Self-other boundary under social threat in schizophrenia.

Spatial representation of the self plays a vital role constructing our sense of bodily self-boundary that distinguishes the self from others. This perceptual border, known as the peripersonal space (PPS), has been suggested to be altered in individuals with schizophrenia (SZ). PPS represents a protective defensive zone that triggers alarm signals upon threat detection; thus disrupted PPS could lead to social interactional difficulties. However, very little is known about the impact of threat on PPS. To address this gap, a visual-tactile response-time (RT) experiment was conducted in immersive virtual reality (VR) for SZ and matched controls (CO). Participants were asked to detect a tactile vibration on their hand while an avatar (either threatening or neutral) approached them. Avatars were presented at different distance from the participants. PPS size and slope were estimated by identifying significant RT drop at the hypothesized self-other boundary. We also examined the relationship between PPS parameters, clinical symptoms and social disconnection. There was no overall group difference in PPS size. Perceived social threat posed in the avatars sharpened the self-boundary in CO but not in SZ. In SZ, shallower PPS slope was associated with delusion, persecution, negative symptoms and loneliness but not in CO. These results show that the regulation of self-other boundary in response to impending social threat may be maladaptive in SZ. Further research is needed on the causal mechanisms between self-disturbance and social impairments.

Social connectedness and resilience post COVID-19 pandemic: Buffering against trauma, stress, and psychosis.

The present study investigated psychosocial predictors of psychosis-risk, depression, anxiety, and stress in Croatia two years after the onset of the COVID-19 pandemic. Given the existing transgenerational war trauma and associated psychiatric consequences in Croatian population, a significant pandemic-related deterioration of mental health was expected. Recent studies suggest that after an initial increase in psychiatric disorders during the pandemic in Croatia, depression, stress, and anxiety rapidly declined. These findings highlight the role of social connectedness and resilience in the face of the global pandemic. We examined resilience and psychiatric disorder risk in 377 Croatian adults using an anonymous online mental health survey. Results indicate that there was an exacerbation of all mental ill health variables, including depression, anxiety, stress, and a doubled risk for psychosis outcome post-COVID pandemic. Stress decreased levels of resilience, however, those exposed to previous traumatic experience and greater social connectedness had higher resilience levels. These findings suggest that individual differences in underlying stress sensitization of Croatian population due to past trauma may continue to influence mental health consequences two years after COVID-19 pandemic. It is essential to promote the importance of social connectedness and resilience in preventing the development of variety of mental health disorders.

The felt-presence experience: from cognition to the clinic.

The felt presence experience is the basic feeling that someone else is present in the immediate environment, without clear sensory evidence. Ranging from benevolent to distressing, personified to ambiguous, felt presence has been observed in neurological case studies and within psychosis and paranoia, associated with sleep paralysis and anxiety, and recorded within endurance sports and spiritualist communities. In this Review, we summarise the philosophical, phenomenological, clinical, and non-clinical correlates of felt presence, as well as current approaches that use psychometric, cognitive, and neurophysiological methods. We present current mechanistic explanations for felt presence, suggest a unifying cognitive framework for the phenomenon, and discuss outstanding questions for the field. Felt presence offers a sublime opportunity to understand the cognitive neuroscience of own-body awareness and social agency detection, as an intuitive, but poorly understood, experience in health and disorder.

Sensed Presence, Attenuated Psychosis, and Transliminality: At the Threshold of Consciousness.

INTRODUCTION: The experience of "sensed presence" or "felt presence" in the absence of "other" has been described as a complex multimodal experience to which meaning is given. Sensed presence (SenP) is a transdiagnostic experience that exists along a continuum that can appear during isolation, spirit quests, exposure to extreme elements, bereavement, anxiety, and psychosis. Given the prevalence and vast heterogeneity of SenP, in addition to a surprising lack of targeted research into this phenomenon, this research examined the interrelationship of SenP, attenuated psychosis symptoms (APS), and transliminality. Transliminality is composed of absorption, fantasy proneness, paranormal belief, mystical experiences, increased creativity, and hyperaesthesia. METHODS: A completely anonymous online survey of unusual experiences and mental health was distributed via social media (i.e., Twitter, Facebook, Reddit, and mass emailing lists) to recruit participants. Demographic data were analyzed using χ2 tests and one-way ANOVAs. A two-step cluster analysis was conducted to identify distinct sub-categories of transliminality followed by ANOVAs with bootstrapping at 1,000 iterations to compare SenP, increased APS, and transliminality. Pearson's bivariate correlations were conducted to determine the association between SenP, APS, and transliminality. RESULTS: Together with descriptive findings, we show distinct characteristics between clusters. T1 cluster consisted of individuals with few SenP experiences, low APS, and low transliminality. T2 consisted of individuals with a moderate prevalence of SenP, low APS, moderate transliminality, and increased overall feeling of closeness to G-d. There was no significant difference in APS between T1 and T2 or in the level of distress associated with APS. T3 individuals showed a significantly higher prevalence of SenP in all domains (frequency, distress, vividness, and total score), higher APS, and higher transliminality, compared to T1 and T2. The T3 cluster met criteria for high risk to develop psychosis. CONCLUSION: Thus, our findings demonstrate a strong association and entanglement of these experiences which suggests that the interrelatedness of transliminality/absorption and APS may serve as a potentially provocative underlying structure in the phenomenology of SenP.

Unequal outcomes: The effects of the COVID-19 pandemic on mental health and wellbeing among Hispanic/Latinos with varying degrees of 'Belonging'.

BACKGROUND: The COVID-19 pandemic has brought disparities in mental and physical health faced by ethnic minorities to the forefront. In the U.S., Hispanic/Latino communities are plagued by elevated rates of psychiatric conditions and trauma. Exacerbating this burden, common discourse often implicates Hispanic/Latino ethnicity as a causal factor, despite clear evidence of systemic causes, including lack of access to resources, and discrimination. AIMS: To parse apart Hispanic/Latino ethnicity from determinants of wellbeing (such as trauma, financial status, and loneliness), we examined mental and physical health during COVID-19 via an online, anonymous survey available in both English and Spanish. METHODS: We examined wellbeing across three participant groups, including two groups of Hispanic/Latino adults with varying degrees of 'belonging' to the dominant culture in their country of residence: Hispanic/Latino individuals living in Spanish-speaking and/or Central or Latin American countries (Group 1), Hispanic/Latino individuals living in the U.S. (Group 2), and non-Hispanic/Latino individuals living in the U.S. (Group 3). RESULTS: Results demonstrated there were significant differences between groups in specific aspects of wellbeing. Most importantly, results showed Hispanic/Latino ethnicity does not significantly predict psychosocial wellbeing or psychosis risk, and identified several predictors of these outcomes, including U.S. residence, trauma, loneliness, and age. CONCLUSION: Our results demonstrate that Hispanic/Latino ethnicity itself is not a causal factor of poor psychosocial wellbeing or elevated psychosis risk and instead identify several social and systemic causal factors commonly faced by Hispanic/Latino Americans. We suggest that language reporting on minority mental health acknowledge systemic factors as contributing to poor outcome rather than referring to ethnicity as if it were a causal factor.

Loneliness and psychosocial predictors of psychosis-proneness during COVID-19: Preliminary findings from Croatia.

The present study investigated psychosocial predictors of psychosis-risk, depression, anxiety, and stress in Croatia during the COVID-19 pandemic. Given Croatia's recent transgenerational war trauma and the relative lack of available prodromal data, this study presents a unique opportunity to examine the impact of loneliness and other psychosocial factors on psychosis-risk and mental health in this population. 404 Croatian participants completed an anonymous online survey of physical and mental health questions. 48 participants met the criteria for elevated psychosis-risk on prodromal questionnaire (PQ-16). Loneliness had a significant impact on psychosis-risk. Exposure to trauma was associated with psychosis-risk and loneliness, while domestic abuse/violence was associated only with the distress surrounding psychotic-like symptoms. COVID concern was also associated with psychosis-risk. Lastly, the associations between psychosis-risk and depression, anxiety, and stress were robust. These findings highlight the important role of loneliness in psychosis-proneness in Croatia. Depression, anxiety, and stress were also closely related to elevated psychosis-risk. Loneliness is a highly salient issue for individuals with psychosis and it is important to target loneliness within a multi-faceted psychosocial intervention for those at risk for schizophrenia.

Altered Peripersonal Space and the Bodily Self in Schizophrenia: A Virtual Reality Study.

Self-disturbances such as an anomalous perception of one's own body boundary are central to the phenomenology of schizophrenia (SZ), but measuring the spatial parameters of the hypothesized self-other boundary has proved to be challenging. Peripersonal space (PPS) refers to the immediate zone surrounding the body where the self interacts physically with the environment; the space that corresponds to hypothesized self-other boundary. PPS is represented by enhanced multisensory integration and faster reaction time (RT) for objects near the body. Thus, multisensory RT tasks can be used to estimate self-other boundary. We aimed to quantify PPS in SZ using an immersive virtual reality visuotactile RT paradigm. Twenty-four participants with SZ and 24 demographically matched controls (CO) were asked to detect tactile vibration while watching a ball approaching them, thrown by either a machine (nonsocial condition) or an avatar (social condition). Parameters of PPS were estimated from the midpoint of the spatial range where the tactile RT decreased most rapidly (size) and the gradient of the RT change at this midpoint (slope). Overall, PPS was smaller in participants with SZ compared with CO. PPS slope for participants with SZ was shallower than CO in the social but not in nonsocial condition, indicating an increased uncertainty of self-other boundary across an extended zone in SZ. Social condition also increased false alarms for tactile detection in SZ. Clinical symptoms were not clearly associated with PPS parameters. These findings suggest the context-dependent nature of weakened body boundary in SZ and underscore the importance of reconciliating objective and subjective aspects of self-disturbances.

Cross-cultural comparisons of psychosocial distress in the USA, South Korea, France, and Hong Kong during the initial phase of COVID-19.

The COVID-19 crisis has resulted in disruption of everyday life worldwide but the impact and response to the pandemic have not been uniform. Many countries rapidly deployed physical-distancing mandates to curb the spread of the virus; others did not. Social distancing strategies are necessary to reduce the transmission of the virus but there may be unintended consequences. We examined psychological distress in four societies with distinct public health strategies (South Korea, Hong Kong, France and the United States) to identify common and region-specific factors that may contribute to mental health outcome during the pandemic. From March to July of 2020, a survey of demographics, general health, mental health, loneliness and social networks was conducted. Overall, younger age, greater concern for COVID, and more severe loneliness predicted worse psychological outcome but the magnitudes of these effects varied across the four regions. Objective measures of social isolation did not affect mental health. There were also notable differences in psychological outcome; Hong Kong, with very strict social distancing protocols plus ongoing political unrest, suffered the most drastic deterioration of mental health. To prepare for an impending mental health crisis, concerted efforts to reduce loneliness should be integrated into a comprehensive public health strategy.

Deterioration of mental health despite successful control of the COVID-19 pandemic in South Korea.

South Korea was able to successfully control the spread of COVID-19 without nationwide lockdowns or drastic social distancing efforts, but pandemic-related psychological outcome of the general population remains unknown. Between March and June 2020, 400 South Korean residents participated in an online study of depression, anxiety, stress, psychosis-risk and loneliness, as well as indices of social network, physical health and demographics. Clinical levels of depression, anxiety or stress were reported by 45% of the respondents, and psychosis-risk was present in 12.8%; a drastic increase above the base rate reported by previous studies conducted in South Korea prior to the pandemic. Subjective feelings of loneliness, but not the size of the social network accounted for poor mental health. Women were especially at increased risk for mental health problems. Thus, despite effective mitigation of the pandemic, there was a striking deterioration of mental health. As the psychological burden of the continuing pandemic accrues, the probability of an impending mental health crisis is increasing, especially in countries with greater infection and death rates than South Korea. Comprehensive efforts to address the psychological aftermath of the pandemic are urgently needed.