The Roles of Emotion Regulation and Alexithymia in the Relationship Between Sleep and Social Functioning.

Poor sleep quality has been tied to worse social functioning outcomes, including greater loneliness, fewer social interactions, and lower social integration. Other factors likely play a role in the relationship between sleep quality and social functioning. Specifically, alexithymia and emotion regulation may serve as moderators in these relationships. Data for this study came from the Pittsburgh Cold Study 3, a publicly available dataset (N = 213). Participants completed self-report measures including the Pittsburgh Sleep Quality Index, the Emotional Regulation Questionnaire, Toronto Alexithymia Scale, and four measures of social functioning: Social Network Index, Social Participation Measure, Short Loneliness Scale, and Interpersonal Support Evaluation List for providing support to others. Sleep quality was significantly related to the social functioning variables. Further, the use of the emotion regulation strategy reappraisal significantly moderated the relationship between sleep quality and social participation. Worse sleep quality was related to lower engagement in social activities, only for participants high in use of reappraisal. Additionally, the use of reappraisal significantly moderated the relationship between sleep quality and giving of support. Worse sleep quality was related to less self-reported giving of support to others only for participants high in the use of reappraisal. Results suggest that the use of reappraisal may be an important factor to consider in the relationship between sleep and social functioning. Future work should extend these findings to the general population and a sample of individuals with relevant diagnoses, such as borderline personality or schizophrenia-spectrum disorders.

Social Activity in Schizotypy: Measuring Frequency and Enjoyment of Social Events.

Improving social functioning deficits-a core characteristic of schizophrenia-spectrum disorders-is often listed by patients as a key recovery goal. Evidence suggests that social deficits also extend to people with schizotypy, a group at heightened risk for psychotic and other psychopathological disorders. One challenge of social functioning research in schizotypy is understanding whether social deficits arise from receiving less pleasure from social activities or from participating less in high-pleasure activities. However, limited information exists on what constitutes highly pleasurable, common social activities. In this study, 357 college students rated the frequency and enjoyment of 38 social activities. Our aims were to categorize activities based on their frequency and enjoyment, and whether these correlated with validated social functioning and schizotypy measures. We found that social activities could be characterized based on their frequency and enjoyment and created a frequency-enjoyment matrix that could be useful for future studies. Activities were correlated with social functioning, generally reaching a small effect size level, with increasing frequency and enjoyment showing associations with greater social functioning. Further, negative and disorganized-but not positive-traits were associated with less engagement and pleasure. Although follow-up studies in community samples are needed, our findings have the potential to help researchers and clinicians better understand which activities participants are more likely to engage in and derive pleasure from. The findings may also illustrate the extent to which social deficits may be due to less engagement or less pleasure from social activities, as well as which aspects of schizophrenia-spectrum disorders are associated with these facets of social functioning.

Recommendations for the assessment of sexual and gender minority status in serious mental illness research and clinical care.

Sexual and gender minority (SGM) groups experience exposure to minority stress, including discrimination, prejudice, microaggressions, and internalized stigma. Despite the sizable portion of the United States' population that identifies as SGM, relatively little research has been done to comprehensively understand the mental health consequences of SGM stress-particularly as they relate to serious mental illnesses (SMIs)-and SGM status is rarely reported in published studies. This article provides an overview of SGM research among people with SMIs as well as other relevant disorders. Findings show that sizable gaps remain in our knowledge of whether SGM groups experience higher rates or greater severity of SMIs, including schizophrenia-spectrum and bipolar disorders, though findings related to depressive and trauma-related disorders may be able to inform research and treatment for those with SMIs. To increase our understanding of potential mental health disparities for those with SMIs, researchers are encouraged to include measures to assess SGM identity, report upon this demographic information within their manuscripts, and examine differences in rates and severity of SMIs between these groups. Clinicians are encouraged to incorporate demographic questions into their standard intake batteries and initiate discussion of SGM status and minority stressors early on in treatment to promote more positive outcomes for this group. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Empathy and Schizotypy: A Network Comparison of the Interpersonal Reactivity Index in High and Low Schizotypy Groups.

Empathy is a multifaceted concept that is vital to effective social functioning; yet, it is impaired in high schizotypy groups. Furthermore, empathy has been found to be a mediator in the relationship between schizotypy and social functioning, highlighting the importance of empathy as a driver in social outcomes. Despite this, the four-factor structure of a widely-used measure of empathy-the Interpersonal Reactivity Index (IRI)-has been found to be psychometrically weak in high schizotypy samples. As such, this study aimed to assess differences in the item-level network of the IRI between high (n = 427) and low schizotypy groups (n = 470). The results reveal that there are significant differences in the structure of these networks, though they evidence similar strengths. Within the high schizotypy group, the network structure was consistent with the four-factor structure of the IRI subscales; items from each subscale clustered together and were distinct from those in the other subscales. By contrast, the low schizotypy group evidenced six clusters that did not mirror the IRI subscales. These results suggest that the item-level structure of the IRI is dependent upon the level of schizotypy of the sample, with the high schizotypy group's network functioning similarly to what would be expected from the original four-factor structure.

Schizotypy Moderates the Relationship Between Sleep Quality and Social Cognition.

ABSTRACT: Poor sleep quality has been tied to worse social cognition. Social cognitive deficits have been noted in those with high schizotypy. Yet, no study has assessed whether schizotypy moderates the relationship between sleep quality and social cognition, which may be vital to our understanding of contributors to social functioning. We conducted a cross-sectional analysis of associations of sleep quality and social cognition, with potential moderation by schizotypy. Participants ( n = 906) completed self-report measures of schizotypy, sleep quality, and social cognition. Levels of schizotypy significantly moderated some of the relationships between sleep and social cognition. For participants low in total or interpersonal schizotypy, worse sleep quality was associated with worse theory of mind scores. For participants low in total, disorganized, or cognitive perceptual schizotypy, worse sleep quality was associated with worse self-reported cognitive empathy. For those high in these facets of schizotypy, worse sleep quality was associated with better self-reported cognitive empathy. These results suggest that the individual facets of schizotypy provide additional information and, therefore, are important to assess when examining social cognition and sleep.

Social functioning mediates the relationship between psychiatric symptoms and recovery among veteran and community service users with serious mental illness.

OBJECTIVE: Previous research has established the impact of psychiatric symptoms on social functioning, while there is a paucity of research examining how social functioning relates to personal recovery, an individual's self-assessment of their mental health recovery. This study examined the mediating effect of social engagement, interpersonal communication, and satisfaction with support in the relationship between distinct psychiatric symptom clusters and perceived mental health recovery. METHODS: In a cross-sectional study, both patient self-report and provider assessment data were collected for 250 patients with serious mental illness (SMI) across four mental health service sites. Parallel mediation analytic models were used. RESULTS: Interpersonal communication partially mediated the relationship between positive and negative symptom clusters and personal recovery. Satisfaction with social supports partially mediated the relationship between excited symptoms and personal recovery. Both interpersonal communication and satisfaction with social supports partially mediated the relationship between general psychological distress and depressive symptoms and personal recovery. Collectively, social functioning mediators explained nearly half of the relationship between general psychological distress and excited symptoms and personal recovery and nearly all of the relationship between positive symptoms and personal recovery. CONCLUSIONS AND IMPLICATIONS FOR PRACTICE: Clinical providers working with persons with SMI should regularly assess social functioning in addition to assessing psychiatric symptoms and personal recovery factors and should incorporate social skills education into SMI group and individual treatments. Social functioning as a target of treatment may be especially beneficial for patients who are dissatisfied with other interventions or feel they have experienced the maximum benefit from treatment and are seeking additional methods to support personal recovery. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Sleep disorders in veterans with serious mental illnesses: prevalence in Veterans Affairs health record data.

STUDY OBJECTIVES: This study aimed to estimate the 12-month prevalence of diagnosed sleep disorders among veterans with and without serious mental illnesses (SMI) in Veterans Affairs health record data in 2019. We also examined diagnosed sleep disorders across a 9-year period and explored associations with demographic and health factors. METHODS: This study used health record data from VISN 4 of the Veterans Health Administration from 2011 to 2019. SMI diagnoses included schizophrenia and bipolar spectrum diagnoses as well as major depression with psychosis. Sleep diagnoses included insomnias, hypersomnias, sleep-related breathing disorders, circadian rhythm sleep-wake disorders, and sleep-related movement disorders. Demographic and health-related factors were also collected from the record. RESULTS: In 2019, 21.8% of veterans with SMI were diagnosed with a sleep disorder. This is a significantly higher proportion than for veterans without SMI, 15.1% of whom were diagnosed with a sleep disorder. Sleep disorder rates were highest in veterans with a chart diagnosis of major depression with psychosis. From 2011 to 2019, the overall prevalence of sleep disorders in veterans with SMI more than doubled (10.2%-21.8%), suggesting improvements in the detection and diagnosis of sleep concerns for this group. CONCLUSIONS: Our findings suggest that identification and diagnosis of sleep disorders for veterans with SMI has improved over the past decade, though diagnoses still likely underrepresent actual prevalence of clinically relevant sleep concerns. Sleep concerns may be at particularly high risk of going untreated in veterans with schizophrenia-spectrum disorders. CITATION: Bonfils KA, Longenecker JM, Soreca I, et al. Sleep disorders in veterans with serious mental illnesses: prevalence in Veterans Affairs health record data. J Clin Sleep Med. 2023;19(9):1651-1660.

Activism in the Digital Age: The Link Between Social Media Engagement With Black Lives Matter-Relevant Content and Mental Health.

Introduction: Research shows that participation in political activism on social media is linked to psychological stress. Additionally, race-based stress disproportionately affects minorities and is linked to greater psychological symptoms. Yet, the impact of the social media presence of Black Lives Matter (BLM) on mental health has yet to be meaningfully assessed.Methods: This study assessed whether engagement with BLM-related social media vignettes was related to mental health symptoms in two non-clinical samples (total N = 389), using a mixed-methods design. Participants completed an online survey with social media vignettes, self-report inventories of mental health symptoms, and open-ended questions about experiences with and the impact of BLM.Results: Correlations revealed that greater engagement with BLM-related social media posts was related to more severe mental health symptoms. Further, moderation analyses revealed that race significantly moderated the relationship between engagement and anxiety and trauma-related symptoms, such that these relationships were stronger for participants who identified as racial minorities. Qualitative analyses revealed that most participants who were engaged in mental health treatment had not discussed BLM-related topics with their providers, despite many participants reporting disrupted relationships and negative emotions due to exposure to BLM-related social media content.Discussion: Taken together, results suggest that engagement with BLM-related content online is linked to increased mental health symptoms, but these issues are infrequently addressed in treatment. Future research should extend these findings with clinical samples, assess the comfort of therapists in addressing these topics in therapy, and develop interventions to improve mental health in digital activists.

Functional outcomes from psychotherapy for people with posttraumatic stress disorder: A meta-analysis.

People with posttraumatic stress disorder (PTSD) experience a wide array of symptoms, often accompanied by significant functional and quality of life impairments. Evidence-based psychotherapies are effective for alleviating symptoms in this group, but functional outcomes following psychotherapy are understudied. This study aimed to synthesize existing work on functional outcomes of psychotherapy to conduct a meta-analytic investigation examining whether people with PTSD experience significant improvements in functioning and quality of life following a course of psychotherapy. A literature search was conducted for studies reporting results of randomized clinical trials of psychotherapies for people diagnosed with PTSD that included a functional or quality of life outcome measured at pre- and post-intervention. Both between-groups and within-groups analyses were conducted using a random effects model. Fifty-six independent samples were included. Results suggest that, on average, people with PTSD experience significant, moderate improvement in functional outcomes after a course of psychotherapy. Taken together, this meta-analysis represents a substantial advance in our understanding of functional outcomes of psychotherapy for people with PTSD. Findings suggest that psychotherapy is one vehicle through which functional outcomes may be improved for this group, though notably to a lesser degree than symptom improvement.

Measuring empathy in groups with high schizotypy: Psychometric evaluation of the Interpersonal Reactivity Index.

Empathy is integral for interpersonal interactions and formation and maintenance of a strong social network. There is wide agreement that empathy is a multidimensional construct, and it is commonly measured with the Interpersonal Reactivity Index (IRI). The IRI is used widely across healthy and clinical populations, yet insufficient evidence exists on whether the IRI is appropriate for use in groups characterized by high levels of schizotypy. This study sought to examine the factor structure and psychometric characteristics of the IRI when used in a sample of participants with high schizotypy. Nine hundred forty-one undergraduates completed the IRI; 218 met criteria for high schizotypy. Confirmatory factor analysis (CFA) was used to test eight a priori factor structures, and scores from the best fitting model were correlated with relevant measures. Of the eight models tested, a two-factor model including the Perspective-Taking and Empathic Concern subscales evidenced the best fit. The original four-factor structure did not meet criteria for adequate fit in our sample. IRI subscale scores correlated with emotional intelligence. Results suggest that a two-factor structure of the IRI is the strongest path forward for use in high schizotypy samples. This approach, in addition to being psychometrically sound, has the added benefit of being a more brief and targeted assessment that aligns well with contemporary models of empathy. (PsycInfo Database Record (c) 2022 APA, all rights reserved).