences in the quality of their daily social experiences rather than differences in their capacity for social pleasure. Results have important implications for clinical interventions that address barriers to social engagement, low-pleasure beliefs, and cognitive remediation to treat schizophrenia.Item Empathy and Its Relationship With Social Functioning in Individuals at Ultra-High Risk for Psychosis(Frontiers Media, 2021-11-11) Kuis, Daan Jan; van de Giessen, Tara; de Jong, Steven; Sportel, Bouwina Esther; Boonstra, Nynke; van Donkersgoed, Rozanne; Lysaker, Paul H.; Hasson-Ohayon, Ilanit; Pijnenborg, Gerdina Hendrika Maria; Psychiatry, School of MedicineIntroduction: Social functioning is often impaired in the ultra-high-risk (UHR) phase of psychosis. There is some evidence that empathy is also impaired in this phase and that these impairments may underlie difficulties in social functioning. The main aim of this study was to investigate whether cognitive and affective empathy are lower in people in the UHR phase of psychosis in comparison to healthy controls, and whether possible impairments have the same magnitude as in people with schizophrenia. A second aim was to examine whether there is a relationship between empathy and social functioning in individuals in the UHR phase. Method: Forty-three individuals at UHR for psychosis, 92 people with a schizophrenia spectrum disorder, and 49 persons without a psychiatric disorder completed the Interpersonal Reactivity Index (IRI), Questionnaire of Cognitive and Affective Empathy (QCAE), and Faux Pas as instruments to measure empathy. The Time Use survey was used to measure social functioning. MAN(C)OVA was used to analyse differences between groups on empathy and social functioning, and correlations were calculated between empathy measures and social functioning for each group. Results: The UHR group presented significantly lower levels of self-reported cognitive empathy than the healthy controls, but not compared to patients with SSD, while performance-based cognitive empathy was unimpaired in the UHR group. On the affective measures, we found that people with UHR and patients with SSD had significantly higher levels of self-reported distress in interpersonal settings compared to healthy controls. In the UHR group, perspective-taking was negatively associated with time spent on structured social activities. In the SSD group, we found that structured social activities were positively associated with perspective-taking and negatively associated with personal distress in interactions with others. Lastly, in people without mental illness, social activities were positively associated with performance-based perspective-taking. Conclusion: Impairments in subjective cognitive empathy appear to be present in the UHR phase, suggesting that difficulties in interpreting the thoughts and feelings of others precede the onset of psychotic disorders. This can inform future interventions in the UHR phase.Item Personalizing Interventions Using Real-World Interactions: Improving Symptoms and Social Functioning in Schizophrenia with Tailored Metacognitive Therapy(American Psychological Association, 2022) Minor, Kyle S.; Marggraf, Matthew P.; Davis, Beshaun J.; Mickens, Jessica L.; Abel, Danielle B.; Robbins, Megan L.; Buck, Kelly D.; Wiehe, Sarah E.; Lysaker, Paul H.; Psychology, School of ScienceObjective: When clients' lives are not reflected in therapy, they struggle to apply the skills learned in treatment to everyday situations. In this pilot study, we determined if using clients' real-world interactions in therapy could effectively target metacognitive capacity-yielding improved symptoms and social functioning-by tailoring treatment to focus on issues faced by clients in daily life. Method: Using a randomized controlled trial design, schizophrenia subjects with metacognitive deficits completed 24 sessions of: (a) Standard Metacognitive Reflection and Insight Therapy (MERIT); or (b) Tailored MERIT. Real-world interactions were captured via the Electronically Activated Recorder (EAR), a smartphone application that passively records audio in daily life. All subjects wore the EAR; however, real-world interactions were only used to personalize sessions in Tailored MERIT. Results: Feasibility and acceptability were shown; those in Tailored MERIT wore the EAR 84% of their waking hours and reported minimal burden. When compared to Standard MERIT, Tailored MERIT participants showed large pre-post reductions in negative metacognitive beliefs and disorganized symptoms. Small, but nonsignificant, improvements in social functioning were also observed. Conclusions: Compared to an evidence-based benchmark, we observed that real-world interactions can be used to tailor metacognitive therapy and improve outcomes in schizophrenia. Tailored MERIT has the potential to impact practice by personalizing treatment to account for individual variations in environment and lifestyle-aligning with the Precision Medicine Initiative-in a way that is not possible with current therapy. This is particularly salient in schizophrenia, where limited insight and cognitive deficits often make subjective reporting unreliable.Item Quality versus Quantity: Determining Real-world Social Functioning Deficits in Schizophrenia(Elsevier, 2021) Abel, Danielle B.; Salyers, Michelle P.; Wu, Wei; Monette, Mahogany A.; Minor, Kyle S.; Psychology, School of ScienceSocial 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.Item Schizotypy in an online sample: Associations with functioning, wellbeing, and stigma toward psychological treatment(Office of the Vice Chancellor for Research, 2016-04-08) Dempsey, Abigail E.; Bonfils, Kelsey A.; Firmin, Ruth L.; Salyers, Michelle P.Background: Social functioning and positive attitudes toward treatment have been strongly linked with recovery in people with schizophrenia, yet less is known for schizotypy – traits that are associated with risk for schizophrenia. Previous studies of schizotypy have used primarily undergraduate or small community samples. The aim of the current study was to investigate correlates of schizotypy in a large online sample. We hypothesized that people with schizotypy traits would report lower functioning, well-being, and greater stigmatizing attitudes regarding treatment. Methods: In a sample (N=856) recruited using Amazon’s Mechanical Turk (MTurk), participants were dichotomized into non-schizotypy or schizotypy groups based on their endorsement of schizotypal traits on the Schizotypal Personality Questionnaire – Brief Revised (SPQ-BR; schizotypy group n=101; non-schizotypy group n=431). Participants completed a demographic survey and several measures related to functioning, well-being, and stigma, including the Romantic Relationship Functioning Scale (RRFS), the Social Adjustment Scale – Self-Report: Screener (SAS-SR: Screener), the SPQ-BR, the Short Form-12 Health Survey (SF-12), and the Stigma Scale for Receiving Psychological Help (SSRPH). Independent-samples t-tests were conducted to compare schizotypy groups on these variables. Results: Those who reported high levels of schizotypy reported significantly poorer social functioning, t(122.74)=-10.66, p<.001; poorer romantic relationship functioning, t(129.01)=12.00, p<.001; poorer mental wellbeing ,t(132.58)=13.42, p=.001; and greater stigma toward receiving psychological treatment, t(137.06)=-3.89, p=.037. There was no significant difference in physical wellbeing. Discussion: These findings support the use of online samples and suggest schizotypy is associated with poorer functioning and wellbeing and increased stigma toward seeking treatment. Results support the emergence of deficits in key social domains among those at risk for developing greater psychosis symptoms. Given the links between these deficits and attitudes and poorer functioning in clinical samples, these findings suggest social functioning and help-seeking attitudes may be important targets of early intervention services.Item Social Activity in Schizotypy: Measuring Frequency and Enjoyment of Social Events(MDPI, 2024-06-05) DeBats, Candice C.; Abel, Danielle B.; Sullivan, Morgan M.; Koesterer, Sophia C.; Linton, Imani S.; Mickens, Jessica L.; Russell, Madisen T.; Hammer, Lillian A.; Minor, Kyle S.; Psychology, School of ScienceImproving social functioning deficits-a core characteristic of schizophrenia-spectrum disorders-is often listed by patients as a key recovery goal. Evidence suggests that social deficits also extend to people with schizotypy, a group at heightened risk for psychotic and other psychopathological disorders. One challenge of social functioning research in schizotypy is understanding whether social deficits arise from receiving less pleasure from social activities or from participating less in high-pleasure activities. However, limited information exists on what constitutes highly pleasurable, common social activities. In this study, 357 college students rated the frequency and enjoyment of 38 social activities. Our aims were to categorize activities based on their frequency and enjoyment, and whether these correlated with validated social functioning and schizotypy measures. We found that social activities could be characterized based on their frequency and enjoyment and created a frequency-enjoyment matrix that could be useful for future studies. Activities were correlated with social functioning, generally reaching a small effect size level, with increasing frequency and enjoyment showing associations with greater social functioning. Further, negative and disorganized-but not positive-traits were associated with less engagement and pleasure. Although follow-up studies in community samples are needed, our findings have the potential to help researchers and clinicians better understand which activities participants are more likely to engage in and derive pleasure from. The findings may also illustrate the extent to which social deficits may be due to less engagement or less pleasure from social activities, as well as which aspects of schizophrenia-spectrum disorders are associated with these facets of social functioning.Item Social Functioning in Schizophrenia: Comparing Laboratory-based Assessment with Real-world Measures(Elsevier, 2021) Abel, Danielle B.; Minor, Kyle S.; Psychology, School of ScienceResearchers have measured social functioning in schizophrenia using many different strategies. Recent technological advances have made it possible to passively measure behaviors in real-world social situations-allowing for more objective, ecologically valid assessments. Yet, research testing the convergent validity among real-world and laboratory-based social functioning assessment is sparse. The purpose of this study was to test the convergent validity among four social functioning measures: two interview-based rating scales, a self-reported ecological momentary assessment (EMA), and a passive, ambulatory ecological assessment. Data was collected from 36 people with schizophrenia and 33 control participants. Across the entire sample, relationships between interview-based ratings and real-world measures of social functioning only demonstrated small correlations (r's = 0.17-0.19), whereas real-world measures exhibited moderate correlations with one another (r = 0.36). Within groups, real-world measures showed moderate, significant relationships in the control group (r = 0.44) but not in the schizophrenia group (r = 0.27). For those with schizophrenia, the interview-based measures of social functioning were moderately associated with ambulatory ecological assessment (r's = 0.38 and 0.47), but only small associations were observed with self-reported EMA (r's = 0.15 and 0.17). Results suggest social functioning assessments are not highly convergent and likely target different aspects of social functioning. Laboratory-based measures offer global impressions of social functioning whereas real-world measures represent a more nuanced approach. Moreover, ambulatory ecological assessment may most accurately gauge frequency of daily social interactions for those with schizophrenia as it circumvents common pitfalls of self-report and offers a less-biased, in-depth evaluation of social behavior.Item Social functioning in schizotypy: How affect influences social behavior in daily life(Wiley, 2020-12) Minor, Kyle S.; Hardin, Kathryn L.; Beaudette, Danielle M.; Waters, Lesley C.; White, Anna L.; Gonzenbach, Virgilio; Robbins, Megan L.; Psychology, School of ScienceObjective: Social deficits are already exhibited by people at risk for schizophrenia-spectrum disorders. Technological advances have made passive detection of social deficits possible at granular levels. Method: In this real-world study, we tested if schizotypy status (high/low) predicted two types of social behavior: (1) being around other people; and (2) actively socializing with others. We also examined if schizotypy influences relationships between social behavior and affect using subjective and objective instruments. Results: Our findings revealed that socializing with others was significantly decreased in the high schizotypy group. Positive affect increased in social situations and predicted later social behavior in those low, but not high, in schizotypy. Conclusion: Decreased social behavior in schizotypy may be explained, in part, by these individuals being less incentivized than their peers to pursue social situations. Future studies should test this explanation in larger samples exhibiting elevated positive, negative, and disorganized schizotypy traits.