Risk factors for loneliness

Manuscript accepted

Risk factors for loneliness: The high relative importance of age versus other factors.

Loneliness is a potent predictor of negative health outcomes, making it important to identify risk factors for loneliness. Though extant studies have identified characteristics associated with loneliness, less is known about the cumulative and relative importance of these factors, and how their interaction may impact loneliness. Here, 4,885 individuals ages 10-97 years from the US completed the three-item UCLA Loneliness Survey on TestMyBrain.org. Using census data, we calculated the population and community household income of participants' census area, and the proportion of individuals in the participant's census area that shared the participant's demographic characteristics (i.e., sociodemographic density). We evaluated the relative importance of three classes of variables for loneliness risk: those related to the person (e.g., age), place (e.g., community household income), and the interaction of person X place (sociodemographic density). We find that loneliness is highly prevalent and best explained by person (age) and place (community household income) characteristics. Of the variance in loneliness accounted for, the overwhelming majority was explained by age with loneliness peaking at 19 years and declining thereafter. The congruence between one's sociodemographic characteristics and that of one's neighborhood had no impact on loneliness. These data may have important implications for public health interventions

Social defeat and psychosis-related outcomes: Associative and experimental tests related to the nature of defeat, specificity of outcomes, and psychosis-proneness

Several forms of social defeat, including ostracism, discrimination, bullying, and related experiences, have been associated with psychotic disorders and experiences. The social defeat hypothesis of schizophrenia attempts to explain these associations by positing that chronic exclusion due to having outsider status leads to deleterious neurobiological changes that produce psychosis. Here, we test non-neurobiological tenants of this theory, including the relative impact of daily, real-world, chronic social defeat versus an acute, time-limited, experimentally-induced socially defeating experience (i.e., social exclusion), the moderating role of psychosis-proneness, and the specificity of social defeat on psychosis-related outcomes. We find that real-world, chronic, but not acute, time-limited, laboratory-based social defeat is associated with decreased trust, but not false-alarms on an auditory signal detection task. These associations were qualified by interactions that are in line with social reconnection (i.e., positive appraisals of social stimuli following exclusion). Real-world, chronic social defeat was also associated with delusion- and hallucination-proneness. Together, these data highlight the importance of daily, real-world forms of social defeat versus laboratory manipulations on specific psychosis-related outcomes

Decision-making under risk and its correlates in schizophrenia

Schizophrenia spectrum disorders (SSD) are associated with pervasive cognitive impairments, including deficits in decision-making under risk. However, there is inconclusive evidence regarding specific mechanisms underlying altered decision-making patterns. In this study, participants (33 SSD and 28 non-SSD) completed the Columbia Card Task, an explicit risk-taking task, to better understand risk preference and adjustment in dynamic decision-making. We found that while there is no group difference in overall risk-taking, risk preference, or optimal decision-making, risk adjustment to contextual factors (e.g., loss probability) is blunted in SSD. We also found associations between risk-taking/suboptimal decision-making and disorganized symptoms, excited symptoms, and role functioning, but no associations between decision-making and working memory. These results suggest that during a complex, dynamic risk-taking task, individuals with SSD exhibit less adaption to changing information about risk, which may reflect risk imperception

Training volitional control of the theory of mind network with real-time fMRI neurofeedback

Is there a way improve our ability to understand the minds of others? Towards addressing this question, here, we conducted a single-arm, proof-of-concept study to evaluate whether real-time fMRI neurofeedback (rtfMRI-NF) from the temporo-parietal junction (TPJ) leads to volitional control of the neural network subserving theory of mind (ToM; the process by which we attribute and reason about the mental states of others). As additional aims, we evaluated the strategies used to self-regulate the network and whether volitional control of the ToM network was moderated by participant characteristics and associated with improved performance on behavioral measures. Sixteen participants underwent fMRI while completing a task designed to individually-localize the TPJ, and then three separate rtfMRI-NF scans during which they completed multiple runs of a training task while receiving intermittent, activation-based feedback from the TPJ, and one run of a transfer task in which no neurofeedback was provided. A priori region-of-interest analyses demonstrated volitional control in most regions during the training tasks and during the transfer task, although the effects were smaller in magnitude and not observed in one of the neurofeedback targets for the transfer task. Text analysis demonstrated that volitional control was most strongly associated with thinking about prior social experiences when up-regulating the neural signal. Analysis of behavioral performance and brain-behavior associations largely did not reveal behavior changes except for a positive association between volitional control in RTPJ and changes in performance on one ToM task. Together, this study demonstrates the feasibility of training volitional control of a social cognitive brain network, which may have clinical applications

Altered neural response to social awkwardness in schizophrenia spectrum disorders

Individuals with a schizophrenia spectrum disorder (SSD) have difficulties with social information processing, including mental state attribution, or “theory of mind” (ToM). Prior work has shown that these difficulties are related to disruption to the neural network subserving ToM. However, few such studies utilize naturalistic stimuli that are more representative of daily social interaction. Here, SSD and Non-SSD individuals underwent fMRI while watching The Office to better understand how the ToM network responds to dynamic and complex social information, such as socially awkward moments. We find that medial prefrontal cortex tracks less with moment-to-moment awkwardness in SSD individuals. We also find a broad decrease in functional connectivity in the ToM network in SSD. Furthermore, neural response during awkward moments and functional connectivity was associated with psychotic experiences and social functioning. These results suggest that during naturalistic, socially awkward moments where mental state attribution is critical, individuals with SSD fail to recruit key regions of the ToM network, possibly contributing to decreased social understanding and impaired functioning

Training individuals with schizophrenia to gain volitional control of the theory of mind network with real-time fMRI: A pilot study

Individuals diagnosed with schizophrenia spectrum disorders (SSDs) often demonstrate alterations in the Theory of Mind Network (ToM-N). Here, in this proof-of-concept, single-arm pilot study, we investigate whether participants with an SSD are able to learn to volitionally control regions of the ToM-N using real-time fMRI neurofeedback (rtfMRI-NF). Region-of-interest analyses demonstrate that after neurofeedback training, participants were able to gain volitional control of the majority of ToM-N brain regions during the transfer task, where no active feedback was given. These findings suggest that trained volitional control over the ToM-N is tentatively feasible with rtfMRI neurofeedback in SSD, although findings need to be replicated with more robust designs that include a control group and larger samples