Supplement: Neurobehavioral mechanisms of social isolation and loneliness in serious mental illness

补充：严重精神疾病中社会孤立和孤独的神经行为机制

基本信息

批准号：
10615480
负责人：
DANIEL C FULFORD
金额：
$ 3.72万
依托单位：
MASSACHUSETTS GENERAL HOSPITAL
依托单位国家：
美国
项目类别：
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

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) 社会孤立（社交接触次数少）和 2）社交脱节（孤独感）的主观体验这些情况经常伴随着社会孤立和孤独，极大地影响日常功能和生活。与 SMI 心脏代谢健康状况不佳和早期死亡有关，目前尚无可用的方法可以预防或扭转这些疾病造成的破坏性后果的治疗方法。部分原因是 SMI 中社会孤立和孤独的神经和心理机制，以及然而，人们对它们如何影响健康结果知之甚少。先进的神经影像和数字评估已成为一种新颖的调查方法的基础本提案中概述的此类机制表明，客观上的孤立和孤独是存在的。最近的神经影像学研究结果支持了这一模型，揭示了这一点。社会孤立和孤独既有共同的又有不同的神经关联，但是，很明显，这些之间存在共同的和不同的神经关联。不是静态现象；基于智能手机的评估揭示了社会的短暂、动态变化孤立和孤独感与短暂的拒绝预期有关。因此，在当前的情况下，人们会经历孤独、更多的回避以及随后的社会孤立感的增加。应用中，我们建议综合测量相对稳定的神经和行为预测因子社会孤立和孤独，以及这些经历的每时每刻的变化，在 60 在拟议项目的目标 1 中，我们将展示具有 SMI 的个体和 60 名对照受试者。 SMI 中的社会孤立和孤独感与对社会刺激的共同且独特的神经反应有关，与社会孤立相关的社会感知相关回路（内侧颞叶区域）的反应不足，在目标 2 中，我们将研究与孤独相关的奖励相关回路（基底神经节区域）的反应不足。通过智能手机评估，使用纵向测量来衡量社会孤立和孤独感的短暂变化最后，在目标3中，我们将确定社会孤立和孤独的量化标记。目标 1 和 2 中确定的预测心脏代谢健康指数，测量这些关联的稳定性因此，在这个项目中，我们将展示基本的神经和行为过程驱动瞬时。社会隔离和孤独感的变化，直接影响 SMI 的心脏代谢健康。在后续工作中，这些发现可以作为新颖干预措施研究的客观目标，旨在解决这些早期死亡的主要原因。