Laboratory and Self-Report Methods to Assess Reappraisal and Distraction in Youth.

Coping and emotion regulation are central features of risk and resilience in childhood and adolescence, but research on these constructs has relied on different methods of assessment. The current study aimed to bridge the gap between questionnaire and experimental methods of measuring secondary control coping strategies, specifically distraction and cognitive reappraisal, and examine associations with symptoms of anxiety and depression in youth. A community sample of 70 youth (ages 9-15) completed a novel experimental coping and emotion regulation paradigm and self-report measures of coping and emotion regulation and symptoms. Findings indicate that use of distraction and reappraisal during the laboratory paradigm was associated with lower levels of negative emotion during the task. Youth emotion ratings while implementing distraction, but not reappraisal, during the laboratory task were associated with youth self-reported use of secondary control coping in response to family stress. Youth symptoms of anxiety and depression were also significantly positively associated with negative emotion ratings during the laboratory task, and both laboratory task and self-reported coping and emotion regulation accounted for significant variance in symptoms in youth. Both questionnaire and laboratory methods to assess coping and emotion regulation in youth are important for understanding these processes as possible mechanisms of risk and resilience and continued integration of these methods is a priority for future research.

A pilot choral intervention in individuals with schizophrenia-spectrum conditions; Singing away loneliness.

Social disconnection is associated with poor outcome and long-term disability in individuals with schizophrenia-spectrum conditions (SCZ) but social isolation is not typically a target for treatment. Singing together has long been shown to promote unique group cohesion and improve sense of well-being across the lifespan. Accordingly, we devised a novel choral intervention to examine the potential efficacy of this low-burden social intervention strategy designed to reduce loneliness in SCZ. Seventeen SCZ participated in a weekly, 1-hr choir group for 8 weeks. At pre- and post-intervention, we examined symptoms, loneliness, stress, and face recognition. Choral intervention led to significant reductions in scores for loneliness, the Brief Psychiatric Rating Scale (BPRS) and the Beck Depression Inventory-II (BDI-II). No significant changes were observed in scores for the Scale for the Assessment of Negative Symptoms (SANS), the Scale for the Assessment of Positive Symptoms (SAPS), face recognition, or the Perceived Stress Scale (PSS). Diminished loneliness was inversely correlated with the number of sessions attended. Participants judged the choir intervention to be acceptable and enjoyable. Reduced loneliness and symptom improvement after 8 weeks of intervention in SCZ suggest that choral intervention presents an enjoyable and low-burden opportunity to collaborate in a group setting for isolated individuals and thus may serve as a beneficial adjunct in a multi-arm intervention strategy for alleviating symptom distress and loneliness.

Efficacy of PEERS® for Adolescents via Telehealth Delivery.

PEERS® for Adolescents is an evidence-based social skills intervention for autistic youth and adolescents with other social challenges. The efficacy and effectiveness of PEERS® are well established; however, limited data on PEERS® via telehealth delivery exist. The current study aimed to examine the efficacy of PEERS® for Adolescents via telehealth and compare outcomes between telehealth and in-person modalities. Thirty-one adolescents (Mage = 13.77, SD = 2.14) participated in telehealth groups, and outcomes were compared with 212 adolescents (Mage = 14.02, SD = 2.00) from in-person groups. Findings demonstrate PEERS® for Adolescents via telehealth results in significant improvements in social skills knowledge, social responsiveness, overall social skills and problem behaviors, and social engagement. Telehealth outcomes are relatively equivalent to in-person delivery.

Equity in Mental Health Services for Youth at Clinical High Risk for Psychosis: Considering Marginalized Identities and Stressors.

Prevention and early intervention programs have been initiated worldwide to serve youth at Clinical High Risk for Psychosis (CHR-P), who are adolescents and young adults experiencing subclinical psychosis and functional impairment. The primary goals of these efforts are to prevent or mitigate the onset of clinical psychosis, while also treating comorbid issues. It is important to consider issues of diversity, equity, and inclusion in CHR-P work, especially as these programs continue to proliferate around the world. Further, there is a long history in psychiatry of misdiagnosing and mistreating psychosis in individuals from racial and ethnic minority groups. Although there have been significant developments in early intervention psychosis work, there is evidence that marginalized groups are underserved by current CHR-P screening and intervention efforts. These issues are compounded by the contexts of continued social marginalization and significant mental health disparities in general child/adolescent services. Within this narrative review and call to action, we use an intersectional and minority stress lens to review and discuss current issues related to equity in CHR-P services, offer evidence-based recommendations, and propose next steps. In particular, our intersectional and minority stress lenses incorporate perspectives for a range of marginalized and underserved identities related to race, ethnicity, and culture; faith; immigration status; geography/residence; gender identity; sexual orientation; socioeconomic status/class; and ability status.

Decoupling of spontaneous facial mimicry from emotion recognition in schizophrenia.

Past research indicates that spontaneous mimicry facilitates the decoding of others' emotions, leading to enhanced social perception and interpersonal rapport. Individuals with schizophrenia (SZ) show consistent deficits in emotion recognition and expression associated with poor social functioning. Given the prominence of blunted affect in schizophrenia, it is possible that spontaneous facial mimicry may also be impaired. However, studies assessing automatic facial mimicry in schizophrenia have yielded mixed results. It is therefore unknown whether emotion recognition deficits and impaired automatic facial mimicry are related in schizophrenia. SZ and demographically matched controls (CO) participated in a dynamic emotion recognition task. Electromyographic activity in muscles responsible for producing facial expressions was recorded during the task to assess spontaneous facial mimicry. SZ showed deficits in emotion identification compared to CO, but there was no group difference in the predictive power of spontaneous facial mimicry for avatar's expressed emotion. In CO, facial mimicry supported accurate emotion recognition, but it was decoupled in SZ. The finding of intact facial mimicry in SZ bears important clinical implications. For instance, clinicians might be able to improve the social functioning of patients by teaching them to pair specific patterns of facial muscle activation with distinct emotion words.

The acceptability and feasibility of a novel virtual reality based social skills training game for schizophrenia: Preliminary findings.

Social impairment is a core feature of schizophrenia that presents a major barrier toward recovery. Some of the psychotic symptoms are partly ameliorated by medication but the route to recovery is hampered by social impairments. Since existing social skills interventions tend to suffer from lack of availability, high-burden and low adherence, there is a dire need for an effective, alternative strategy. The present study examined the feasibility and acceptability of Multimodal Adaptive Social Intervention in Virtual Reality (MASI-VR) for improving social functioning and clinical outcomes in schizophrenia. Out of eighteen patients with schizophrenia who enrolled, seventeen participants completed the pre-treatment assessment and 10 sessions of MASI-VR, but one patient did not complete the post-treatment assessments. Therefore, the complete training plus pre- and post-treatment assessment data are available from sixteen participants. Clinical ratings of symptom severity were obtained at pre- and post-training. Retention rates were very high and training was rated as extremely satisfactory for the majority of participants. Participants exhibited a significant reduction in overall clinical symptoms, especially negative symptoms following 10 sessions of MASI-VR. These preliminary results support the feasibility and acceptability of a novel virtual reality social skills training program for individuals with schizophrenia.