Increased Internet use and poorer ability to manage emotions in youth at high-risk for psychosis

AbstractThe relationship between Internet use and social behavior remains unknown. However, research indicates that Internet use (IU) may have some causal role in certain types of psychopathology and overall functioning. In contrast, other work suggests that IU may be protective and buffer against social isolation. Poorer emotional processing (EP) is characteristic of schizophrenia, and these deficits are present prior to illness onset (the ultra high-risk period (UHR)). UHR adolescents/young adults also fall within an age demographic characterized by extensive IU, which suggests that evaluating a link between IU and social behavior in this population may be especially informative. The present study examined the relationship between IU and emotional processing in 98 adolescents/young adults (52 UHR youth and 46 controls). UHR youth exhibited greater problematic IU (β=−6.49, F(1,95)=8.79, p=0.002) and social withdrawal/problems resulting from this use (β=−3.23, F(1,95)=11.43, p<0.001), as well deficits in emotional processing in comparison to healthy peers (β=4.59, F(1,94)=5.52, p=0.011). Furthermore, the social problems resulting from IU were significantly related to the ability to process emotional information in the UHR group (β=−0.51, t(1,48)=−2.10, p=0.021). UHR youth showed evidence of problematic IU relative to controls, and the social problems resulting from IU related to poorer EP. Findings replicate extant research involving other psychosis risk populations, while adding information regarding how social processes may relate to IU

MRI Indices of Cortical Development in Young People With Psychotic Experiences: Influence of Genetic Risk and Persistence of Symptoms

Background Psychotic experiences (PEs) are considered part of an extended psychosis phenotype and are associated with an elevated risk of developing a psychotic disorder. Risk of transition increases with persistence of PEs, and this is thought to be modulated by genetic and environmental factors. However, it is unclear if persistence is associated with progressive schizophrenia-like changes in neuroanatomy. Methods We examined cortical morphometry using MRI in 247 young adults, from a population-based cohort, assessed for the presence of PEs at ages 18 and 20. We then incorporated a polygenic risk score for schizophrenia (PRS) to elucidate the effects of high genetic risk. Finally, we used atlas-based tractography data to examine the underlying white matter. Results Individuals with persisting PEs showed reductions in gyrification (local gyrification index: lGI) in the left temporal gyrus as well as atypical associations with brain volume (TBV) in the left occipital and right prefrontal gyri. No main effect was found for the PRS, but interaction effects with PEs were identified in the orbitofrontal, parietal, and temporal regions. Examination of underlying white matter did not provide strong evidence of further disturbances. Conclusions Disturbances in lGI were similar to schizophrenia but findings were mostly limited to those with persistent PEs. These could reflect subtle changes that worsen with impending psychosis or reflect an early vulnerability associated with the persistence of PEs. The lack of clear differences in underlying white matter suggests our findings reflect early disturbances in cortical expansion rather than progressive changes in brain structure

Transcranial direct current stimulation, symptomatology, and cognition in psychosis: A qualitative review

Schizophrenia is a chronic, debilitating condition that affects approximately 1% of the population. Individuals diagnosed with schizophrenia typically exhibit positive (e.g., hallucinations) and negative symptoms (e.g., anhedonia) and impairments in cognitive function. Given the limitations of antipsychotic medication and psychotherapy in fully treating psychosis symptomatology, there has been increasing interest in other interventions such as transcranial direct current stimulation (tDCS). tDCS is a non-invasive neuromodulation technique, that is safe, cost-effective, and widely accessible. Here, we discuss treatment studies that seek to improve symptoms and cognitive performance in schizophrenia using tDCS. Currently within the literature, there is support for reductions in positive symptoms such as hallucinations after receiving tDCS. Further, studies indicate that tDCS can improve cognitive functioning, which is an area of investigation that is sorely needed, as it is unclear which types of interventions may be useful in ameliorating cognitive deficits among this group. Taken together, the evidence suggests that tDCS holds promise in improving symptoms and cognition. To that end, tDCS has critical clinical implications for this population

Intrinsic Functional Connectivity in Salience and Default Mode Networks and Aberrant Social Processes in Youth at Ultra-High Risk for Psychosis

<div><p>Social processes are key to navigating the world, and investigating their underlying mechanisms and cognitive architecture can aid in understanding disease states such as schizophrenia, where social processes are highly impacted. Evidence suggests that social processes are impaired in individuals at ultra high-risk for the development of psychosis (UHR). Understanding these phenomena in UHR youth may clarify disease etiology and social processes in a period that is characterized by significantly fewer confounds than schizophrenia. Furthermore, understanding social processing deficits in this population will help explain these processes in healthy individuals. The current study examined resting state connectivity of the salience (SN) and default mode networks (DMN) in association with facial emotion recognition (FER), an integral aspect of social processes, as well as broader social functioning (SF) in UHR individuals and healthy controls. Consistent with the existing literature, UHR youth were impaired in FER and SF when compared with controls. In the UHR group, we found increased connectivity between the SN and the medial prefrontal cortex, an area of the DMN relative to controls. In UHR youth, the DMN exhibited both positive and negative correlations with the somatosensory cortex/cerebellum and precuneus, respectively, which was linked with better FER performance. For SF, results showed that sensory processing links with the SN might be important in allowing for better SF for both groups, but especially in controls where sensory processing is likely to be unimpaired. These findings clarify how social processing deficits may manifest in psychosis, and underscore the importance of SN and DMN connectivity for social processing more generally.</p></div

Sample characteristics.

<p>Unless otherwise indicated, values are mean (standard deviation). SIPS (Structured Interview for Prodromal Syndromes); ER-40 (Emotion Recognition 40 Task); Social functioning represented score on the Global Functioning Scale: Social (GFS:S). Current Axis I diagnosis is based off DSM-IV criteria. Medications are shown indicating the percentage of the sample taking the medication.</p><p>*<i>p<</i>0.05</p><p>**<i>p<</i>0.001)</p><p>Sample characteristics.</p

Seed regions of interest.

<p><i>Note</i>: The salience network, defined using a seed in the rAI (right anterior insula), MNI coordinates (38, -22, 10). The default mode network, defined using a seed in the PCC (posterior cingulate cortex), MNI coordinates (1, -55, 17).</p

Associations between connectivity and facial emotion recognition.

<p><i>Note</i>: Results indicate positive correlations (yellow) between the default mode network (defined by the posterior cingulate cortex as a seed region) and the somatosensory cortex (shown bilaterally) and the cerebellum among UHR individuals. An inverse relationship in signal (blue) between the default mode network with the precuneus is shown in the medial left hemisphere at the top. Results are thresholded at the voxel-level at <i>p</i>_{<i>uncorrected</i>} <0.001 and then corrected at the cluster-level using a false-discovery rate (FDR) of <i>p</i><0.05.</p

Group Differences in seed to voxel connectivity.

<p><i>Note</i>: Results show increased connectivity between the salience network (as defined by the right anterior insula seed region) and the medial prefrontal cortex in ultra high-risk youth relative to controls. Results are thresholded at the voxel-level at p_uncorrected <0.001 and then corrected at the cluster-level using a false-discovery rate (FDR) of <i>p</i><0.05.</p