Social deficits are a hallmark characteristic of schizophrenia, and recent evidence suggests that this impairment may be evident in the prodromal stage of psychosis (the stage immediately preceding the first episode of psychosis). The current conceptualization of social processes outlines four functional constructs including affiliation and attachment, social communication, perception/understanding of self, and perception/understanding of others. This approach to understanding social processing highlights a dimensional understanding of social behavior and emphasizes assessing these constructs from multiple levels of analyses (e.g., brain, behavior, self-report, etc.). Although several distict studies have implicated areas of social processing dysfunction in the prodrome (e.g., emotion recognition and theory of mind) to date, there have been no multimodal investigations designed to determine functioning across the four constructs. Clarifying our understanding of social processing in a clinical high-risk group (CHR) (those deemed to meet clinical criteria for a prodromal syndrome) stands to increase our knowledge of social processing more broadly as well as improve our understanding of the etiology of psychosis. This project aims to clarify the nature of social processes in a CHR group, test for neuroanatomical correlates of the four constructs, and to assess for individual differences in the relationship between psychotic symptoms and social processes. In this study, 40 individuals with a prodromal syndrome and 40 controls will be evaluated by using multiple levels of analysis (i.e., behavior, imaging, self-report). Social constructs will be measured as follows: Affiliation and attachment will be assessed using a measure of social anhedonia from the Structured Interview for Prodromal Syndromes (SIPS); social communication will be evaluated using various emotion-related tasks (ER-40, FEDT, MSCEIT) as well as questionnaires to get at more productive aspects of social communication (social responsiveness scale, social communication questionnaire, broad autism phenotype); perception/understanding of self will be measured using the Beck Cognitive Insight Scale and Scale to Assess Unawareness of Mental Disorder insight scales; finally, perception/understanding of others will be assessed using The Awareness of Social Inference Test. Structural and diffusion tensor imaging will also be used in order to evaluate neural regions and circuitry currently believed to be involved in social functioning. Throughout the course of this project, the applicant will receive education and training in social processes, workwith experts in the field in regards to affective neuroimaging, statistical analyses of imaging data, and prodromal syndromes. This training plan, incorporating coursework, specialized training in social domains, colloquia/conference attendance, and work with the Sponsor/Co-Sponsors will enable the applicant to effectively complete the current proposal as well as develop the necessary skills to pursue an independent research career investigating social processes, and specifically, how this functioning domain manifests in psychotic disorders.
Schizophrenia is a debilitating; chronic mental illness that incurs great costs to those afflicted; their families; and society as a whole. Although research has advanced our understanding of schizophrenia and other psychotic disorders; we are still limited in our basic knowledge of how these disorders develop. Current research indicates that aspects of social processes may be endophenotypes for schizophrenia; investigating social processes constructs in individuals exhibiting a prodromal syndrome (those at-risk for developing schizophrenia) stands to clarify our understanding of social processes; the developmental trajectory of schizophrenia; as well as improve efforts in early intervention and preventative treatment.
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