Sleep disturbance and inflammation as determinants of social cognition and behavior: An intensive longitudinal study of adults with schizophrenia-spectrum disorders (NIH Supplemental)

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ABSTRACT People with schizophrenia-spectrum disorders (SSDs) experience deficits in social cognition, which contribute to real-world functional outcomes. As such, social cognition is an important treatment target in SSDs. Yet, current research has not adequately focused on determinants of social cognition, and intervention efforts do not reliably improve functional outcomes or produce durable gains. The parent study associated with this supplement application (1 R15 MH129814-01) aims to address this gap by examining sleep disturbance and inflammation as novel determinants of social cognition in people with SSDs. This supplement application will scientifically extend the parent award in two keys. First, in addition to inflammatory markers including C-reactive protein (CRP) and interleukin-6 (IL-6), this supplement will fund analysis of tumor necrosis factor-alpha (TNF-α). TNF-α is a proinflammatory cytokine that is heightened in people with SSDs, both during acute illness and after treatment, and linked to important outcomes such as depressive symptoms, cognitive deficits, and functioning and quality of life. Especially in light of the link between TNF-α and negative symptoms, it is an important area of investigation with regard to social cognition for those with schizophrenia. Second, this supplement would expand the multi- modal approach of the parent study to include qualitative inquiry. Several qualitative investigations of sleep have been undertaken in samples of people with serious mental illnesses, including schizophrenia. Yet, no study to date has specifically focused on participants’ perceptions of the impact of their sleep on social and other functional outcomes; thus, work is needed in this realm to complement our knowledge from quantitative studies and build depth in our understanding of participants’ perceptions of the detrimental impacts of disturbed sleep. This will be particularly important for future intervention development targeted to improve social outcomes. Together, these aims extend our ability to examine inflammation and incorporate participant perspectives into our understanding of the relationship between sleep and social outcomes for people with SSDs. Thus, impact of the parent study’s results will be increased and better contextualized, while staying within the scope of the original award. In addition to scientific extensions, this supplement will significantly expand the training footprint of the parent award and increase impact for students from diverse and/or underrepresented backgrounds in the School of Psychology at the University of Southern Mississippi. This will be achieved by increasing availability of training opportunities in qualitative research and access to appropriate tools (e.g., NVivo software) and providing financial support and close, individualized mentoring for five additional funded students from diverse and/or underrepresented backgrounds. These aims are consistent both with the goals of the notice of special interest regarding excellence in diversity, equity, inclusion, and accessibility (DEIA) mentorship (NOT-OD-23-002) and the parent award, which is funded by the Research Enhancement Award Program (REAP).