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Social disconnection, including objective social isolation and subjective loneliness, is linked to substantial health risks. Yet, little is known about the predictors of social disconnection in individuals with mental illness. Here, we used machine learning to identify predictors of social isolation and loneliness in schizophrenia (N = 72), a psychiatric condition associated with social disconnection. For comparison, we also included two other groups: a psychiatric comparison sample of bipolar disorder (N = 48) and a community sample enriched for social isolation (N = 151). We fitted statistical models of social isolation and loneliness within and across groups. Each model included five candidate predictors: social avoidance motivation, depression, nonsocial cognition, social anhedonia, and social cognition. The results showed that social anhedonia explained unique variance in social isolation and loneliness in all samples, suggesting that it contributes to social isolation and loneliness broadly. However, nonsocial cognition explained unique variance in social isolation only within schizophrenia. Thus, social anhedonia could be a potential intervention target across populations, whereas nonsocial cognition may play a unique role in determining social disconnection in schizophrenia.

People with schizophrenia (SCZ) and bipolar disorder (BD) have impairments in processing social information, including faces. The neural correlates of face processing are widely studied with the N170 ERP component. However, it is unclear whether N170 deficits reflect neural abnormalities associated with these clinical conditions or differences in social environments. The goal of this study was to determine whether N170 deficits would still be present in SCZ and BD when compared with socially isolated community members. Participants included 66 people with SCZ, 37 with BD, and 125 community members (76 Community-Isolated; 49 Community-Connected). Electroencephalography was recorded during a face processing task in which participants identified the gender of a face, the emotion of a face (angry, happy, neutral), or the number of stories in a building. We examined group differences in the N170 face effect (greater amplitudes for faces vs buildings) and the N170 emotion effect (greater amplitudes for emotional vs neutral expressions). Groups significantly differed in levels of social isolation (Community-Isolated > SCZ > BD = Community-Connected). SCZ participants had significantly reduced N170 amplitudes to faces compared with both community groups, which did not differ from each other. The BD group was intermediate and did not differ from any group. There were no significant group differences in the processing of specific emotional facial expressions. The N170 is abnormal in SCZ even when compared to socially isolated community members. Hence, the N170 seems to reflect a social processing impairment in SCZ that is separate from level of social isolation.

BACKGROUND: People with schizophrenia on average are more socially isolated, lonelier, have more social cognitive impairment, and are less socially motivated than healthy individuals. People with bipolar disorder also have social isolation, though typically less than that seen in schizophrenia. We aimed to disentangle whether the social cognitive and social motivation impairments observed in schizophrenia are a specific feature of the clinical condition v. social isolation generally. METHODS: We compared four groups (clinically stable patients with schizophrenia or bipolar disorder, individuals drawn from the community with self-described social isolation, and a socially connected community control group) on loneliness, social cognition, and approach and avoidance social motivation. RESULTS: Individuals with schizophrenia (n = 72) showed intermediate levels of social isolation, loneliness, and social approach motivation between the isolated (n = 96) and connected control (n = 55) groups. However, they showed significant deficits in social cognition compared to both community groups. Individuals with bipolar disorder (n = 48) were intermediate between isolated and control groups for loneliness and social approach. They did not show deficits on social cognition tasks. Both clinical groups had higher social avoidance than both community groups. CONCLUSIONS: The results suggest that social cognitive deficits in schizophrenia, and high social avoidance motivation in both schizophrenia and bipolar disorder, are distinct features of the clinical conditions and not byproducts of social isolation. In contrast, differences between clinical and control groups on levels of loneliness and social approach motivation were congruent with the groups degree of social isolation.

PURPOSE: Mental health trajectories during the COVID-19 pandemic have been examined in Veterans with tenuous social connections, i.e., those with recent homelessness (RHV) or a psychotic disorder (PSY), and in control Veterans (CTL). We test potential moderating effects on these trajectories by psychological factors that may help individuals weather the socio-emotional challenges associated with the pandemic (i.e., psychological strengths). METHODS: We assessed 81 PSY, 76 RHV, and 74 CTL over 5 periods between 05/2020 and 07/2021. Mental health outcomes (i.e., symptoms of depression, anxiety, contamination concerns, loneliness) were assessed at each period, and psychological strengths (i.e., a composite score based on tolerance of uncertainty, performance beliefs, coping style, resilience, perceived stress) were assessed at the initial assessment. Generalized models tested fixed and time-varying effects of a composite psychological strengths score on clinical trajectories across samples and within each group. RESULTS: Psychological strengths had a significant effect on trajectories for each outcome (ps

BACKGROUND: Individuals with psychosis spectrum disorders (PSD) have difficulty developing social relationships. This difficulty may reflect reduced response to social feedback involving functional alterations in brain regions that support the social motivation system: ventral striatum, orbital frontal cortex, insula, dorsal anterior cingulate cortex, and amygdala. Whether these alterations span PSD is unknown. METHODS: 71 individuals with PSD, 27 unaffected siblings, and 37 control participants completed a team-based fMRI task. After each trial, participants received performance feedback paired with the expressive face of a teammate or opponent. A 2 × 2 (win versus loss outcome x teammate versus opponent) repeated measures ANOVA by group was performed on activation in the five key regions of interest during receipt of feedback. RESULTS: Across groups, three social motivation regions, ventral striatum, orbital frontal cortex, and amygdala, showed sensitivity to feedback (significant main effect of outcome), with greater activation during win versus loss trials, regardless of whether the feedback was from a teammate or opponent. In PSD, ventral striatum and orbital frontal cortex activation to win feedback was negatively correlated with social anhedonia scores. CONCLUSIONS: Patterns of neural activation during social feedback were similar in PSD, their unaffected siblings, and healthy controls. Across the psychosis spectrum, activity in key social motivation regions during social feedback was associated with individual differences in social anhedonia.

Functional connectome organization is altered in schizophrenia (SZ) and bipolar disorder (BD). However, it remains unclear whether network reorganization during a task relative to rest is also altered in these disorders. This study examined connectome organization in patients with SZ (N = 43) and BD (N = 42) versus healthy controls (HC; N = 39) using fMRI data during a visual object-perception task and at rest. Graph analyses were conducted for the whole-brain network using indices selected a priori: three reflecting network segregation (clustering coefficient, local efficiency, modularity), two reflecting integration (characteristic path length, global efficiency). Group differences were limited to network segregation and were more evident in SZ (clustering coefficient, modularity) than in BD (clustering coefficient) compared to HC. State differences were found across groups for segregation (local efficiency) and integration (characteristic path length). There was no group-by-state interaction for any graph index. In summary, aberrant network organization compared to HC was confirmed, and was more evident in SZ than in BD. Yet, reorganization was largely intact in both disorders. These findings help to constrain models of dysconnection in SZ and BD, suggesting that the extent of functional dysconnectivity in these disorders tends to persist across changes in mental state.

Several studies of reward processing in schizophrenia have shown reduced sensitivity to positive, but not negative, outcomes although inconsistencies have been reported. In addition, few studies have investigated whether patients show a relative deficit to social versus nonsocial rewards, whether deficits occur across the spectrum of psychosis, or whether deficits relate to negative symptoms and functioning. This study examined probabilistic implicit learning via two visually distinctive slot machines for social and nonsocial rewards in 101 outpatients with diverse psychotic disorders and 48 community controls. The task consisted of two trial types: positive (optimal to choose a positive vs. neutral machine) and negative (optimal to choose a neutral vs. negative machine), with two reward conditions: social (faces) and nonsocial (money) reward conditions. A significant group X trial type interaction indicated that controls performed better on positive than negative trials, whereas patients showed the opposite pattern of better performance on negative than positive trials. In addition, both groups performed better for social than nonsocial stimuli, despite lower overall task performance in patients. Within patients, worse performance on negative trials showed significant, small-to-moderate correlations with motivation and pleasure-related negative symptoms and social functioning. The current findings suggest reward processing disturbances, particularly decreased sensitivity to positive outcomes, extend beyond schizophrenia to a broader spectrum of psychotic disorders and relate to important clinical outcomes.

Schizophrenia is associated with deficits in both object perception and visual attention. However, few studies in schizophrenia have investigated object-based attention, which is dissociable from other forms of visuospatial attention. Recent research in healthy populations has shown that the spotlight of sustained visual attention flickers in a rhythmic, oscillatory fashion at specific frequencies in the 4-12 Hz range. In healthy samples, this oscillatory signature has been used to investigate spatiotemporal dynamics of object-based attention, showing that the attentional spotlight spreads to uncued locations within cued objects, and also periodically alternates focus between cued and uncued objects. In this study, we adapted a performance-based visual object cueing task to investigate object-based attention in individuals with a schizophrenia diagnosis and healthy controls. In controls, spatiotemporal patterns of object-based attention closely resembled those reported in previous studies of healthy individuals. In the schizophrenia group, the oscillatory signature of attention also appeared in the location of the cue and on uncued objects, similar to the effects in controls. Indeed, the oscillatory signature of attention at the spatial location of the cue was stronger in the schizophrenia group than in controls. However, attention did not spread across the cued object in schizophrenia; rather, attention appeared to remain hyperfocused at the spatial location of the cue. These findings provide the first evidence that visual attention has oscillatory characteristics in schizophrenia, as in the general population. The results also show that the fundamental process of attentional spreading which underlies object-based attention is abnormal in schizophrenia.

The COVID-19 pandemic and social distancing have directly impacted the socioeconomic well-being of most Americans. Veterans with psychosis (PSY) and Veterans who were recently housed (RHV) through a supportive housing programme may be especially vulnerable to experiencing negative socioeconomic effects of the pandemic. In this study, we investigated socioeconomic experiences and challenges during the pandemic in these two putatively vulnerable Veteran groups and in Veterans with no history of PSY or homeless (i.e., control Veterans, CTL). A total of 231 Veterans (81 PSY, 76 RHV, 64 CTL) participated in the baseline assessment, and 203 in the follow-up assessment (74 PSY, 63 RHV, 66 CTL). At both assessment points we obtained socioeconomic information, including personal finances, financial concerns, housing concerns, experience of material hardships, and employment status. All groups of Veterans reported socioeconomic challenges during the pandemic, but the pattern of effects differed across groups. Although RHV was in a similar position to the PSY group with respect to personal finances, they reported lower levels of financial well-being and were more prone to experiencing material hardships compared to the other two groups. CTL was most vulnerable to experiencing negative financial shocks. Contrary to expectations, PSY did not experience disproportionate material hardships compared to CTL. Veterans face significant socioeconomic challenges during the COVID-19 pandemic. However, RHV disproportionately experienced certain concerns and hardships, and these are a target for intervention by clinicians and service providers. PSY generally fared better than anticipated, possibly reflecting longstanding engagement with VA services that could serve to buffer the socioeconomic impact of the pandemic.

Event-related potential (ERP) studies of motivated attention in schizophrenia typically show intact sensitivity to affective vs. non-affective images depicting diverse types of content. However, it is not known whether this ERP pattern: 1) extends to images that solely depict social content, (2) applies across a broad sample with diverse psychotic disorders, and (3) relates to self-reported trait social anhedonia. We examined late positive potential (LPP) amplitudes to images involving people that were normatively pleasant (affiliative), unpleasant (threatening), or neutral in 97 stable outpatients with various psychotic disorders and 38 healthy controls. Both groups showed enhanced LPP to pleasant and unpleasant vs. neutral images to a similar degree, despite lower overall LPP in patients. Within the patients, there were no significant LPP differences among subgroups (schizophrenia vs. other psychotic disorders; affective vs. non-affective psychosis) for the valence effect (pleasant/unpleasant vs. neutral). Higher social anhedonia showed a small, significant relation to lower LPP to pleasant images across all groups. These findings suggest intact motivated attention to social images extends across psychotic disorder subgroups. Dimensional transdiagnostic analyses revealed a modest association between self-reported trait social anhedonia and an LPP index of neural sensitivity to pleasant affiliative images.

The COVID-19 pandemic continues to disproportionately impact people of color and individuals experiencing psychosis and homelessness. However, it is unclear whether there are differences by race in psychosocial responses to the pandemic in vulnerable populations. The double jeopardy hypothesis posits that multiply marginalized individuals would experience worse psychosocial outcomes. The present study investigated the clinical and functional initial responses to the pandemic in both Black (n = 103) and White veterans (n = 98) with psychosis (PSY), recent homelessness (RHV), and in a control group (CTL) enrolled in Department of Veterans Affairs (VA) healthcare services. Clinical interviews were administered via phone at two time points: baseline (mid-May through mid-August 2020) and follow-up (mid-August through September 2020). The baseline interview also included retrospective measures of pre-COVID status from January 2020. There were no significant differences between Black and White veterans in depression, anxiety, or loneliness. However, Black veterans did endorse more fears of contamination, F(1, 196.29) = 9.48, p = .002. Across all groups, Black veterans had better family integration compared to White veterans, F(1, 199.98) = 7.62, p = .006. There were no significant differences by race in social integration, work/role productivity, or independent living. In sum, there were few significant differences between Black and White veterans in initial psychosocial response to the pandemic. The lack of racial disparities might reflect the presence of VA's wrap-around services. The findings also highlight the robust nature of social support in Black veterans, even in the context of a global pandemic. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

BackgroundThe COVID-19 pandemic has had unprecedented effects on mental health and community functioning. Negative effects related to disruption of individuals' social connections may have been more severe for those who had tenuous social connections prior to the pandemic. Veterans who have recently experienced homelessness (RHV) or have a psychotic disorder (PSY) are considered particularly vulnerable because many had poor social connections prior to the pandemic.MethodsWe conducted a 15-month longitudinal study between May 2020 -July 2021 assessing clinical (e.g., depression, anxiety) and community (e.g., social functioning, work functioning) outcomes. Eighty-one PSY, 76 RHV, and 74 Veteran controls (CTL) were interviewed over 5 assessment periods. We assessed changes in mental health and community functioning trajectories relative to pre-pandemic retrospective ratings and examined group differences in these trajectories.ResultsAll groups had significantly increased symptoms of depression, anxiety, and concerns with contamination at the onset of the pandemic. However, RHV and PSY showed faster returns to their baseline levels compared to CTL, who took nearly 15 months to return to baseline. With regards to functioning, both RHV and PSY, but not CTL, had significant improvements in family and social networks over time. Work functioning worsened over time only in PSY, and independent living increased over time in both RHV and PSY but not CTL.ConclusionsThese results reveal that vulnerable Veterans with access to VA mental health and case management services exhibited lower negative impacts of the COVID-19 pandemic on mental health and community functioning than expected.

The COVID-19 pandemic has upended the lives of everyone in the United States, negatively impacting social interactions, work, and living situations, and potentially exacerbating mental health issues in vulnerable individuals. Within the Department of Veterans Affairs (VA) healthcare system, two vulnerable groups include those with a psychotic disorder (PSY) and those who have recently experienced homelessness (recently housed Veterans, RHV). We conducted phone interviews with PSY (n = 81), RHV (n = 76) and control Veterans (CTL, n = 74) between mid-May - mid-August 2020 ("initial") and between mid-August - mid-October 2020 ("follow-up"). At the initial period, we also collected retrospective ratings relative to January 2020 ("pre-COVID-19"). We assessed clinical factors (e.g., depression, anxiety, loneliness) and community integration (e.g., social and role functioning). All groups reported worse clinical outcomes after the onset of the COVID-19 pandemic. However, PSY and RHV exhibited improvements in depression and anxiety from initial to follow up, whereas CTL continued to exhibit elevated levels. There was little change in community integration measures. Our results indicate that all groups reported increased mental health problems after the onset of the pandemic, but vulnerable Veterans were not disproportionately affected and had better mental health resilience (i.e., for depression and anxiety) as the pandemic progressed compared to CTL. This effect could be due to the availability and utilization of VA services for PSY and RHV (e.g., housing and financial support, medical and mental health services), which may have helped to mitigate the impact of the pandemic.

Visual processing abnormalities in schizophrenia (SZ) are poorly understood, yet predict functional outcomes in the disorder. Bipolar disorder (BD) may involve similar visual processing deficits. Converging evidence suggests that visual processing may be relatively normal at early stages of visual processing such as early visual cortex (EVC), but that processing abnormalities may become more pronounced by mid-level visual areas such as lateral occipital cortex (LO). However, little is known about the connectivity of the visual system in SZ and BD. If the flow of information to, from, or within the visual system is disrupted by reduced connectivity, this could help to explain perceptual deficits. In the present study, we performed a targeted analysis of the structural and functional connectivity of the visual system using graph-theoretic metrics in a sample of 48 SZ, 46 BD, and 47 control participants. Specifically, we calculated parallel measures of local efficiency for EVC and LO from both diffusion weighted imaging data (structural) and resting-state (functional) imaging data. We found no structural connectivity differences between the groups. However, there was a significant group difference in functional connectivity and a significant group-by-region interaction driven by reduced LO connectivity in SZ relative to HC, whereas BD was approximately intermediate to the other 2 groups. We replicated this pattern of results using a different brain atlas. These findings support and extend theoretical models of perceptual dysfunction in SZ, providing a framework for further investigation of visual deficits linked to functional outcomes in SZ and related disorders.

Individuals with schizophrenia and bipolar disorder show alterations in functional neural connectivity during rest. However, resting-state network (RSN) disruptions have not been systematically compared between the two disorders. Further, the impact of RSN disruptions on social cognition, a key determinant of functional outcome, has not been studied. Forty-eight individuals with schizophrenia, 46 with bipolar disorder, and 48 healthy controls completed resting-state functional magnetic resonance imaging. An atlas-based approach was used to examine functional connectivity within nine RSNs across the cortex. RSN connectivity was assessed via nonparametric permutation testing, and associations with performance on emotion perception, mentalizing, and emotion management tasks were examined. Group differences were observed in the medial and lateral visual networks and the sensorimotor network. Individuals with schizophrenia demonstrated reduced connectivity relative to healthy controls in all three networks. Individuals with bipolar disorder demonstrated reduced connectivity relative to controls in the medial visual network and connectivity within this network was significantly positively correlated with emotion management. In healthy controls, connectivity within the medial and lateral visual networks positively correlated with mentalizing. No significant correlations were found for either visual network in schizophrenia. Results highlight the role of altered early visual processing in social cognitive deficits in both schizophrenia and bipolar disorder. However, individuals with bipolar disorder appear to compensate for disrupted visual network connectivity on social cognitive tasks, whereas those with schizophrenia do not. The current study adds clarity on the neurophysiology underlying social cognitive deficits that result in impaired functioning in serious mental illness.

BackgroundHuman beings find social stimuli rewarding, which is thought to facilitate efficient social functioning. Although reward processing has been extensively studied in schizophrenia, a few studies have examined neural processes specifically involved in social reward processing. This study examined neural sensitivity to social and nonsocial rewards in schizophrenia.MethodsTwenty-seven patients with schizophrenia and 25 community controls completed a One-Armed Bandit Task, an implicit reinforcement learning task, in the scanner. There were 2 conditions with an identical trial structure, one with social rewards and the other with nonsocial rewards. The data were analyzed using a region of interest (ROI) approach, focusing on the ventral striatum, ventromedial prefrontal cortex, and anterior cingulate cortex.ResultsAcross all 3 ROIs, patients showed reduced activation for social rewards compared to controls. However, the 2 groups showed comparable levels of activation for nonsocial rewards. Within the patient group, levels of neural activation in these ROIs during the social reward condition were associated with better performance.ConclusionsThis study found reduced neural sensitivity in patients with schizophrenia in key reward-processing regions for social but not for nonsocial rewards. These findings suggest a relatively specific social reward-processing deficit in schizophrenia during an implicit reinforcement learning task.

Functional magnetic resonance imaging (fMRI) adaptation (also known as fMRI repetition suppression) has been widely used to characterize stimulus selectivity in vivo, a fundamental feature of neuronal processing in the brain. We investigated whether SZ patients and BD patients show aberrant fMRI adaptation for object perception. About 52 SZ patients, 55 BD patients, and 53 community controls completed an object discrimination task with three conditions: the same object presented twice, two exemplars from the same category, and two exemplars from different categories. We also administered two functional localizer tasks. A region of interest analysis was employed to evaluate a priori hypotheses about the lateral occipital complex (LOC) and early visual cortex (EVC). An exploratory whole brain analysis was also conducted. In the LOC and EVC, controls showed the expected reduced fMRI responses to repeated presentation of the same objects compared with different objects (i.e., fMRI adaptation for objects, p

Recent interest has focused on oxytocin (OT), a neurotransmitter that promotes social processing, to improve social functioning in people with schizophrenia. However, little information is available regarding the doses of OT that are effective for influencing social processing in the brain (i.e., target engagement). In this study, we conducted a double-blind, placebo-controlled, cross-over dose ranging study of OT. In total 47 patients with schizophrenia were randomly assigned to one of eight doses of OT (8, 12, 24, 36, 48, 60, 72, or 84 IU). Patients completed two social processing tasks: one electroencephalography (EEG) task, a biological motion Mu-suppression task (i.e., identifying the gender, emotion, or direction of walking of point-light animations of human movement); and one pupillometry task, pupil dilation in response to viewing affective faces. Participants completed these tasks twice, one week apart, and were randomly administered drug or placebo intranasally 30 min prior to each session. Mu-suppression, i.e., suppression of oscillations in the 8-12 Hz range over central electrodes in response to social stimuli, was significantly enhanced at doses of 36 and 48 IU in comparison to placebo, but not at other doses. Significant pupil dilation was observed in response to faces vs. non-face stimuli, though there were no drug effects at any dose. Results suggest that OT affects central measures of social information processing in patients with schizophrenia and is optimal at a mid-range dose (36-48 IU). These results provide dosing guidance for future studies of OT to be used to enhance social processing in people with schizophrenia.

People with schizophrenia (SZ) or bipolar disorder (BD) experience dysfunction in visual processing. Dysfunctional neural tuning, in which neurons and neuronal populations are selectively activated by specific features of visual stimuli, may contribute to these deficits. Few studies have examined this possibility and there are inconsistent findings of tuning deficits in the literature. We utilized an event-related potential (ERP) paradigm to examine neural adaptation for visual objects, a measure of neural tuning whereby neurons respond less strongly to the repeated presentation of the same stimulus. Seventy-seven SZ, 53 BD, and 49 healthy comparison participants (HC) were examined. In three separate conditions, pictures of objects were presented repeatedly: the same object (SS), different objects from the same category (e.g., two different vases; SD), or different objects from different categories (e.g., a barrel and a clock, DD). Mass-univariate cluster-based permutation analyses identified electrodes and time-windows in which there were significant differences between the SS vs. DD and the SD vs. DD conditions. Mean ERP amplitudes were extracted from these clusters and analyzed for group differences. Results revealed a significant condition difference over parieto-occipital electrodes for the SS-DD comparison between 109-164 ms and for the SD-DD comparison between 78-203 ms, with larger amplitudes in the DD compared to either SS or SD condition. However, there were no significant differences in the pattern of results between groups. Thus, while we found neural adaptation effects using this ERP paradigm, we did not find evidence of group differences. Our results suggest that people with SZ or BD may not exhibit deficits in neural tuning for processing of visual objects using this EEG task with rapidly presented stimuli. However, the results are inconsistent with other studies using different methodologies (e.g., fMRI, behavioral tasks) that have found tuning deficits in people with schizophrenia.

Social perceptual deficits in schizophrenia are well established. Recent work suggests that the ability to extract social information from bodily cues is reduced in patients. However, little is known about the neurobiological mechanisms underlying this deficit. In the current study, 20 schizophrenia patients and 16 controls completed two tasks using point-light animations during fMRI: a basic biological motion task and an emotion in biological motion task. The basic biological motion task was used to localize activity in posterior superior temporal sulcus (pSTS), a critical region for biological motion perception. During the emotion in biological motion task, participants viewed brief videos depicting happiness, fear, anger, or neutral emotions and were asked to decide which emotion was portrayed. Activity in pSTS and amygdala was interrogated during this task. Results indicated that patients showed overall reduced activation compared to controls in pSTS and at a trend level in amygdala across emotions, despite similar task performance. Further, a functional connectivity analysis revealed that controls, but not patients, showed significant positive connectivity between pSTS and left frontal regions as well as bilateral angular gyrus during the emotion in biological motion task. These findings indicate that schizophrenia patients show aberrant neural activity and functional connectivity when extracting complex social information from simple motion stimuli, which may contribute to social perception deficits in this disorder.

People with schizophrenia typically show visual processing deficits on masking tasks and other performance-based measures, while people with bipolar disorder may have related deficits. The etiology of these deficits is not well understood. Most neuroscientific studies of perception in schizophrenia and bipolar disorder have focused on visual processing areas in the cerebral cortex, but perception also depends on earlier components of the visual system that few studies have examined in these disorders. Using diffusion weighted imaging (DWI), we investigated the structure of the primary sensory input pathway to the cortical visual system: the optic radiations. We used probabilistic tractography to identify the optic radiations in 32 patients with schizophrenia, 31 patients with bipolar disorder, and 30 healthy controls. The same participants also performed a visual masking task outside the scanner. We characterized the optic radiations with three structural measures: fractional anisotropy, mean diffusivity, and tract volume. We did not find significant differences in those structural measures across groups. However, we did find a significant correlation between the volume of the optic radiations and visual masking thresholds that was unique to the schizophrenia group and explained variance in masking performance above and beyond that previously accounted for by differences in visual cortex. Thus, individual differences in the volume of the optic radiations explained more variance in visual masking performance in the schizophrenia group than the bipolar or control groups. This suggests that individual differences in the structure of the subcortical visual system have an important influence on visual processing in schizophrenia.

Patients with schizophrenia show specific abnormalities in visual perception, and patients with bipolar disorder may have related perceptual deficits. During tasks that highlight perceptual dysfunction, patients with schizophrenia show abnormal activity in visual brain areas, including the lateral occipital complex (LOC) and early retinotopic cortex. It is unclear whether the anatomical structure of those visual areas is atypical in schizophrenia and bipolar disorder. In members of those two patient groups and healthy controls, we localized LOC and early retinotopic cortex individually for each participant using functional magnetic resonance imaging (MRI), then measured the thickness of those regions of interest using structural MRI scans. In both regions, patients with schizophrenia had the thinnest cortex, controls had the thickest cortex, and bipolar patients had intermediate cortical thickness. A control region, motor cortex, did not show this pattern of group differences. The thickness of each visual region of interest was significantly correlated with performance on a visual object masking task, but only in schizophrenia patients. These findings suggest an anatomical substrate for visual processing abnormalities that have been found with both neural and behavioral measures in schizophrenia and other severe mental illnesses.

IntroductionDeficits in visual perception are well-established in schizophrenia and are linked to abnormal activity in the lateral occipital complex (LOC). Related deficits may exist in bipolar disorder. LOC contains neurons tuned to object features. It is unknown whether neural tuning in LOC or other visual areas is abnormal in patients, contributing to abnormal perception during visual tasks. This study used multivariate pattern analysis (MVPA) to investigate perceptual tuning for objects in schizophrenia and bipolar disorder.MethodsFifty schizophrenia participants, 51 bipolar disorder participants, and 47 matched healthy controls completed five functional magnetic resonance imaging (fMRI) runs of a perceptual task in which they viewed pictures of four different objects and an outdoor scene. We performed classification analyses designed to assess the distinctiveness of activity corresponding to perception of each stimulus in LOC (a functionally localized region of interest). We also performed similar classification analyses throughout the brain using a searchlight technique. We compared classification accuracy and patterns of classification errors across groups.ResultsStimulus classification accuracy was significantly above chance in all groups in LOC and throughout visual cortex. Classification errors were mostly within-category confusions (e.g., misclassifying one chair as another chair). There were no group differences in classification accuracy or patterns of confusion.ConclusionsThe results show for the first time MVPA can be used successfully to classify individual perceptual stimuli in schizophrenia and bipolar disorder. However, the results do not provide evidence of abnormal neural tuning in schizophrenia and bipolar disorder.

People with schizophrenia experience difficulties with social interactions. One contributor to these social deficits is dysfunction in processing facial features and facial emotional expressions. However, it is not known whether face processing deficits are evident in those with other psychotic disorders or in those genetically at‐risk for psychosis (i.e., first‐degree relatives of those with psychosis). We assessed event‐related potentials (ERPs) during a facial and emotion processing task in 100 people with a diagnosis of schizophrenia or another psychotic condition (PSY), 32 of their siblings (SIB) and 45 healthy comparison participants (CTL). In separate blocks, participants identified the sex (male or female) or emotion (happy, angry, neutral) of faces. In a comparison condition, participants indicated whether buildings had one or two floors. ERPs were examined in two stages. First, we compared ERPs across the emotion, sex and building identification conditions. Second, we compared ERPs among the three different facial emotions. PSY exhibited significantly lower amplitudes over parietal‐occipital regions between 111 and 151 ms when viewing faces but not buildings than CTL, consistent with a face‐selective N170 ERP component deficit. The SIB group was intermediate for faces, but not significantly different than PSY or CTL. During emotion identification, all three groups showed increased N170 amplitudes to angry and happy versus neutral expressions, with no group differences. In follow up analyses, we examined differences between PSY with or without affective psychosis, and differences between those with schizophrenia versus other psychotic disorders; there were no significant differences in these analyses. Face processing deficits assessed with ERPs were observed in a group of diverse psychotic disorders, though deficits were not seen to be modulated by facial emotion expression. Additionally, N170 deficits are not evident in siblings of those with PSY. [ABSTRACT FROM AUTHOR]