Neurobehavioral mechanisms of social isolation and loneliness in serious mental illness

总结 严重精神疾病（SMI）最令人衰弱和有害的方面是：1）社会孤立 (low社会联系的数量）和2）社会脱节（孤独）的主观体验， 经常伴随着这些症状。社会孤立和孤独对日常生活产生巨大影响 在SMI中起作用，并与整体生活质量差和早期死亡率相关。目前有 没有可用的干预措施可以防止或扭转这些严重的后果。这可以是 部分原因是SMI中社会孤立和孤独的潜在神经和心理机制 不太了解。然而，最近的线索，从研究采用先进的神经成像和数字 评估方法可为调查此类机制的新方法提供基础。先前工作 他指出，客观孤立和孤独是相关的，但也有些独立。最近 神经影像学研究结果支持这一模型，揭示了社会孤立和孤独都有共享， 不同的神经关联然而，同样清楚的是，这些都不是静态的现象;基于智能手机的 评估显示，社会孤立和孤独感发生了短暂的动态变化。个体差异 在预期的拒绝与短暂的孤独感，更大的回避， 社会隔离的加剧。因此，在目前的提案中，我们计划全面衡量 这两个相对稳定的神经和行为预测社会孤立和孤独，以及 在60名患有SMI和60名没有SMI的人中，这些经历的每时每刻的变化。目标1， 在拟议的项目中，我们将表明，SMI中较高水平的社会孤立和孤独与以下因素有关： 对社会刺激的共同和不同的神经反应，社会感知相关电路的反应较低 （内侧颞叶区域）与社交孤立有关，以及奖励相关回路（基底）的反应较低 神经节区域）与孤独有关。在目标2中，我们将测量社会隔离的瞬时变化， 孤独感与智能手机评估使用纵向“突发”设计。最后，在目标3中，我们将确定 目标1和目标2中确定的社会孤立和孤独的相关因素如何相互联系， 功能水平，并衡量这些协会随时间的稳定性。因此，在这个项目中，我们计划 来证明基本的神经和行为过程驱动了体验中的瞬间变化 社会孤立和孤独，并直接影响功能和生活质量的SMI。在后续工作中， 这些发现可以作为定量目标，用于研究旨在解决这些问题的新干预措施。 残疾和早期死亡的主要原因。

Summary Some of the most debilitating and detrimental aspects of serious mental illnesses (SMI) are the 1) social isolation (low numbers of social contacts) and 2) the subjective experiences of social disconnection (loneliness) that frequently accompany these conditions. Social isolation and loneliness have an immense impact on day-to-day functioning in SMI and are associated with an overall poor quality of life and early mortality. Currently there are no available interventions that can prevent or reverse these devastating consequences of SMI. This may be in part because the underlying neural and psychological mechanisms of social isolation and loneliness in SMI are poorly understood. However, recent clues from studies employing advanced neuroimaging and digital assessment approaches can provide the basis for a new approach to investigating such mechanisms. Prior work has indicated that objective isolation and loneliness are correlated but also somewhat independent. Recent neuroimaging findings support this model, revealing that social isolation and loneliness have both shared and distinct neural correlates. However, it is also clear that these are not static phenomena; smartphone-based assessments have revealed transient, dynamic changes in social isolation and loneliness. Individual differences in the anticipation of rejection are associated with momentary experiences of loneliness, greater avoidance and subsequent increases in social isolation. Thus, in the current proposal, we plan to comprehensively measure both the relatively stable neural and behavioral predictors of social isolation and loneliness, as well as the moment-to-moment changes in these experiences, in 60 individuals with SMI and 60 without SMI. In Aim 1 of the proposed project, we will show that the higher levels of social isolation and loneliness in SMI are linked to shared and distinct neural responses to social stimuli, with lower responses of social perception-related circuitry (medial temporal lobe regions) linked to social isolation, and lower responses of reward-related circuitry (basal ganglia regions) linked to loneliness. In Aim 2, we will measure transient changes in social isolation and loneliness with smartphone assessments using a longitudinal “burst” design. Lastly, in Aim 3, we will determine how the correlates of social isolation and loneliness identified in Aims 1 and 2 are linked to each other and to levels of functioning, and measure the stability of these associations over time. Therefore, in this project, we plan to demonstrate that fundamental neural and behavioral processes drive momentary variation in the experience of social isolation and loneliness, and directly impact functioning and quality of life in SMI. In follow-up work, these findings can be used as quantitative targets in studies of novel interventions which aim to address these major causes of disability and early mortality.