Social interactions are dynamic exchanges that most people navigate with ease. However, these exchanges are actually quite complex and nuanced. Indeed, Veterans with schizophrenia often find them confusing, resulting in poor social functioning. A key process underlying social interactions is empathy: the ability to understand and share the perspectives and mental states of others. The current proposal divides empathy into two major components: affective empathy and cognitive empathy. Affective empathy might be relatively intact in schizophrenia and it involves vicariously sharing another person?s mental states. Affective empathy can be further divided into two subcomponents. Motor resonance refers to the brain?s tendency to activate the same regions during first-hand action as well as second-hand observation of motor movements. Associated brain regions include the inferior parietal lobule, posterior superior temporal sulcus, and inferior frontal gyrus. Affect sharing refers to overlapping activation of brain regions during first- and second-hand experience of emotion, and is associated with dorsal anterior cingulate cortex and anterior insula brain regions. Cognitive empathy involves taking the perspective of others, and ranges from simple visual perspective taking (inferring which objects someone sees from a different view point) to emotional perspective taking (more complex inferences about another?s feelings, beliefs, and intentions). It is consistently impaired in schizophrenia Cognitive empathy is associated with the medial prefrontal cortex, precuneus and temporo-parietal junction. The complex construct of empathy requires integration and coordination among regions within and between these brain networks. The network architecture underlying empathy in schizophrenia is not known, including any alterations in connections within and between regions of these empathy networks. The goal of this proposal is address this gap in the literature. To do so, the applicant will receive training in functional and structural brain connectivity methods and apply them to a multi-modal imaging study designed to better understand where empathy processing functions break down at the neural level in Veterans with schizophrenia. Acquiring the skills outlined in the training component will allow the applicant to utilize sophisticated, cutting-edge neuroimaging methods to conduct the next generation of translational neuroscience research on psychotic disorders. The primary mentor will be Michael F. Green, PhD, Director of the VISN 22 MIRECC Treatment Unit, an established leader in the field of schizophrenia research. The applicant will work with Dr. Green and three co-mentors who are experts in their respective fields, to learn skills necessary to analyze fMRI data for functional connectivity using multivariate techniques, dMRI data for structural connectivity, and apply graph theory, an advanced computational analysis, to the study of neural connectivity patterns. The work stands to make a significant contribution to the field by moving beyond a regional neural focus toward a neural network model of underlying mechanisms of psychopathology. The applicant?s career goal is to become a VA-based research psychologist, working to advance understanding of schizophrenia while also benefiting Veterans through practical application of research findings. This CDA will facilitate the applicant?s goal of independence, providing a unique combination of skills to become a local expert and long-term VA researcher. The applicant?s training environment at the VA MIRECC/UCLA provides an excellent environment and infrastructure from which to complete the proposed study.
More than 80,000 Veterans receive treatment for schizophrenia through the VA, and this treatment accounts for a disproportionately large percentage of the VA?s health care budget. Social cognitive dysfunction is a major contributor to poor community outcomes in affected Veterans, constituting a major public health concern. Evidence-based social cognitive training interventions exist for improving social processing, but our ability to improve impaired empathy in Veterans with schizophrenia is limited. This proposal aims to understand neural networks underlying this impairment. Results from this study can inform the application of innovative interventions, such as neurostimulation, to the specific aspects of empathy most disrupted in schizophrenia, ultimately improving the daily lives of Veterans with this debilitating disorder and reducing the cost and burden associated with patient care at VA.