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In many European countries, flexible assertive community treatment (FACT) has replaced assertive community treatment (ACT) despite limited evidence for FACT's effectiveness in improving functional and patient-reported outcomes. This study evaluated the effectiveness of FACT relative to ACT in improving functioning, client satisfaction, and the working alliance. The authors used a nonblinded, quasi-experimental controlled study design to compare outcomes of patients treated by ACT teams that were reconfigured to FACT teams with those of patients treated by a remaining ACT team. Patients from nine ACT teams in the Capital Region of Denmark were included. Six of the nine ACT teams were reconfigured to FACT in 2018 and 2019 by integrating them with community mental health teams. The remaining three ACT teams were used as control groups. Assignment to treatment was based solely on administrative considerations. The study included 131 patients (FACT, N=74; ACT, N=57). Patients treated by FACT teams had poorer personal and social functioning than patients assigned to ACT teams (adjusted difference in means=−2.9, 95% CI=−5.8 to −0.1). No between-group differences were found in client satisfaction or working alliance. Patients treated by FACT teams had significantly lower functioning than patients treated by ACT teams, but the clinical relevance or causality of this finding remains unclear. Given the reconfiguration of the FACT teams during follow-up, along with substantial drop-out rates and baseline differences between the two groups, these results must be interpreted with caution. The findings require further examination in a randomized controlled trial that includes fidelity measures of the treatment models. [ABSTRACT FROM AUTHOR]

Schizophrenia is a major cause of disability worldwide. As new treatments for functioning are tested, the need grows to demonstrate real-world functioning gains. Ecological momentary assessment (EMA) may provide a more ecologically valid measure of functioning. In this study, smartphone-based EMA was used to signal participants with schizophrenia (N = 100) and controls (N = 71) 7 times a day for 7 days to respond to brief questionnaires about social interactions and functioning behaviors. Excellent adherence was found, with both groups completing an average of 85% of surveys and only 3% of participants with schizophrenia excluded for poor adherence. Four-week test-retest reliability was high (r = .83 for total productive behaviors). Relative to controls, participants with schizophrenia reported significantly less total productive activity (d = 1.2), fewer social interactions (d = 0.3), more nonproductive behaviors (d = 1.0; watching TV, resting), and more time at home (d = 0.8). Within the schizophrenia group, participants living independently showed better functioning on EMA relative to participants in supported housing (d = 0.8) and participants engaged in vocational activities showed better functioning than individuals not engaged in vocational activities (d = 0.55). Modest correlations were found between EMA and an in-lab self-report measure of functioning activities performed in the community, but not between EMA and measures of functional capacity or potential. This study demonstrated the feasibility, sensitivity reliability, and validity of EMA methods to assess functioning in schizophrenia. EMA provides a much-needed measure of what individuals with schizophrenia are actually doing in real-world contexts. These results also suggest that there may be important disjunctions between indices of abilities and actual real-world functioning.

Social and occupational functioning deficits contribute to overall disability in hoarding disorder (HD), and psychiatric symptoms are likely strong contributors. In turn, social/occupational impairment and psychiatric illness are known to contribute to suicidality. However, few studies have examined the relationship between these factors. We examined these relationships in 313 treatment seeking individuals with HD, measuring hoarding severity with the Saving Inventory, Revised and functional impairment with the Activities of Daily Living for Hoarding Disorder (ADL-H). We created a composite social/occupational function variable assessing employment, cohabitation, and marriage. A path analysis was used to assess the relationship between social functioning, occupational functioning, hoarding related functional impairment in activities of daily living, hoarding severity, psychiatric burden, and suicidality in HD. At least one lifetime psychiatric comorbidity was noted in 61% of participants. High rates of unemployment, living alone, never marrying or being divorced/separated, and lifetime suicide attempts were present. Hoarding severity and hoarding-related functional impairment were associated with social/occupational impairment, and, along with psychiatric burden, with suicidality in this population. These findings suggest that thorough psychiatric evaluation and assessment of suicidality is warranted for those with HD, and that hoarding-related functional impairment is closely related to measures of real-world social functioning.

Social and occupational functioning deficits contribute to overall disability in hoarding disorder (HD), and psychiatric symptoms are likely strong contributors. In turn, social/occupational impairment and psychiatric illness are known to contribute to suicidality. However, few studies have examined the relationship between these factors. We examined these relationships in 313 treatment seeking individuals with HD, measuring hoarding severity with the Saving Inventory, Revised and functional impairment with the Activities of Daily Living for Hoarding Disorder (ADL-H). We created a composite social/occupational function variable assessing employment, cohabitation, and marriage. A path analysis was used to assess the relationship between social functioning, occupational functioning, hoarding related functional impairment in activities of daily living, hoarding severity, psychiatric burden, and suicidality in HD. At least one lifetime psychiatric comorbidity was noted in 61% of participants. High rates of unemployment, living alone, never marrying or being divorced/separated, and lifetime suicide attempts were present. Hoarding severity and hoarding-related functional impairment were associated with social/occupational impairment, and, along with psychiatric burden, with suicidality in this population. These findings suggest that thorough psychiatric evaluation and assessment of suicidality is warranted for those with HD, and that hoarding-related functional impairment is closely related to measures of real-world social functioning.

The main purpose of this study is to examine the relationship between social anxiety and social cognition skills (emotion identification/discrimination, theory of mind, attribution bias, social functioning) and to investigate the predictive power of social cognition skills on social anxiety. In the study, it was also investigated whether social anxiety, social cognition skills and depression scores differed according to gender, age, reported diagnosis status and anxiety level. The sample of the study consisted of a total of 385 participants between the ages of 18-60. The research data were collected from the participants online using the Liebowitz Social Anxiety Scale, the Facial Emotion Identification and Facial Emotion Discrimination Tests, Reading the Mind in the Eyes Test, the Internal, Personal and Situational Attributes Scale, the Social Functioning Scale, the Beck Depression Inventory, and the Sociodemographic Information Form. It was determined that there was a negative relationship between social anxiety and emotion recognition, emotion discrimination and mind reading, and a positive relationship with externalization bias and depression. It was found that depression, emotion recognition and discrimination, mind reading, and antecedent social activities scale scores significantly predicted social anxiety. These variables explain 52% of the total variance related to social anxiety. In addition, when the depression effect was controlled, it was seen that social cognition skills explained 32% of the variance related to social anxiety. It was determined that the deterioration in social cognition skills and depression scores were associated with an increase in social anxiety. According to the results obtained from the research, suggestions were made to prevent social anxiety. It is suggested that it would be beneficial to include activities to develop social cognition skills, which are important for individuals' interpersonal communication, within intervention programs.

Abstract Background People with severe mental illness (SMI) often suffer from long-lasting symptoms that negatively influence their social functioning, their ability to live a meaningful life, and participation in society. Interventions aimed at increasing physical activity can improve social functioning, but people with SMI experience multiple barriers to becoming physically active. Besides, the implementation of physical activity interventions in day-to-day practice is difficult. In this study, we aim to evaluate the effectiveness and implementation of a physical activity intervention to improve social functioning, mental and physical health. Methods In this pragmatic stepped wedge cluster randomized controlled trial we aim to include 100 people with SMI and their mental health workers from a supported housing organization. The intervention focuses on increasing physical activity by implementing group sports activities, active guidance meetings, and a serious game to set physical activity goals. We aim to decrease barriers to physical activity through active involvement of the mental health workers, lifestyle courses, and a medication review. Participating locations will be divided into four clusters and randomization will decide the start of the intervention. The primary outcome is social functioning. Secondary outcomes are quality of life, symptom severity, physical activity, cardiometabolic risk factors, cardiorespiratory fitness, and movement disturbances with specific attention to postural adjustment and movement sequencing in gait. In addition, we will assess the implementation by conducting semi-structured interviews with location managers and mental health workers and analyze them by direct content analysis. Discussion This trial is innovative since it aims to improve social functioning in people with SMI through a physical activity intervention which aims to lower barriers to becoming physically active in a real-life setting. The strength of this trial is that we will also evaluate the implementation of the intervention. Limitations of this study are the risk of poor implementation of the intervention, and bias due to the inclusion of a medication review in the intervention that might impact outcomes. Trial registration This trial was registered prospectively in The Netherlands Trial Register (NTR) as NTR NL9163 on December 20, 2020. As the The Netherlands Trial Register is no longer available, the trial can now be found in the International Clinical Trial Registry Platform via: https://trialsearch.who.int/Trial2.aspx?TrialID=NL9163 .

Problem considered: Social skills training helps improve interpersonal relationship in schizophrenia patients. However, there is a lacuna of studies in India reporting the efficacy of such training. Hence, we assessed the effectiveness of social skills program (SSP) among schizophrenia patients using Vellore assessment of social performance (VASP) scale and evaluated the association of social performance pre- and post-test with demographic variables. Methods: This study was conducted on 40 patients diagnosed with schizophrenia admitted to in-patient psychiatric ward of a tertiary care hospital in south India. They were assigned to two groups of 20 each, where one underwent SSP intervention for 7 days, and the other routine care. Results: In the routine care group, majority of the patients had poor skills both pre-test (70%), and post-test (40%, p = 0.083), but in the interventional group, majority of the patients exhibited poor skills (60%) pre-test and post SSP majority of them scored significantly higher (85%, p = 0.022) VASP scores. Mean scores were significantly different with age (F = 4.130, p = 0.01) in intervention and with duration of illness (F = 3.748, p = 0.045) in routine care groups. Conclusion: SSP effectively improved social performance among schizophrenia in-patients, and can be implemented as part of routine care therapy for the holistic treatment of these patients.

Objective: Previous research has established the impact of psychiatric symptoms on social functioning, while there is a paucity of research examining how social functioning relates to personal recovery, an individual's self-assessment of their mental health recovery. This study examined the mediating effect of social engagement, interpersonal communication, and satisfaction with support in the relationship between distinct psychiatric symptom clusters and perceived mental health recovery. Methods: In a cross-sectional study, both patient self-report and provider assessment data were collected for 250 patients with serious mental illness (SMI) across four mental health service sites. Parallel mediation analytic models were used. Results: Interpersonal communication partially mediated the relationship between positive and negative symptom clusters and personal recovery. Satisfaction with social supports partially mediated the relationship between excited symptoms and personal recovery. Both interpersonal communication and satisfaction with social supports partially mediated the relationship between general psychological distress and depressive symptoms and personal recovery. Collectively, social functioning mediators explained nearly half of the relationship between general psychological distress and excited symptoms and personal recovery and nearly all of the relationship between positive symptoms and personal recovery. Conclusions and Implications for Practice: Clinical providers working with persons with SMI should regularly assess social functioning in addition to assessing psychiatric symptoms and personal recovery factors and should incorporate social skills education into SMI group and individual treatments. Social functioning as a target of treatment may be especially beneficial for patients who are dissatisfied with other interventions or feel they have experienced the maximum benefit from treatment and are seeking additional methods to support personal recovery. Impact and Implications: Social functioning such as interpersonal behavior and satisfaction with support partially mediated the impact of psychological symptom presentation on patient-perceived mental health recovery. Clinicians should regularly assess social functioning and incorporate evidence-based practices that serve to enhance interpersonal functioning into treatment for individuals with SMI. [ABSTRACT FROM AUTHOR]

Schizophrenia is associated with high rates of global, social and occupational functional impairments. While prior meta-analyses have extensively examined the impact of exercise on physical and mental health, the impact on functioning in schizophrenia have yet to be fully established. This review aimed to update the evidence base regarding the impact of exercise on functioning in schizophrenia, and explore moderators of effect. A systematic search was conducted to identify randomized controlled trials (RCTs) of exercise evaluating global functioning versus any comparator in people with schizophrenia; between group meta-analyses of global functioning (and secondary – social, living skills, occupational, adverse events) were computed using a random effects model. Subgroup analyses based on diagnosis and aspects of the intervention were conducted. 18 full text articles were included, involving 734 participants. A moderate impact of exercise on global functioning was found (g = 0.40, 95 % C·I. = 0.12 to 0.69, p = 0.006), with a moderate impact of exercise on social (N = 5, g = 0.54 95 % C. I = 0.16 to 0.9 p = 0.005), and daily living functioning (N = 3, g = 0.65, 95 % C.I. = 0.07 to 1.22, p = 0.005). There is good evidence that exercise can improve the global functioning of people with schizophrenia, with preliminary evidence for social and daily living skills; exercise should be considered an important adjunct to usual care. Higher impacts on global functioning were seen in aerobic interventions and of at least moderate to vigorous intensity. More research is required into resistance training, in early psychosis cohorts and to evaluate the comparison of exercise with other established psychosocial therapies. [ABSTRACT FROM AUTHOR]

Alexithymia has been identified as a risk factor for a variety of psychiatric disorders and physical and mental health problems. Moreover, alexithymics often exhibit maladaptive coping strategies when addressing interpersonal problems, which can damage their subjective well-being. To date, the neural basis of alexithymics’ cognitive bias in processing emotions is unclear. Additionally, it remains unknown whether this neural basis of coping with emotion is associated with their ability to communicate and empathize with others. Thus, we used functional magnetic resonance imaging (fMRI) to examine the neural correlates of alexithymics’ emotional coping styles in an emotional semantic judgment task. Emotional valence (positive, negative, neutral) and association strength (strong, weak) were independently varied to study emotional semantic processing. Participants were asked to decide whether two emotional words presented in Chinese were related in meaning. The social functioning questionnaires further evaluated their social communication performance and empathetic abilities. First, compared to individuals with low alexithymia (LA), those with high alexithymia (HA) exhibited lower activation in the amygdala and precuneus in response to negative related pairs than neutral related pairs when the association was weak, reflecting the early avoidance of perceiving negative information. Additionally, the early prioritization of both positive and negative emotions enabled quick responses and required less involvement of the inferior frontal gyrus (IFG) and middle temporal gyrus (MTG) in individuals with HA in judging the meaning when the association was weak. Moreover, frontotemporal activation in response to unpleasant stimuli was correlated with abilities to socialize/empathize with others, which suggests that early vigilance to emotional cues may cause individuals with HA to avoid unpleasant social situations, such as self-disclosure, potentially hindering their abilities to socially interact. In summary, the cognitive bias of early avoidance may bring temporary relief by allowing individuals to escape from social interactions, but, ultimately, this damages well-being. [ABSTRACT FROM AUTHOR]

Objective: Many people with epilepsy (PWE) suffer from reduced everyday functioning such as unemployment, relationship difficulties, or lifestyle limitations. To identify whether subjective cognitive impairment (SCI) is a potential source of these impairments, associations with restrictions of daily life (RDL) and reduced daily activities (DA) were examined. Methods: In a prospective cross‐sectional sample of 316 adult in‐patients with epilepsy, multiple regression analyses were calculated predicting RDL and DA. The relationships between these two measures and SCI were controlled for age, sex, seizure frequency, presence of structural lesions, epilepsy duration, mono‐ vs polytherapy and adverse events of antiseizure medication (ASM), level of depressive and anxiety symptoms, education, and employment. We also checked for an interaction between depressive symptoms and SCI, to evaluate whether patients with more depressive symptoms are more vulnerable for unfavorable associations between SCI and RDL or DA, respectively. General dominance indices (GDIs) were calculated to compare predictors. Results: Substantial SCI was present in 46% of our sample. SCI was independently associated with RDL and DA. Comparison of relative predictor importance revealed that SCI accounted for 23% of the total variance of RDL (GDISCI = 0.12, RRDL2 = 50%) and 24% of the total variance of DA (GDISCI = 0.08, RDA2 = 32%). SCI was among the two most important predictors in both models. PWE with more depressive symptoms had stronger associations between SCI and RDL or DA, respectively. Significance: Subjective cognitive impairment represents a frequent concern in PWE and may have detrimental consequences for their everyday life. PWE with depressive symptoms may be at greater risk of unfavorable relationships between SCI and everyday functioning. Exchange and collaboration between professionals offering psychotherapeutic, neuropsychological, and psychosocial interventions are crucial to address the patients' individual needs. [ABSTRACT FROM AUTHOR]

Perceived threat in youth's environments can elevate risk for mental health, social, and neurocognitive difficulties throughout the lifespan. However, few studies examine variability in youth's perceptions of threat across multiple contexts or evaluate outcomes across multiple domains, ultimately limiting our understanding of specific risks associated with perceived threats in different contexts. This study examined associations between perceived threat in youth's neighborhood, school, and family contexts at ages 9–10 and mental health, social, and neurocognitive outcomes at ages 11–12 within a large US cohort (N = 5525) enrolled in the Adolescent Brain Cognitive DevelopmentSM Study (ABCD Study®). Latent profile analysis revealed four distinct profiles: Low Threat in all contexts, Elevated Family Threat, Elevated Neighborhood Threat, and Elevated Threat in all contexts. Mixed-effect models and post hoc pairwise comparisons showed that youth in Elevated Threat profile had poorer mental health and social outcomes 2 years later. Youth in the Elevated Family Threat profile uniquely showed increased disruptive behavior symptoms, whereas youth in the Elevated Neighborhood Threat profile predominantly displayed increased sleep problems and worse neurocognitive outcomes 2 years later. Together, findings highlight the importance of considering perceptions of threat across multiple contexts to achieve a more nuanced developmental picture. [ABSTRACT FROM AUTHOR]

Background: Sarcomas account for almost 11% of all cancers in adolescents and young adults (AYAs; 18–39 years). AYAs are increasingly recognized as a distinct oncological age group with its own psychosocial challenges and biological characteristics. Social functioning has been shown to be one of the most severely affected domains of health‐related quality of life in AYA cancer survivors. This study aims to identify AYA sarcoma survivors with impaired social functioning (ISF) and determine clinical and psychosocial factors associated with ISF. Methods: AYAs from the population‐based cross‐sectional sarcoma survivorship study (SURVSARC) were included (n = 176). ISF was determined according to the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire Core 30 social functioning scale, and age‐ and sex‐matched norm data were used as reference. Results: The median time since diagnosis was 6.2 years (range, 1.8–11.2). More than one‐quarter (28%) of AYA sarcoma survivors experienced ISF. Older age, higher tumor stage, comorbidities, lower experienced social support, uncertainty in relationships, feeling less attractive, sexual inactivity, unemployment, and financial difficulties were associated with ISF. In a multivariable analysis, unemployment (OR, 3.719; 95% CI, 1.261–10.967) and having to make lifestyle changes because of financial problems caused by one's physical condition or medical treatment (OR, 3.394; 95% CI, 1.118–10.300) were associated with ISF; better experienced social support was associated with non‐ISF (OR, 0.739; 95% CI, 0.570–0.957). Conclusion: More than one‐quarter of AYA sarcoma survivors experience ISF long after diagnosis. These results emphasize the importance of follow‐up care that is not only disease‐oriented but also focuses on the psychological and social domains. Plain Language Summary: Sarcomas account for almost 11% of all cancers in adolescents and young adults (AYAs; 18–39 years). The AYA group is increasingly recognized as a distinct oncological age group with its own psychosocial challenges and biological characteristics.Social functioning has been shown to be severely affected in AYA cancer survivors.A population‐based questionnaire study to identify AYA sarcoma survivors with impaired social functioning (ISF) and determine factors associated with ISF was conducted. More than one‐quarter of AYA sarcoma survivors experience ISF long after diagnosis. These results emphasize the importance of follow‐up care that is not only disease‐orientated but also focuses on the psychological and social domains. More than one‐quarter of adolescent sarcoma survivors experience impaired social functioning long after diagnosis. These results emphasize the importance of follow‐up care that is not only disease‐oriented but also focuses on the psychological and social domains. [ABSTRACT FROM AUTHOR]

The main aim of the present scoping review is to systematically review the available studies that investigated the associations between socioemotional alterations (i.e., social cognition impairments/alexithymia/difficulties in emotion regulation) and both reduced QoL and social functioning in patients with Multiple Sclerosis (MS). The articles were selected from the PubMed, PsycINFO, and Scopus databases. The main exclusion criteria were qualitative studies, articles that did not use validated instruments, and studies that did not investigate the association between socioemotional skills and QoL/social functioning in MS. Of the eight studies fulfilling the inclusion criteria, six found significant associations between social cognitive and emotion regulation abilities and QoL/social functioning in patients with MS, while two found no significant relationships particularly between the performance on social cognition tasks and QoL measures. Overall, the majority of findings seem to highlight that socioemotional alterations contribute to impaired QoL and social functioning in MS. However, given the still limited evidence, future studies are needed to replicate and confirm the available results, paying attention to two principal aspects: the use of standardized and ecological tasks for the assessment of social cognition skills and the recruitment of samples involving patients with different types of MS. [ABSTRACT FROM AUTHOR]

Background and Hypothesis There is growing appreciation for the contribution of sensory disruptions to disease morbidity in psychosis. The present study examined auditory cortex (AC) dynamic range: the scaling of neurophysiological responses to stimulus intensity, among individuals with a schizophrenia spectrum illness (FESz) and its relationship to clinical outcomes at disease onset. Study Design Magnetoencephalography (MEG) was recorded from 35 FESz and 40 healthy controls (HC) during binaural presentation of tones at three intensities (75 dB, 80 dB, and 85 dB). MRIs were obtained to enhance cortical localization of MEG sensor-level activity. All participants completed the MATRICS cognitive battery (MCCB) and Global Functioning: Role and Social scales (GFR/GFS). Patients were administered the Positive and Negative Syndrome Scale (PANSS). Study Results FESz exhibited reduced AC response relative to HC. Enhancement of AC activity to tones of increasing intensity was blunted in FESz relative to HC. Reduced dynamic range (85–75 dB AC response) was associated with lower GFS (r =.58) and GFR (r =.45) scores, worse MCCB performance (r =.45), and increased PANSS Negative symptom subscale scores (r = −.55) among FESz, relationships not observed with AC responses to individual tones. Conclusion Beyond an impaired AC response to pure tones, FESz exhibit reduced dynamic range relative to HC. This impairment was correlated with markers of disease morbidity including poorer community functioning as well as cognitive and negative symptoms. The relationship with impaired social functioning may reflect the role of AC dynamic range in decoding the emotional content of language and highlights its importance to future therapeutic sensory remediation protocols. [ABSTRACT FROM AUTHOR]

Background 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. [ABSTRACT FROM AUTHOR]

Background: Diminished sensory gating (SG) is a robust finding in psychotic disorders, but studies of early psychosis (EP) are rare. It is unknown whether SG deficit leads to poor neurocognitive, social, and/or real-world functioning. This study aimed to explore the longitudinal relationships between SG and these variables. Methods: Seventy-nine EP patients and 88 healthy controls (HCs) were recruited at baseline. Thirty-three and 20 EP patients completed 12-month and 24-month follow-up, respectively. SG was measured using the auditory dual-click (S1 & S2) paradigm and quantified as P50 ratio (S2/S1) and difference (S1-S2). Cognition, real-life functioning, and symptoms were assessed using the MATRICS Consensus Cognitive Battery, Global Functioning: Social (GFS) and Role (GFR), Multnomah Community Ability Scale (MCAS), Awareness of Social Inference Test (TASIT), and the Positive and Negative Syndrome Scale (PANSS). Analysis of variance (ANOVA), chi-square, mixed model, correlation and regression analyses were used for group comparisons and relationships among variables controlling for potential confounding variables. Results: In EP patients, P50 ratio (p < 0.05) and difference (p < 0.001) at 24-month showed significant differences compared with that at baseline. At baseline, P50 indices (ratio, S1-S2 difference, S1) were independently associated with GFR in HCs (all p < 0.05); in EP patients, S2 amplitude was independently associated with GFS (p = 0.037). At 12-month and 24-month, P50 indices (ratio, S1, S2) was independently associated with MCAS (all p < 0.05). S1-S2 difference was a trending predictor of future function (GFS or MCAS). Conclusions: SG showed progressive reduction in EP patients. P50 indices were related to real-life functioning. [ABSTRACT FROM AUTHOR]

Background: Young people with a psychotic disorder have the same social goals as their healthy peers, but their social networks are smaller, they participate less often in leisure activities and are less successful in work and education. Causes of these problems are multifaceted, but culminate in difficulties with interacting in daily life social situations. Current treatments have only moderate effects on social functioning and often target one specific domain. Virtual reality (VR) has the potential to improve the treatment of social interaction difficulties. We developed a modular VR treatment for social functioning and participation (VR-SOAP). In this study, the effect of this intervention will be investigated in a randomized controlled trial (RCT). Methods: A total of 116 participants (age 18–40) with a DSM-5 diagnosis of schizophrenia spectrum or other psychotic disorder and problems with social functioning will be recruited from mental healthcare institutes in the Netherlands. Participants will be randomized to the experimental condition (VR-SOAP) or active VR control condition (VRelax). VR-SOAP consists of 14 sessions and 5 modules addressing causes of impaired social functioning: four optional modules (1–4) and one fixed module (5). Vrelax consists of 14 sessions that entail psychoeducation, stress management, relaxation techniques, and the exploration of relaxing environments in VR. Primary outcomes are quantity and quality of social contacts, leisure activities and social participation, measured with the experience sampling method (ESM). Secondary outcomes are psychiatric symptoms, social behaviour, social cognition, self-esteem, self-stigma and paranoid thoughts. Treatment effects will be compared at pre-treatment (baseline), post-treatment and at 6-month follow-up. Discussion: If VR-SOAP proves to be effective, it provides therapists with a much-needed tool to improve social functioning of young adults with a psychotic disorder. Additionally, since the treatment consists of multiple modules targeting different transdiagnostic factors, this trial might provide input for new treatments to improve social functioning in a range of symptoms and disorders, e.g. mood, autism spectrum and anxiety disorders. Trial registration: On the 10th of November 2021, this trial was registered prospectively in the Dutch Trial Register as NL9784. [ABSTRACT FROM AUTHOR]

Background: In schizophrenia spectrum disorders (SSD), social cognition mediates the relationship between neurocognition and social functioning. Although people with major depressive disorder (MDD) also exhibit cognitive impairments, which are often prolonged, little is known about the role of social cognition in MDD. Methods: Using data obtained through an internet survey, 210 patients with SSD or MDD were selected using propensity score matching based on their demographics and illness duration. Social cognition, neurocognition, and social functioning were evaluated using the Self-Assessment of Social Cognition Impairments, Perceived Deficits Questionnaire, and Social Functioning Scale, respectively. The mediation effects of social cognition on the relationship between neurocognition and social functioning were examined in each group. Invariances of the mediation model across the two groups were then analyzed. Results: The SSD and MDD groups had mean ages of 44.49 and 45.35 years, contained 42.0% and 42.8% women, and had mean illness durations of 10.76 and 10.45 years, respectively. In both groups, social cognition had significant mediation effects. Configural, measurement, and structural invariances across the groups were established. Conclusion: The role of social cognition in patients with MDD was similar to that in SSD. Social cognition could be a common endophenotype for various psychiatric disorders. [ABSTRACT FROM AUTHOR]

Background Executive and social functioning difficulty is well established in pediatric brain tumor survivors. Few studies have compared posterior fossa (PF) tumor survivors in comparison to their peers. The relationship between attention, processing speed, working memory, fatigue, and executive and social functioning was investigated to better understand the factors that impact executive and social functioning in PF tumor populations. Methods Sixteen medulloblastomas, 9 low-grade astrocytomas (LGAs), and 17 healthy controls recruited from 4 sites completed measures of working memory and processing speed, and self-reported fatigue. One parent completed questionnaires on executive and social functioning. Results There were no significant differences among all 3 groups on parent-reported executive and social functioning; of note, parents of LGA survivors expressed greater concerns regarding behavioral and cognitive regulation than did parents of medulloblastoma survivors and healthy controls. Parent-reported attention was related to parent-reported emotion, behavior, and cognitive regulation. Worse self-reported fatigue was associated with greater emotional dysregulation for the 2 PF tumor groups. Conclusions Parents of PF tumor survivors described their children as performing similarly to their peers in most facets of executive and social functioning. While LGA survivors are traditionally thought to have more favorable outcomes, our finding of parent-reported executive functioning concerns to be worse for this group highlights the importance of long-term follow-up for all PF tumor survivors. Additionally, significant effects of attention on aspects of executive functioning in PF tumor survivors may inform current clinical practice and the future development of more effective interventions. [ABSTRACT FROM AUTHOR]

The current study presents and preliminarily tests a brief, theory driven intervention designed to target social connectivity as a transdiagnostic mechanism of health. We tested four hypotheses to examine whether and how explicitly targeting social behavior engagement (activating values-led behaviors towards specific network members) may improve other downstream aspects of social connectivity (i.e., social cognitions measured as loneliness, interpersonal closeness, perceived social support) and functioning (quality of life [QOL] and posttraumatic stress symptoms [PTS]). Methods. Participants included 15 patients (10 veterans, 5 firefighters) who completed the six-session intervention. Demographics: age (M = 46, SD = 17), 87% male, race (80% Caucasian, 20% Hispanic), 60% married/partnered, 47% living alone. Our multi-analytic approach included parametric and non-parametric tests: (a) significance testing and effect sizes to examine whether variables of interest changed, and (b) Granger causality analysis of repeated measures to examine the mechanistic theory of change (does social behavior engagement lead to improved social cognition and functioning?). Results. Statistically significant, medium-large effect size improvements were shown for QOL (Cohens d = 1.05), PTS (d = 1.05), social behavior engagement (d = 0.78), and several social cognitions (loneliness, d = 0.80, interpersonal closeness, d = 0.53). Models accounted for medium-large variance explained in improved QOL (R2 = 0.47, 95% CI [0.00,0.66]) and PTS (R2 = 0.56, 95% CI[0.07,0.72]). The theory of change was supported, with increase in social behaviors preceding improvement in social cognitions (not vice-versa). Conclusions. Improving social connectivity is a mechanism for improving QOL and mental health. Focus on initiating values-driven social behaviors may be an efficient and effective entry point to stimulate change. • Loneliness and intimacy can improve by increasing social behavior engagement. • Improving social connectivity improved quality of life and mental health symptoms. • Change in social behavior engagement preceded change in loneliness. [ABSTRACT FROM AUTHOR]

This study investigated the extent to which specific facets of positive affectivity (PA) demonstrate differential relationships with social anxiety symptomatology as well as social functioning. Following the conceptual framework of the Broaden and Build theory, as well as prior work demonstrating reward-based linkages to specific PA subdomains, we hypothesized that motivationally-valenced PA facets would show distinct associations with social anxiety and social functioning measures. Two samples (N = 446 and N = 375) completed self-report measures of PA, social anxiety, internalizing symptoms, and social functioning. Correlational, multiple and logistic regression, and contrast analyses of correlated correlation coefficients were used to identify the presence and magnitude of relationships between PA facets and symptom measures. Relationships between social anxiety and specific subdomains of PA appeared to depend on the motivational relevance of each facet. Specifically, self-assurance was associated with social anxiety symptoms above and beyond other PA facets and negative affect. Additionally, contrast analyses indicated that motivationally-valenced (versus non-motivationally-valenced) PA facets were stronger negative predictors of social anxiety symptoms. These results demonstrate a statistically significant divergence between motivationally-valenced subdomains of PA and non-motivationally-valenced subdomains of PA, as they relate to social anxiety symptom severity. [ABSTRACT FROM AUTHOR]

Abstract Emotion recognition deficit is related to impaired community functioning. Loneliness is also associated with impaired social performance. However, the way in which emotion recognition and loneliness may contribute to social functioning remains unclear in euthymic patients with bipolar disorder. We aimed to examine emotion recognition ability in Han Chinese euBD patients relative to healthy controls (HCs) and to investigate the associations between emotion recognition, loneliness, and social functioning. Thirty‐nine HCs and 46 euthymic BD patients completed an emotion recognition task and nonsocial cognitive measures related to executive function and attention. The UCLA loneliness scale and Social Performance Scale were administered to evaluate psychological loneliness and social functioning, respectively. We observed lower emotion recognition accuracy, higher loneliness, and poorer social functioning in the BD patients after adjustment for demographic data. Loneliness was negatively associated with global social functioning in both the BD and HC groups. Higher loneliness and lower emotion recognition accuracy were associated with poorer social functioning in euthymic BD in different subdomains. Our study confirmed a subtle impairment of emotion recognition ability in euthymic BD. Loneliness impacts globally on social functioning, while emotion recognition ability may affect specific subdomains of social functioning in euthymic BD. Alleviation of loneliness and enhancement of social cognition might improve social functioning in BD patients.

Exposure to IPV can negatively impact children's social functioning. However, children exposed to IPV can also display significant strengths. The early educational environment can be a key factor promoting resilience outside of the family, with early educators in an ideal position to identify a broad range of social challenges, strengths and needs of children exposed to IPV. Despite this, no known studies have investigated early childhood educators' perspectives of the impacts of IPV on children's social functioning and their strengths. Understanding early educators' perspectives could help to provide insight into the social challenges, strengths and needs of children exposed to IPV. The aim of this study was to understand the social functioning and strengths of children exposed to IPV from the perspective of early childhood educators. Semi-structured individual interviews were conducted with 12 early educators in a caring role for children aged three to five in Victoria, Australia. Thematic analysis was used to analyse the interviews. The first theme identified was impacts of IPV on child development that disrupts social functioning. Subthemes included: (i) difficulties with attachment and trust, (ii) emotional distress and dysregulation, and (iii) impacts on speech and language. The second theme identified was impacts of IPV on social play and peer relationships. Subthemes were (i) disconnection from peers through withdrawal or aggression, (ii) difficulties with social skills and play, (iii) trouble building and maintaining friendships, and (iv) vulnerable to being bullied. The final theme was children's strengths with subthemes including: (i) children's capacity for curiosity and learning with trusted relationships and (ii) learned ways of coping. This study provided a comprehensive understanding of how IPV affects children's social relationships within an early educational context. The findings also highlighted how educators can be a key relational support for children exposed to IPV which is able to facilitate their capacity to learn skills such as emotion regulation and build their ability to engage in play and friendships. Further research on educators' experiences and training needs when supporting the social functioning and strengths of children exposed to IPV is needed. [ABSTRACT FROM AUTHOR]

Childhood maltreatment is frequently reported to be associated with cognitive deficits in patients with schizophrenia, but research on the childhood neglect subtype in childhood maltreatment is limited. This study sets out from the impact of childhood neglect on cognitive impairment in schizophrenia, and explores the interrelationship of childhood neglect, social functioning, resilience, and cognitive functioning. Two-hundred and thirty-two patients who met the DSM-IV criteria for schizophrenia were recruited at the Second Xiangya Hospital of Central South University. The Childhood Trauma Questionnaire (CTQ), Social and Occupational Functioning Assessment Scale (SOFAS), Connor-Davidson Resilience Scale (CD-RISC), and Digit Symbol Substitution Test (DSST) were used to assess childhood emotional and physical neglect, social functioning, resilience, and cognitive functioning respectively. The results indicate that (1) both emotional neglect (Spearman's r = −0.167, p = 0.015) and physical neglect (Spearman's r = −0.263, p < 0.001) are associated with cognitive deficits in patients with schizophrenia; (2) social functioning partially mediated the cognitive impairment in schizophrenia that related to emotional neglect (βtotal = −0.15, SE = 0.07, 95 % CI: LL = -0.31 ~ UL = -0.03); (3) resilience is associated with emotional neglect (Spearman's r = −0.244, p = 0.002) and appears to be independent of cognitive impairment (Spearman's r = −0.006, p = 0.942). Social functioning is a significant mediating factor between childhood emotional neglect and cognitive impairment in patients with schizophrenia. This suggests that interventions aimed at improving social functioning may help ameliorate cognitive deficits in patients with schizophrenia who have high levels of emotional neglect scores. [ABSTRACT FROM AUTHOR]

Most studies on recovery of psychotic disorders focus on first-episode populations using premorbid and baseline data to predict recovery. However, many patients experience a long duration of illness and many factors are dynamic and change during life. To investigate factors strongest associated with clinical, societal and personal recovery, and recovery change scores in people with a long duration of illness using current data measured at the same assessment. Least absolute shrinkage and selection operator regression analyses with cross-validation were used to identify the correlates of (changes in) clinical (N = 1054), societal (N = 1145) and personal recovery (N = 1187) in people with psychotic disorders. Subsequently, the identified associated factors were included in separate linear regression models, examining the associative strength of the identified variables and overall fit of the models. Better clinical recovery was associated with better societal and personal recovery, experiencing fewer problems with daily functioning and social relations. Participants had a better societal recovery when they were employed, had fewer problems in daily life, less negative symptoms, had a life partner and better clinical recovery. Personal recovery was associated with greater satisfaction with life in general, no depressive mood and increased clinical recovery. Change scores were small with minimal fluctuation and no significant associations with change scores were detected. Recovery domains strongly influence each other in people with a long illness duration of psychosis and should therefore have an equally important focus during treatment. • Current instead of baseline factors of recovery in psychosis were investigated. • Clinical, societal and personal recovery strongly influence each other. • One-year changes in recovery were too small to find predictors. • Stimulating participation of people with long-term psychosis in society is key. [ABSTRACT FROM AUTHOR]

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.

Research identifying the effects of cognitive training on negative symptoms of psychosis is limited. We examined the effects of Compensatory Cognitive Training (CCT) on expressive deficits and social amotivation in a randomized controlled trial comparing CCT to standard pharmacotherapy alone in 43 individuals with psychosis. ANCOVA analyses demonstrated significant CCT-associated effects on both expressive deficits and social amotivation. Moreover, improvements in both sub-domains were associated with improvements in global life satisfaction, with improvements in social amotivation also related to increased social contact. CCT appears to be a beneficial treatment approach for improving multiple aspects of negative symptoms.

BackgroundMeta-analyses have reported that the effects of cognitive remediation might go beyond improvement in cognition to include unexpected benefits for schizophrenia patients such as negative symptom reduction and improvements in functioning. In addition, some evidence indicated that these potentially beneficial effects are also present in the initial course of schizophrenia, but work in this area is still developing.MethodA RCT compared Cognitive Remediation (CR) to Healthy Behaviors Training (HBT) in 80 patients (78% male) with a mean age of 21.9years and mean education of 12.3years who had a first psychotic episode within two years of study entry. Participants were trained using CR programs or received HBT involving 50 sessions over 6months and then booster sessions over the next 6months. The SANS and BPRS were used to assess symptoms. The UCLA Social Attainment Survey assessed social functioning.ResultsUsing GLMM, improvements over 12months were found favoring CR for SANS Expressive Symptoms (p

Abstract Background Despite the growing morbidity and mortality rates associated with opioid use disorder, a large gap still exists between treatment need and capacity. Low-threshold clinics utilizing medication for opioid use disorder (MOUD) treatment can increase treatment access but are understudied, and little is known about how patient demographic characteristics are associated with their social support and functioning in these settings. Methods We used multivariate regression to estimate associations between demographic characteristics and self-reported social support or functioning indicators among patients receiving MOUD in a low-threshold clinic using several validated instruments administered at intake: Behavior and Symptom Identification Scale, Brief Pain Inventory, and Life Events Checklist for DSM-5. Patients initiating MOUD treatment between April 1 and December 31, 2017, with complete surveys were included (N=582). Results Patients were primarily male (62%), aged 34 or older (53%), non-Hispanic White (79%), separated or not married (86%), and unemployed (64%). Over 20% did not live in a house or apartment in the past month. Women were more likely to “get along” with people outside their family or in social situations and to identify their partner as their source of support. Women, non-White, and older patients were at higher risk of social functioning-disrupting events (physical/sexual assaults or experiencing chronic pain), while employment and housing were protective against exposure to these trauma-related events. However, employment and housing also decreased the odds of talking with others about substance use. The aforementioned results were obtained from multivariate logistic regression models and were significant to p

Introduction: This systematic review aimed to answer whether we can predict subsequent social functioning in first episode psychosis (FEP) by means of an initial cognitive examination. In order to do this, we gathered longitudinal studies which evaluated neurocognition and/or social cognition regarding their impact on long-term social functioning of FEP patients. Methods: The MOOSE method was employed and 28 studies covering data from a total of 2572 patients with longitudinal trajectories from 2 months to 5 years were reviewed. Results: In general, cognitive deficits impacted on the social functioning of the FEP patients across the time. The neurocognitive domains which most closely predicted social functioning were processing speed, sustained attention and working memory. An overall cognitive dysfunction, low IQ and the academic trajectory were also found predictive. Regarding social cognition, the findings were not unanimous. Discussion: In addition of the impact of each variable, several of the articles found a complex relationship between social cognition, neurocognition, social functioning and negative symptoms, pointing social cognition as a modulator of neurocognition but being modulated as well by negative symptoms. The principal clinical implication of this review is that the initial assessment of FEP patients and their rehabilitation must take cognition into account. [ABSTRACT FROM AUTHOR]

Purpose: For cancer survivors, social functioning greatly influences other quality of life dimensions. While there is potential for differences in social functioning to vary as a function of geographic residence, few studies examine the social functioning of rural cancer survivors specifically. This study aims to help fill this gap. Methods: This was an embedded mixed‐methods study where all participants completed a questionnaire, and some were purposively selected to complete an interview to gather more information about social functioning (ie, social roles, activities, network, support, and constraint). Participants (n = 93; 63% rural) were recruited through a state cancer registry and cancer care facility. Participants were predominately White, non‐Hispanic (92.47%), roughly half female (54.84%), and on average, diagnosed in the past two years (SD = 1.68), and 61.45 (SD = 10.87) years old. Findings: Few differences in the social functioning of rural and nonrural participants were found on questionnaires, though rural participants reported larger networks and more overall support. Across groups, common themes in the interview data were the experience of both social support (eg, instrumental support) and social constraint (eg, others minimizing participants' problems or sharing their own negative experiences). Conclusions: This was the first cancer survivorship study to thoroughly examine social functioning by geographic residence. Rural cancer survivors described some unique strengths, but major group differences were not apparent. All participants highlighted situations when others, even with good intentions, were unhelpful to them. Future interventions to improve social functioning could work to dispel the belief that cancer survivors should handle their cancer on their own. [ABSTRACT FROM AUTHOR]

Social impairment is one of the most prevalent adverse outcomes ADHD-related. It is well established that this outcome is independent of externalizing behaviors and environmental factors. Little is known about the cognitive aspects related to it. We analyzed the Interpersonal Negotiation Strategies (INS) of children and adolescents with ADHD and discussed their contribution to understand interpersonal relationship deficits. The performance at INSI of 70 children and adolescents (41 ADHD and 29 clinical controls) were compared and related to the severity of ADHD and the presence of comorbidities. The INSS in ADHD was significantly deficient when compared with the control group (p <.01), independently of the age, gender, and the presence of comorbidities. The comprehension of the problem appeared as an important cognitive factor to contribute to this. These findings have a significant potential to contribute to the novel's cognitive targets of treatment approaches. [ABSTRACT FROM AUTHOR]

Social cognition impairments in severe alcohol use disorder (SAUD) are increasingly established. However, fundamental aspects of social cognition, and notably the attentional processing of socio-affective information, remain unexplored, limiting our understanding of underlying mechanisms. Here, we determined whether patients with SAUD show attentional biases to specific socio-affective cues, namely emotional faces. In a modified dot-probe paradigm, 30 patients with SAUD and 30 demographically matched healthy controls (HC) were presented with pairs of neutral-emotional (angry, disgusted, happy, sad) faces while having their eye movements recorded. Indices of early/automatic (first fixations, latency to first fixations) and later/controlled (number of fixations, dwell-time) processes were computed. Patients with SAUD did not differ from HC in their attention to angry/disgusted/sad vs. neutral faces. However, patients with SAUD fixated/dwelled less on happy vs. neutral faces in the first block of stimuli than HC, who presented an attentional bias to happy faces. Sample-size was determined to detect medium-to-large effects and subtler ones may have been missed. Further, our cross-sectional design provides no explanation as to whether the evidenced biases precede or are a consequence of SAUD. These results extend the social cognition literature in SAUD to the attentional domain, by evidencing the absence of a controlled attentional bias toward positive social cues in SAUD. This may reflect reduced sensitivity to social reward and could contribute to higher order social cognition difficulties and social dysfunction. • We investigated socio-affective attentional biases in SAUD using eye-tracking. • Patients with SAUD attended less to happy vs. neutral faces than controls. • Patients with SAUD did not present an attentional bias toward happy faces. • This may contribute to interpersonal and clinical difficulties in SAUD. [ABSTRACT FROM AUTHOR]

Growing appreciation of the impact of social cognition deficits on social functioning among people with serious mental illness (SMI) has led to the development of interventions that target them. The purpose of the present study was to conduct a qualitative analysis of the effectiveness of two group interventions, social cognition and interaction therapy (SCIT) and therapeutic alliance focused therapy (TAFT), and to explore the processes and factors that contribute to the SCIT and TAFT outcomes. Thirty-two participants (16 participants from each group) were interviewed after completing the interventions. Content analysis based on grounded theory was conducted by two psychologists. The majority of participants experienced the intervention they completed as beneficial. The completers attributed the positive changes to several factors including professional information, therapeutic alliance, and their own agency. Comparison of the two groups revealed that SCIT completers were more likely to report changes in their experience of self and in their daily coping, while TAFT completers were more likely to report changes in the way they felt. Although not the majority, five completers from each group reported a positive change in their interpersonal relationships. Integrative and flexible approaches to psychotherapy, which combine common factors and elicit health including actions, are important in order to improve social cognition deficits among people with SMI. [ABSTRACT FROM AUTHOR]

Childhood trauma is associated with a variety of negative outcomes in psychosis, but it is unclear clear if childhood trauma affects day-to-day social experiences. We aimed to examine the association between childhood trauma and functional and structural characteristics of real-world social relationships in psychosis. Participants with psychotic disorders or affective disorders with psychosis completed ecological momentary assessments (EMAs) over ten days (N = 209). Childhood trauma was assessed retrospectively using the Childhood Trauma Questionnaire. Associations between childhood trauma and EMA-assessed social behavior and perceptions were examined using linear mixed models. Analyses were adjusted for sociodemographic characteristics and psychotic and depressive symptom severity. Higher levels of childhood trauma were associated with more perceived threat (B = −0.19, 95 % CI [−0.33, −0.04]) and negative self-perception (B = −0.18, 95 % CI [−0.34, −0.01]) during recent social interactions, as well as reduced social motivation (B = −0.29, 95 % CI [−0.47, −0.10]), higher desire for social avoidance (B = 0.34, 95 % CI [0.14, 0.55]), and lower sense of belongingness (B = −0.24, 95 % CI [−0.42, −0.06]). These negative social perceptions were mainly linked with emotional abuse and emotional neglect. In addition, paranoia was more strongly associated with negative social perceptions in individuals with high versus low levels of trauma. Childhood trauma was not associated with frequency (i.e., time spent alone) or type of social interactions. Childhood trauma – particularly emotional abuse and neglect – is associated with negative social perceptions but not frequency of real-world social interactions. Our findings suggest that childhood trauma may affect day-to-day social experiences beyond its association with psychosis. [ABSTRACT FROM AUTHOR]

In patients with psychotic disorders, insecure attachment styles and impaired social functioning are highly prevalent. Our aim was to explore the multi-cross-sectional and longitudinal associations between attachment style and social functioning. This study was performed in a subsample of 119 patients with non-affective psychotic disorders, 128 unaffected siblings and 66 healthy controls within the Genetic Risk and Outcome of Psychosis (GROUP) Study. Attachment style (using the Psychosis Attachment Measure) and three social functioning domains, namely withdrawal, interpersonal behaviour and pro-social activities as measured with the Social Functioning Scale (SFS) were assessed on two moments in time. Generalized linear mixed models and linear regression models were used. Bonferroni correction for multiple testing was applied. In the patient group, a significant negative association was found between avoidant attachment and pro-social functioning. In the sibling and control group, we found significant negative associations between avoidant attachment and the social functioning domains withdrawal and interpersonal behaviour. We also found a significant negative association between anxious attachment and the social functioning domain withdrawal in siblings. Higher levels of insecure anxious attachment at baseline predicted a reduction of the social functioning domain interpersonal behaviour in siblings over a period of three years on a trend level. Findings indicate that levels of insecure attachment are elevated in patients with psychotic disorders and have a negative association with social functioning in both patients, siblings and controls. These findings warrant specific attention for attachment style in the treatment of patients with psychotic disorders and individuals with an increased vulnerability for developing psychosis. [ABSTRACT FROM AUTHOR]

Prader–Willi syndrome (PWS) is a genetic disorder produced by a lack of expression of paternally derived genes in the 15q11–13 region. Research has generally focused on its genetic and behavioral expression, but only a few studies have examined epigenetic influences. Prenatal testosterone or the maternal testosterone-to-estradiol ratio (MaTtEr) has been suggested to play an important role in the development of the 'social brain' during pregnancy. Some studies propose the 2D:4D digit ratio of the hand as an indirect MaTtEr measure. The relationship between social performance and MaTtEr has been studied in other neurodevelopmental conditions such as Autism Spectrum Disorder (ASD), but to our best knowledge, it has never been studied in PWS. Therefore, our study aims to clarify the possible existence of a relationship between social performance—as measured using the Social Responsiveness Scale (SRS)—and MaTtEr levels using the 2D:4D ratio. We found that, as a group, PWS individuals have shorter index and ring fingers than the control group, but no significant difference in the 2D:4D ratios. The 2D:4D ratio showed a correlation only with Restricted Interests and Repetitive Behavior Subscale, where a positive correlation only for male individuals with PWS was found. Considering only PWS with previous GH treatment during childhood/adolescence (PWS-GH), index and ring fingers did not show differences in length with the control group, but the 2D:4D ratio was significantly higher in the right or dominant hand compared to controls. [ABSTRACT FROM AUTHOR]

Schizophrenia spectrum disorders represent a varied class of mental illnesses characterised by psychosis. In addition to negative and positive symptoms, a significant lack of insight often hinders the therapeutic process. We performed an overview of the existing literature concerning these disorders to summarise the state of knowledge in the psychotherapies applied to treating psychotic symptoms. We searched the PubMed database, including randomised controlled and clinical trials, including 17 studies conducted on 1203 subjects. Psychotherapy of schizophrenia spectrum disorders can improve social functioning and positive symptoms, as well as many other symptomatic areas, and could therefore be considered a helpful adjunctive treatment of schizophrenia spectrum disorders. Among cognitive-behavioural therapies and the newest derived approaches, there is evidence that they can improve different psychotic symptoms. On the other hand, psychodynamic psychotherapies can have a positive influence on psychotic symptoms as well. Further studies are needed to identify better-tailored treatment protocols for schizophrenia spectrum disorders. [ABSTRACT FROM AUTHOR]

Early Onset Dystonia (EOD) is thought to result from basal ganglia dysfunction, structures also involved in non-motor functions, like regulation of behavior, mood and anxiety. Problems in these domains have been found in proxy-reports but not yet in self-reports of EOD patients. The main questions are whether proxy-reports differ from those of patients and how problems relate to everyday social functioning. Subjective complaints about executive problems (BRIEF) and symptoms of depression and anxiety (CBCL) were obtained through a cross-sectional questionnaire study conducted on 45 EOD patients. Scores were in the normal range in patients and proxies. Proxy-rated behavior regulation was correlated with the estimated number of friends and quality of relations. Proxy-reported scores of depression correlated with the quality of relations and were higher than self-reports of adolescent/young adult patients. EOD patients and proxies do not seem to experience problematic regulation of behavior, mood and anxiety. Still, our study revealed two important aspects: (1) all measures were related to the estimated quality of relations with others, relating questionnaires to everyday social functioning; (2) proxies reported more symptoms of depression than patients. This may indicate overestimation by proxies or higher sensitivity of proxies to these symptoms, implying underestimation of problems by patients. [ABSTRACT FROM AUTHOR]

Objective: This study aims to compare the cognitive function and social functioning in male patients with deficit syndrome (DS) and non-DS, and to explore whether cognitive function serves as a mediator in the relationship between the two factors of negative symptoms (motivation and pleasure (MAP) and expressivity (EXP) deficits, and social functioning in schizophrenia patients. Methods: One hundred and fifty-six male patients with schizophrenia and 109 age- and education-matched normal controls were enrolled in the current study. The Chinese version of a Schedule for Deficit Syndrome (SDS) was used for DS and non-DS categorization. The Brief Psychiatric Rating Scale (BPRS) and the Brief Negative Symptoms Scale (BNSS) were used to assess psychotic and negative symptoms in patients. The Social-Adaptive Functioning Evaluation (SAFE) was adopted to evaluate patients' social functioning, and a battery of classical neurocognitive tests was used to assess cognition, including sustained vigilance/attention, cognitive flexibility, ideation fluency, and visuospatial memory. Results: We found that male patients with DS performed worse in all four cognitive domains and social functioning compared to non-DS patients. Both total negative symptoms and its two factors were significantly associated with all four domains of cognition and social functioning in male patients. Interestingly, our results indicate that only cognitive flexibility mediates the relationship between negative symptoms and social functioning in schizophrenia patients, but there were no differences between EXP and MAP negative factors in this model. Conclusion: Our findings suggest that DS patients may represent a unique clinical subgroup of schizophrenia, and the integrated interventions targeting both negative symptoms and cognition, especially cognitive flexibility, may optimally improve functional outcomes in schizophrenia patients. [ABSTRACT FROM AUTHOR]

Background: Continuity of care is considered an important treatment aspect of psychiatric disorders, as it often involves long-lasting or recurrent episodes with psychosocial treatment aspects. We investigated in two psychiatric hospitals in Germany whether the positive effects of relational continuity of care on symptom severity, social functioning, and quality of life, which have been demonstrated in different countries, can also be achieved in German psychiatric care. Methods: Prospective cohort study with a 20-months observation period comparing 158 patients with higher and 165 Patients with lower degree of continuity of care of two psychiatric hospitals. Patients were surveyed at three points in time (10 and 20 months after baseline) using validated questionnaires (CGI Clinical Global Impression rating scales, GAF Global Assessment of Functioning scale, EQ-VAS Euro Quality of Life) and patient clinical record data. Statistical analyses with analyses of variance with repeated measurements of 162 patients for the association between the patient- (EQ-VAS) or observer-rated (CGI, GAF) outcome measures and continuity of care as between-subject factor controlling for age, sex, migration background, main psychiatric diagnosis group, duration of disease, and hospital as independent variables. Results: Higher continuity of care reduced significantly the symptom severity with a medium effect size (p 0.036, eta 0.064) and increased significantly social functioning with a medium effect size (p 0.023, eta 0.076) and quality of life but not significantly and with only a small effect size (p 0.092, eta 0.022). The analyses of variance suggest a time-independent effect of continuity of care. The duration of psychiatric disease, a migration background, and the hospital affected the outcome measures independent of continuity of care. Conclusion: Our results support continuity of care as a favorable clinical aspect in psychiatric patient treatment and encourage mental health care services to consider health service delivery structures that increase continuity of care in the psychiatric patient treatment course. In psychiatric health care services research patients' motives as well as methodological reasons for non-participation remain considerable potential sources for bias. Trial registration: This prospective cohort study was not registered as a clinical intervention study because no intervention was part of the study, neither on the patient level nor the system level. [ABSTRACT FROM AUTHOR]