Stable and dynamic neurobehavioral phenotypes of social isolation and loneliness in serious mental illness

严重精神疾病中社会孤立和孤独的稳定和动态神经行为表型

基本信息

批准号：
10380446
负责人：
DANIEL C FULFORD
金额：
$ 28.23万
依托单位：
MASSACHUSETTS GENERAL HOSPITAL
依托单位国家：
美国
项目类别：
财政年份：
2022
资助国家：
美国
起止时间：
2022-03-15 至 2027-01-31
项目状态：
未结题

来源：
https://reporter.nih.gov/project-details/10380446
关键词：
Address Adult Affect Amygdaloid structure Area Basal Ganglia Behavior Behavioral Behavioral Mechanisms Blood Pressure Body mass index Brain Cellular Phone Chronic Data Diagnosis Disease Early Diagnosis Ecological momentary assessment Face Functional Magnetic Resonance Imaging General Population Health Heart Rate Hippocampus (Brain)Human Illness impact Impairment Individual Individual Differences Intervention Life Light Link Loneliness Longevity Measures Medial Medical Metabolic Marker Modeling Morbidity - disease rate Motivation Neurophysiology - biologic function Outcome Participant Persons Phenotype Process Psychotic Disorders Publishing Quality of life Recording of previous events Reporting Research Rewards Schizophrenia Social Behavior Social Interaction Social Network Social Perception Social isolation Stimulus Temporal Lobe Testing Thalamic structure Time Variant Withdrawal Work cardiometabolism design digital experience follow-up high body mass index improved in vivo indexing inflammatory marker interest intimate behavior longitudinal design mobile computing mortality neural correlate neurobehavioral neurobiological mechanism neuroimaging new therapeutic target novel novel strategies personalized intervention preference prevent psychologic relating to nervous system response severe mental illness smartphone based assessment social social contact social determinants trait

项目摘要

Summary Some of the most debilitating and harmful 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 greatly impact day-to-day functioning and are associated with poor cardiometabolic health and early mortality in SMI, and currently there are no available treatments that can prevent or reverse these devastating consequences of having these illnesses. This may be in part because the neural and psychological mechanisms underlying social isolation and loneliness in SMI, and how they impact health outcomes, are poorly understood. However, recent clues from studies employing advanced neuroimaging and digital assessments have formed the basis of a novel approach to investigating such mechanisms, outlined in this proposal. 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 application, we propose 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 control subjects. 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 deficient responses of social perception-related circuitry (medial temporal lobe regions) linked to social isolation, and deficient 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 quantitative markers of social isolation and loneliness identified in Aims 1 and 2 predict indices of cardiometabolic health, measuring the stability of these associations over time. Thus, in this project, we will show that fundamental neural and behavioral processes drive momentary variation in the experience of social isolation and loneliness, and directly impact cardiometabolic health in SMI. In follow-up work, these findings can be used as objective targets in studies of novel interventions which aim to address these major causes of 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）社会隔离（社会接触数量少）和2）社会脱节的主题经历（孤独）经常适应这些条件。社会隔离和孤独感巨大的日常影响力和与SMI的心脏代谢健康不良和早期死亡率有关，目前尚无可用可以防止或扭转这些疾病的毁灭性后果的治疗方法。这可能是部分是因为SMI中社会隔离和孤独的基础的神经和心理机制，以及它们如何影响健康结果，对健康结果的理解很差。但是，采用研究的最新线索先进的神经影像学和数字评估已经构成了一种新型方法的基础此提案中概述的这种机制。先前的工作表明客观隔离和孤独是相关，但也有些独立。最近的神经影像学发现支持了这一模型，揭示了社会孤立和孤独既有共同的神经相关性。但是，很明显这些不是静态现象；基于智能手机的评估揭示了社交的短暂，动态变化孤立和孤独。拒绝预期的个体差异与瞬时有关孤独的经历，更大的回避和随后的社会隔离经历。那在当前应用，我们建议全面衡量相对稳定的神经和行为预测因子社会孤立和孤独以及这些经历的时刻变化，60 在拟议项目的目标1中，我们将证明较高的级别 SMI中的社会隔离和孤独感与对社会刺激的共享和独特的神经反应有关与社会隔离相关的社会感知相关电路（内侧临时叶区域）的反应不足，与奖励相关电路（基底神经节区域）的反应不足与孤独感有关。在AIM 2中，我们将通过纵向评估智能手机评估的社会隔离和孤独感的瞬态变化 “爆发”设计。最后，在AIM 3中，我们将确定社会隔离和孤独的定量标记在目标1和2中鉴定出心脏代谢健康的指标，测量这些关联的稳定性随着时间的推移。在这个项目中，我们将证明基本的神经和行为过程暂时推动社会隔离和孤独的经验变化，并直接影响SMI的心脏代谢健康。在后续工作中，这些发现可以用作对新干预措施的研究的目标目标，旨在解决这些早期死亡率的主要原因。