Neurobehavioral mechanisms of social isolation and loneliness in serious mental illness

严重精神疾病中社会孤立和孤独的神经行为机制

• 批准号: 10657657
• 负责人: DANIEL C FULFORD
• 金额: $ 73.07万
• 依托单位: MASSACHUSETTS GENERAL HOSPITAL
• 依托单位国家: 美国
• 财政年份: 2021
• 资助国家: 美国
• 起止时间: 2021-09-01 至 2026-06-30
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10657657
• 关键词: Address; Affect; Amygdaloid structure; Basal Ganglia; Behavior; Behavioral; Cellular Phone; Disease; Early Diagnosis; Ecological momentary assessment; Face; Functional Magnetic Resonance Imaging; General Population; Genetic; Hippocampus; Impairment; Individual; Individual Differences; Intervention; Investigation; Knowledge; Life; Link; Loneliness; Measurement; Measures; Medial; Modeling; Monitor; Mood Disorders; Motivation; Neurophysiology - biologic function; Participant; Personal Space; Persons; Phenotype; Play; Process; Psychotic Disorders; Quality of life; Reporting; Research; Rewards; Schizophrenia; Social Behavior; Social Interaction; Social Network; Social Perception; Social isolation; Stimulus; System; Temporal Lobe; Testing; Thalamic structure; Time; Variant; Work; behavior prediction; design; digital assessment; disability; experience; follow-up; functional disability; functional improvement; improved; in vivo; insight; intimate behavior; longitudinal design; mobile computing; mortality; neural; neural correlate; neural model; neurobehavioral; neurobiological mechanism; neuroimaging; new therapeutic target; novel; novel strategies; personalized intervention; predicting response; prevent; psychologic; psychosocial; response; severe mental illness; smartphone based assessment; social; social contact; social determinants; trait

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.

概括 严重精神疾病 (SMI) 的一些最令人衰弱和有害的方面是 1) 社会孤立 （社交接触次数少）和 2）社交脱节（孤独感）的主观体验 经常伴随这些情况。社会孤立和孤独对日常生活产生巨大影响 SMI 功能正常，与整体生活质量差和早期死亡有关。目前有 没有可用的干预措施可以预防或扭转 SMI 的这些破坏性后果。这可能是在 部分原因是 SMI 中社会孤立和孤独的潜在神经和心理机制是 不太了解。然而，最近采用先进神经成像和数字技术的研究提供的线索 评估方法可以为研究此类机制的新方法提供基础。之前的工作 研究表明，客观孤立感和孤独感是相关的，但也有一定的独立性。最近的 神经影像学研究结果支持了这一模型，揭示了社会孤立和孤独感既具有共同性，又具有共同性。 明显的神经相关性。然而，同样清楚的是，这些都不是静态的现象；基于智能手机 评估揭示了社会孤立和孤独感的短暂、动态变化。个体差异 预期被拒绝与短暂的孤独感、更大的回避和 随后社会孤立感加剧。因此，在当前的提案中，我们计划综合衡量 社会孤立和孤独的相对稳定的神经和行为预测因素，以及 在 60 名患有 SMI 的人和 60 名没有 SMI 的人中，这些经历时时刻刻发生变化。目标 1 在拟议的项目中，我们将证明 SMI 中较高水平的社会孤立和孤独感与 对社会刺激有共同且不同的神经反应，与社会感知相关的电路的反应较低 （内侧颞叶区域）与社会隔离有关，以及与奖励相关的电路（基底）的较低反应有关 神经节区域）与孤独有关。在目标 2 中，我们将衡量社会隔离的短暂变化以及 使用纵向“突发”设计通过智能手机评估孤独感。最后，在目标 3 中，我们将确定 目标 1 和 2 中确定的社会孤立和孤独感的相关因素如何相互关联并与 功能水平，并衡量这些关联随着时间的推移的稳定性。因此，在这个项目中，我们计划 证明基本的神经和行为过程驱动体验的瞬时变化 社会孤立和孤独感，并直接影响 SMI 的功能和生活质量。在后续工作中， 这些发现可以用作旨在解决这些问题的新干预措施研究的定量目标 残疾和过早死亡的主要原因。