Prior studies examining the impact of oxytocin on negative symptoms in schizophrenia have yielded mixed results. The current study explored whether oxytocin can improve more proximal indicators of social affiliation as indicated by changes in behavior, language and subjective indices of social affiliation among individuals with schizophrenia spectrum disorders during a role-play designed to elicit affiliative responses. We tested the hypothesis that daily intranasal oxytocin administered for 6 weeks would improve social affiliation as manifested by increased social skill ratings, use of positive, affiliative, and social words, and subjective responses from a previously published randomized controlled trial. Forty outpatients with schizophrenia or schizoaffective disorder were randomized to the oxytocin, galantamine, or placebo group and completed affiliative role-plays and self-report questionnaires of affect, reactions to the affiliative confederate, and willingness to interact at baseline and post-treatment. Results demonstrated that oxytocin was not effective at improving behavioral or subjective indicators of social affiliation. This study adds to a growing literature that the prosocial effects of oxytocin in schizophrenia are limited or null.
Biomarkers are physiologic or pathologic characteristics that can be objectively measured and evaluated as indicators of biologic processes, or biological responses to therapeutic interventions. Traditionally, psychiatry has suffered from a relative paucity of these, with no lab tests or medical devices available for the diagnosis or monitoring of mental health disorders. The widespread adoption of personal digital devices including smartphones and wearables allow to retrieve, record and store large amounts of user-generated data that have been hypothesized to play as “digital biomarkers” - intended as a new type of medical information that can produce actionable insights into the biological state of individuals, just as “normal” biomarkers, but collected through digital tools. As well described by Onnela in 2015, digital biomarkers can define a digital phenotyping characterized by a “moment-by-moment quantification of the individual-level human phenotype in situ using data from personal digital devices,” in particular smartphones and mobile devices. Simpler said, digital biomarkers, can provide a comprehensive representation of people and patients' functioning. Their use in health research, prevention and practice is particularly relevant in the field of mental health being mental disorders highly heterogeneous in nature and over time. In the next years these novel ways of measuring mental health status will provide observations and perspectives into disease that were unavailable before and which will fruitfully inform personalized prevention and care. The presentation will introduce the concept of digital biomarkers and digital phenotyping, it will provide the state of the art on their identification and use in the field of mental health and will discuss the way forward to ensure their potential is exploited through effective collaboration between clinicians, public health researchers and the tech world in a joint effort to promote population well-being.
BackgroundParanoid delusions are reported among those with positive symptoms of schizophrenia (Bentall et al., 2009), those at high-risk for the development of psychosis (Addington et al., 2015; Salokangas et al., 2016), and in the general population (i.e., Freeman et al., 2005). Paranoia is related to functional impairment in multiple domains (i.e. Pinkham et al., 2016; McGurk et al., 2013). Given the presence of paranoia at both clinical and non-clinical levels, paranoia may be best conceptualized dimensionally. Further, robust relations between paranoia and social anxiety suggest that the two may exist together on one spectrum, with paranoia reflecting the most extreme end of this continuum (i.e. Gilbert, Boxall, Cheung, & Irons, 2005; Lim, Rodebaugh, Zyphur & Gleeson, 2016).Evidence suggests that several factors may influence the development of paranoia, including social cognitive biases such as diminished trust, increased hostility, and increased tendency to blame others (Pinkham et al., 2014). These types of social cognitive biases do not seem to be unique to paranoia and are also observed among those with social anxiety (i.e., Green & Phillips, 2004). Additional research suggests that paranoia and social anxiety may share other relevant attributes, such as need for approval from others (Rector, 2004), desire for closeness (Lim, Rodebaugh, Zyphur & Gleeson, 2016), and worry about and expectation of social rejection (Freeman, 2014). Despite literature to support overlap between paranoia and social anxiety, there is less research examining whether core beliefs of social anxiety contribute to the development and maintenance of paranoia. Specifically, core beliefs of social anxiety include (1) conditional beliefs: negative self-appraisals dependent on performance (2) unconditional beliefs: negative self-appraisals independent of behavior, and (3) high-standard beliefs: the attribution of self-worth based on performance (Wong, Moulds & Rapee, 2014). There is a need for research to determine the association between paranoia and beliefs related to social anxiety.The aim of the current study is to identify whether cognitions thought to be central to social anxiety are also related to paranoia in a sample of those with psychosis. We hypothesize that (1) social anxiety and paranoia will be related, and (2) heightened maladaptive self-beliefs of social anxiety will be associated with increased paranoia.MethodsWe will use the Social Interaction Anxiety Scale (Heimberg, Mueller, Holt, Hope & Liebowitz, 1992) to measure social anxiety symptomatology. We will use the Self-Beliefs Related to Social Anxiety Scale (Wong, Moulds & Rapee, 2014) including three subscales: conditional beliefs, unconditional beliefs, and high standard beliefs, to quantify cognitions of social anxiety. To measure paranoia, we will use the Green Paranoid Thoughts Scale (Green et al., 2008).ResultsPreliminary analyses (N = 14) indicate that the social anxiety is robustly related to paranoia (r = 0.59, p < 0.05). Unconditional beliefs were re...
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