Development and Validation of the Perceived Interpersonal Relevancy Scales: A New Measure of Perceived Threat, Opportunity, and Invisibility Appraisals for Use Across the Adult Life-Course.

OBJECTIVES: Interpersonal relevancy appraisals are a dynamic and understudied aspect of human social cognition. Despite their importance, there are no existing measures. This study developed and validated a new measure of self-perceived interpersonal threat, opportunity, and invisibility appraisals among a life-course sample of adults. We also explored the relationships between relevance appraisals, social connectedness, loneliness, age, and sex-assigned-at-birth. METHOD: Items were developed based on a theoretical model of multi-domain interpersonal relevance appraisals and refined following feedback from five experts in social psychology. Cross-sectional data were obtained online from a sample of 1,079 adults (age 18-90 years), recruited from the general population of Australia. Data were split into two pseudo-random samples used for 1) scale development and evaluation, and 2) assessment of internal consistency, construct validity, convergent validity with social connectedness and loneliness, and exploratory analysis with age and sex. RESULTS: Results support the factor structure and internal consistency of 17- and 9-item versions of the Perceived Interpersonal Relevancy Scales (PIRS) and measurement invariance across younger and older age groups. Higher self-perceived threat and invisibility appraisals were associated with decreased social network size, increased loneliness, younger age, and male sex. Higher self-perceived opportunity appraisals were associated with increased social network size and decreased loneliness. DISCUSSION: Results support this new measure of perceived interpersonal relevance appraisals, which shows relationships between the way we believe others perceive us, loneliness, and social isolation. The PIRS likely has wide utility for studies that seek to understand the intersections between human social cognition, well-being, and health across the lifespan.

What motivates early lies? Deception in 2½- to 5-year-olds.

What motivates young children to produce early lies? A total of 217 2½- to 5-year-old children (Mage = 44.5 months, SD = 8.45; 54% girls; 61.7% White) from the southeastern United States were tested using a modified third-party transgression paradigm to examine the motivation behind their deception. Children were assigned to one of three conditions-baseline, self-motivated, or other-motivated condition-and their propensity to lie was captured through both verbal and nonverbal measures. Results show that children's early lies are primarily driven by a self-serving motivation. However, the motivation to lie diversifies by 4 years of age, when children begin to lie for both self-serving and other-serving motivations.

Emotion Processing and Its Relationship to Social Functioning and Symptoms in Psychotic Disorder: A Systematic Review and Meta-analysis.

BACKGROUND: Emotion processing (EP) is impaired in individuals with psychosis and associated with social functioning; however, it is unclear how symptoms fit into this relationship. The aim of this systematic review and meta-analysis was to examine interrelationships between EP, symptoms, and social functioning, test whether different symptom domains mediate the relationship between EP and social functioning, and examine the moderating effects of illness stage and EP task type. STUDY DESIGN: MEDLINE, Embase, and PsycINFO databases were searched for studies that included individuals with psychosis and reported correlations between EP, symptom domains (positive, negative, depressive, and disorganization), and social functioning. Random effects meta-analyses determined the strength of correlations, and subgroup analyses included illness stage and EP task type (lower- vs higher-level processing). Meta-analytic structural equation models tested whether symptom domains mediated the relationship between EP and social functioning. RESULTS: There was a small relationship (r = .18) between EP and social functioning. Positive, negative, and disorganization symptoms mediated this relationship, although indirect effects were small. Higher-level EP tasks were more strongly associated with negative symptoms than lower-level tasks. Relationships between EP and both social functioning and positive symptoms were smaller in the first episode of psychosis than in established illness. CONCLUSIONS: The mediating relationship suggests that EP not only influences social dysfunction directly but contributes to negative and disorganization symptoms, which in turn impair social functioning. This pathway suggests that targeting negative and disorganization symptoms may ultimately improve social outcomes for individuals with psychosis. Future research, particularly in early psychosis, is needed to determine other factors impacting these interrelationships.

Oxytocin differentially modulates reward system responses to social and non-social incentives.

RATIONALE: Oxytocin has been shown to modulate behavior related to processing of monetary incentives and to regulate social and reproductive behavior, yet little is known about how oxytocin differentially influences neural responses to social and non-social incentives. OBJECTIVES: We aimed to evaluate the effects of oxytocin administration on behavioral and neural responses to social and monetary incentives. METHODS: Twenty-eight healthy adults (age 18-45 years) performed both monetary and social incentive tasks during blood oxygenation level dependent (BOLD) imaging. Intranasal oxytocin or placebo was administered before each scan using a double blind, randomized, cross-over design. Task performance and self-reported motivation and mood states were collected. Time-series analysis was conducted to assess the influence of oxytocin on the hemodynamic response in the ventral tegmental area and substantia nigra (VTA/SN) and nucleus accumbens (NAc). RESULTS: Oxytocin demonstrated a multifaceted effect on VTA/SN and NAc when processing reward incentives, with it increasing BOLD response in VTA/SN and decreasing BOLD response in NAc during social incentive anticipation. A reversal of this was shown with decreased BOLD responses in the VTA/SN and increased BOLD response in the NAc during monetary incentive anticipation. CONCLUSIONS: Our findings suggest a more nuanced purpose of oxytocin when evaluating reward incentive decision making. It is possible that while oxytocin does increase salience to rewards, that it is more important for cognitive control when determining short-term versus long-term benefits in rewards. Future studies should more closely examine the relationship between oxytocin and delay discounting.

Social perspective-taking influences on metacognition.

We often effortlessly take the perceptual perspective of others: we represent some aspect of the environment that others currently perceive. However, taking someone's perspective can interfere with one's perceptual processing: another person's gaze can spontaneously affect our ability to detect stimuli in a scene. But it is still unclear whether our cognitive evaluation of those judgements is also affected. In this study, we investigated whether social perspective-taking can influence participants' metacognitive judgements about their perceptual responses. Participants performed a contrast detection task with a task-irrelevant avatar oriented either congruently or incongruently to the stimulus location. By "blindfolding" the avatar, we tested the influence of social perspective-taking versus domain-general directional orienting. Participants had higher accuracy and perceptual sensitivity with a congruent avatar regardless of the blindfold, suggesting a directional cueing effect. However, their metacognitive efficiency was modulated only by the congruency of a seeing avatar. These results suggest that perceptual metacognitive ability can be socially enhanced by sharing perception of the same objects with others.

Definition, assessment and treatment of cognitive impairment associated with schizophrenia: expert opinion and practical recommendations.

A considerable proportion of patients with schizophrenia perform below population norms on standardized neuropsychological tests, and the performance of those performing within normal range is lower than predicted based on parental education. Cognitive impairment predates the onset of psychosis, is observed during symptom remission and in non-affected first-degree relatives of patients. At the present time, cognitive deficits are regarded as key features of schizophrenia, important determinants of poor psychosocial outcome and targets for both pharmacological and non-pharmacological treatment strategies. A group of eight key opinion leaders reviewed and discussed latest advances in scientific research and current good clinical practices on assessment, management, and treatment of CIAS. In the present paper they summarize the current evidence, identify main gaps between current knowledge and mental health services clinical practice, and provide practical recommendations to reduce the gap.

Children's Selective Teaching and Informing: A Meta-Analysis.

Empirical studies on selective teaching and informing indicate that children may vary what they teach depending on whom they are teaching, taking into account how helpful the information is for a given audience. The current meta-analysis quantifies the effect of selective informing and teaching in 2-7-year-olds by examining the relationship between the helpfulness of the information and the frequency of information transmission. Through a systematic search that yielded 1483 results, 28 studies (104 effect sizes, N = 2716) met the inclusion criteria. Using robust variance estimation, we found a medium average effect, Hedges' g = 0.578, 95% CI (0.331, 0.825), suggesting that children selectively share information based on its perceived helpfulness to the listener. Moderator analyses revealed that age and communicative context were significant factors. Children were more informative in their communication when asked to teach compared to other nonpedagogical prompts. This finding supports and extends natural pedagogy theory-young children not only interpret pedagogical information differently than information acquired through other means, but they are more selective in their informing when teaching. Additionally, we observed a key developmental progression at age 4. Four- to 7-year-olds, but not 2-3-year-olds, selectively shared information that was most helpful for a given learner. This coincides with the development of false-belief understanding, which undergoes significant development at around age 4. Taken together, the present synthesis suggests that young children actively engage in selective social learning from both sides, that of beneficiaries and benefactors of valuable information.

An action-observation method for studying social perception: a mini-review.

An important aspect of any social interaction involves inferring other people's mental states, intentions, and their likely next actions, by way of facial expression, body posture, eye gaze, and limb movements. An actor's production of actions during social interactions and the observer's perception of these actions are thus closely linked. In this review, we outline an action-observation methodology, which not only allows for separate analyses of production and perception, but also promotes the study of the dynamic interaction between these two sides of every social exchange. We review two lines of research that have benefited from its application. The first line focuses on individuals performing tasks alone and the observation of their actions by other individuals in order to make inferences about their attentional states. The second line of study focused on pairs of individuals performing collaborative tasks in naturalistic settings and the observation of these performances by other individuals. We offer several suggestions for how this methodology can be extended to improve on the limitations of the present studies, as well as some suggestions of how to use this methodology to venture into new territory. Our aim is to inspire future research applications of this methodology in order to advance our understanding of social action production and perception.

Integrative Neuro-social cognitive Strategy Programme for Instilling REcovery (INSPIRE): a community-based cognitive remediation trial-study procotol.

BACKGROUND: Adults with schizophrenia experience a range of neurocognitive problems that affect their daily functioning. Evidence for the efficacy of cognitive remediation in schizophrenia has been established, but its implementation in under-resourced community-based settings is less well-studied. In recent years, interventions have also focused on the strategy-learning approach in favor of drill-and-practice. Moreover, there is an increasing recognition to address social cognition and negative symptoms alongside neurocognition. This study attempts to carry out cognitive remediation in a community mental health setting. The Neuropsychological and Educational Approach to Remediation (NEAR) is used as the cognitive remediation intervention. Neurocognitive and social cognitive games will be introduced during the computer-assisted cognitive exercises sessions. In addition, the instructional technique will foster the use of metacognition and cognitive strategies. Moreover, metamotivation training will be the focus of some bridging sessions to enhance motivation to engage in goal-directed learning behaviors. The aims of the study are to 1) investigate the effects of cognitive remediation on neurocognition, social cognition and functional outcomes of participants with schizophrenia/schizoaffective disorders in community mental health settings; and 2) explore the mediators for change (eg: metamotivation, metacognition and negative symptoms) in cognitive performance and functional outcomes. METHODS: This randomized controlled trial will be conducted in three Singapore Anglican Community Services (SACS) centers, where standard psychiatric rehabilitation is delivered. Participants who are randomized to the experimental arm will receive cognitive remediation and psychiatric rehabilitation, while those randomized to the control arm will receive standard psychiatric rehabilitation only. Cognitive remediation is carried out three times a week for 12 weeks. It consists of computer-assisted cognitive exercises, as well as bridging groups to aid transfer of learning to daily living. Baseline, post-intervention and eight-week follow-up measurements will be collected. Group by time differences in cognitive performance, negative symptoms, metamotivation, metacognition, functioning and recovery will be analyzed across the three time points. Mediators for improvement in cognitive performance and functioning will also be explored. DISCUSSION: Findings of this research will add to the body of knowledge about the key therapeutic ingredients within a strategy-based cognitive remediation program and improve its implementation within under-resourced community settings. TRIAL REGISTRATION: This study has been registered with ClinicalTrials.gov (ID: NCT06286202). Date of registration: 29 February 2024. Date of last update: 21 May 2024.

Predictive coding for the actions and emotions of others and its deficits in autism spectrum disorders.

Traditionally, the neural basis of social perception has been studied by showing participants brief examples of the actions or emotions of others presented in randomized order to prevent participants from anticipating what others do and feel. This approach is optimal to isolate the importance of information flow from lower to higher cortical areas. The degree to which feedback connections and Bayesian hierarchical predictive coding contribute to how mammals process more complex social stimuli has been less explored, and will be the focus of this review. We illustrate paradigms that start to capture how participants predict the actions and emotions of others under more ecological conditions, and discuss the brain activity measurement methods suitable to reveal the importance of feedback connections in these predictions. Together, these efforts draw a richer picture of social cognition in which predictive coding and feedback connections play significant roles. We further discuss how the notion of predicting coding is influencing how we think of autism spectrum disorder.

Social cognition interventions for patients with first-episode psychosis: A scoping review.

This scoping review seeks to identify existing evidence of social cognition interventions for patients with first-episode psychosis. This review followed the five steps of Arksey and O'Malley's scoping review framework. Studies published between October 2002 and June 2023 were examined in the following six databases: PsycArticles, PsycINFO, CINAHL, EMBASE, Medline, and Scopus. We also searched grey literature and references of included studies. Studies reporting on social cognition interventions for adults with first-episode psychosis were included. Review findings were synthesised employing the PAGER framework. The PRISMA Extension for Scoping Reviews guideline was followed to prepare and report this manuscript. Twelve articles were included in this review. Most of the social cognition interventions were provided in out-patient clinics. Four studies provided board-based social cognition interventions, while the remaining eight studies introduced interventions to targeted domains of social cognition. All studies reported an improvement in patients' social functioning and social skills after receiving the intervention. Barriers and facilitators for patients with first-episode psychosis in receiving social cognition intervention were also summarised. Future studies could be conducted to explore the long-term effects of social cognition interventions, particularly for in-patient setting and the domain of social perception.

Training individuals with schizophrenia to gain volitional control of the theory of mind network with real-time fMRI: A pilot study.

Individuals diagnosed with schizophrenia spectrum disorders (SSDs) often demonstrate alterations in the Theory of Mind Network (ToM-N). Here, in this proof-of-concept, single-arm pilot study, we investigate whether participants with an SSD (N = 7) were able to learn to volitionally control regions of the ToM-N (dorso/middle/ventromedial prefrontal cortex [D/M/VMPFC], left temporoparietal junction [LTPJ], precuneus [PC], right superior temporal sulcus [RSTS], and right temporoparietal junction [RTPJ]) using real-time fMRI neurofeedback (rtfMRI-NF). Region-of-interest analyses demonstrate that after neurofeedback training, participants were able to gain volitional control in the following ToM-N brain regions during the transfer task, where no active feedback was given: right temporoparietal junction, precuneus, and dorso/ventromedial prefrontal cortex (neurofeedback effect Fs > 6.17, ps < .05). These findings suggest that trained volitional control over the ToM-N is tentatively feasible with rtfMRI neurofeedback in SSD, although findings need to be replicated with more robust designs that include a control group and larger samples.

On the Relationship Between Alexithymia and Social Cognition: A Systematic Review.

Objective: This systematic review summarises the studies that have investigated the relationship between dimensions of social cognition (i.e., Theory of Mind - ToM, emotion recognition, and empathy) and alexithymia in the general adult non-clinical population. Method: PubMed, PsycINFO, and Scopus databases were screened, using the following strings: ("alexithymi*") AND ("theory of mind" OR "ToM"); ("alexithymi*") AND ("empath*"); ("alexithymi*") AND ("emotion recognition"); ("alexithymi*") AND ("social cognition"). Results: A total of 117 studies met the inclusion criteria and were included in this review. The total number of participants included in the reviewed studies was 40,231. Mixed results were found for alexithymia and ToM, while the relationship between emotion recognition or empathy and alexithymia was more homogeneous. Alexithymia was found to be significantly associated with both a reduced ability to recognise emotions and empathy. Conclusions: These results support the existence of significant relationships between alexithymia and altered social cognitive abilities. Future research is needed to confirm the present findings and further elucidate the complex relationship between these processes. Suggestions are made on how to overcome some of the theoretical and methodological problems in the literature.

Where the 'bad' and the 'good' go: A multi-lab direct replication report of Casasanto (2009, Experiment 1).

Casasanto (Journal of Experimental Psychology: General, 138, 351-367, 2009) conceptualised the body-specificity hypothesis by empirically finding that right-handed people tend to associate a positive valence with the right side and a negative valence with the left side, whilst left-handed people tend to associate a positive valence with the left side and negative valence with the right side. Thus, this was the first paper that showed a body-specific space-valence mapping. These highly influential findings led to a substantial body of research and follow-up studies, which could confirm the original findings on a conceptual level. However, direct replications of the original study are scarce. Against this backdrop and given the replication crisis in psychology, we conducted a direct replication of Casasanto's original study with 2,222 participants from 12 countries to examine the aforementioned effects in general and also in a cross-cultural comparison. Our results support Casasanto's findings that right-handed people associate the right side with positivity and the left side with negativity and vice versa for left-handers.

Comparative study of emotional facial expression recognition among Prader-Willi syndrome subtypes.

BACKGROUND: Prader-Willi syndrome (PWS) is a congenital disease caused by a rare and generally non-inherited genetic disorder. The inability to recognise facial expressions of emotion is an apparent social cognition deficit in people diagnosed with PWS. The main objective of the present study is to compare the ability to recognise emotional facial expression, in both non-contextualised and contextualised scenarios, among the main subtypes of PWS and a control group. METHODS: The sample consisted of 46 children divided into three groups: deletion (n = 10), maternal uniparental disomy (mUPD) (n = 13) and control (n = 23). The protocol included the Facially Expressed Emotion Labeling and the Deusto-e-Motion 1.0. RESULTS: The control group recognised facial emotions more accurately and quickly in both non-contextualised and contextualised scenarios than children with PWS, regardless of genetic subtype. Despite no differences being detected between PWS subtypes when non-contextualised scenarios were analysed, in contextualised situations, a longer reaction time was observed in children with the mUPD subtype. CONCLUSIONS: This is the first study to assess the ability to recognise emotional facial expressions in contextualised situations among PWS subtypes and a control group. The findings suggest that some of the social cognitive deficits evidenced in children with mUPD PWS may be similar to those in autism spectrum disorder.

How to detect affect recognition alterations in amyotrophic lateral sclerosis.

OBJECTIVE: To define the clinical usability of an affect recognition (AR) battery-the Comprehensive Affect Testing System (CATS)-in an Italian sample of patients with amyotrophic lateral sclerosis (ALS). METHODS: 96 ALS patients and 116 healthy controls underwent a neuropsychological assessment including the AR subtests of the abbreviated version of the CATS (CATS-A). CATS-A AR subtests and their global score (CATS-A AR Quotient, ARQ) were assessed for their factorial, convergent, and divergent validity. The diagnostic accuracy of each CATS-A AR measure in discriminating ALS patients with cognitive impairment from cognitively normal controls and patients was tested via receiver-operating characteristics analyses. Optimal cut-offs were identified for CATS-A AR measures yielding an acceptable AUC value (≥ .70). The ability of CATS-A ARQ to discriminate between different ALS cognitive phenotypes was also tested. Gray-matter (GM) volumes of controls, ALS with normal (ALS-nARQ), and impaired ARQ score (ALS-iARQ) were compared using ANCOVA models. RESULTS: CATS-A AR subtests and ARQ proved to have moderate-to-strong convergent and divergent validity. Almost all considered CATS-A measures reached acceptable accuracy and diagnostic power (AUC range = .79-.83). ARQ showed to be the best diagnostic measure (sensitivity = .80; specificity = .75) and discriminated between different ALS cognitive phenotypes. Compared to ALS-nARQ, ALS-iARQ patients showed reduced GM volumes in the right anterior cingulate, right middle frontal, left inferior temporal, and superior occipital regions. CONCLUSIONS: The AR subtests of the CATS-A, and in particular the CATS-A ARQ, are sound measures of AR in ALS. AR deficits may be a valid marker of frontotemporal involvement in these patients.

Trait self-control as a determinant of health behavior: Recent advances on mechanisms and future directions for research.

We summarize theory and research testing a mechanistic explanation for the trait self-control-health behavior relationship. Specifically, social cognition constructs summarizing individuals' utility, normative, risk, and capacity beliefs with respect to future health behavior performance are proposed to mediate the self-control-health behavior relationship. The effect represents the informational function of self-control in decision making. We also specify a mechanism wherein trait self-control moderates the intention-behavior relationship such that 'good' self-control affords effective intention-to-action translation. Both effects have pervasive support in the extent literature. We propose ongoing meta-analyses expected to provide further robust support for these mechanistic effects and the need for research employing designs enabling better directional and causal inferences in the effects, including experimental or types of cross-lagged panel design.

Social cognition and healthy aging: Cross-sectional associations of emotion perception, theory of mind, and emotional empathy.

OBJECTIVE: Older adults are identified to have reduced social cognitive performance compared to younger adults. However, few studies have examined age-associations throughout later life to determine whether these reductions continue with advancing age. METHOD: This study assesses cross-sectional associations of emotion perception, cognitive and affective theory of mind (ToM), and emotional empathy in a healthy sample of 157 adults aged 50-89 years (M = 65.31, SD = 9.00, 68% female sex). Emotion perception, cognitive ToM, and affective ToM were measured using The Awareness of Social Inference Test Short Form (TASIT-S), while affective ToM was also measured using Reading the Mind in the Eyes Revised (RME-R). Emotional empathy was measured using the Empathy Quotient. RESULTS: Multiple regression analyses, adjusting for multiple comparisons, revealed a moderate negative association between age and emotion perception for all emotions combined, as well as for sad and revolted expressions, but not happy, neutral, anxious, or angry expressions. Age had a negative, moderate association with first-order cognitive, second-order cognitive, and affective ToM measured using TASIT-S, but not RME-R. Age was not significantly associated with emotional empathy. CONCLUSIONS: This study contributes to the limited understanding of age-related associations of social cognitive performance throughout later life. This knowledge can inform future research examining the clinical utility of including social cognitive measures in neuropsychological screening and diagnostic tools for later-life neurological disorders.

Cognitive Mechanisms of Aberrant Self-Referential Social Perception in Psychosis and Bipolar Disorder: Insights From Computational Modeling.

BACKGROUND AND HYPOTHESIS: Individuals with schizophrenia (SZ) and bipolar disorder (BD) show disruptions in self-referential gaze perception-a social perceptual process related to symptoms and functioning. However, our current mechanistic understanding of these dysfunctions and relationships is imprecise. STUDY DESIGN: The present study used mathematical modeling to uncover cognitive processes driving gaze perception abnormalities in SZ and BD, and how they relate to cognition, symptoms, and social functioning. We modeled the behavior of 28 SZ, 38 BD, and 34 controls (HC) in a self-referential gaze perception task using drift-diffusion models parameterized to index key cognitive components: drift rate (evidence accumulation efficiency), drift bias (perceptual bias), start point (expectation bias), threshold separation (response caution), and nondecision time (encoding/motor processes). STUDY RESULTS: Results revealed that aberrant gaze perception in SZ and BD was driven by less efficient evidence accumulation, perceptual biases predisposing self-referential responses, and greater caution (SZ only). Across SZ and HC, poorer social functioning was related to greater expectation biases. Within SZ, perceptual and expectancy biases were associated with hallucination and delusion severity, respectively. CONCLUSIONS: These findings indicate that diminished evidence accumulation and perceptual biases may underlie altered gaze perception in patients and that SZ may engage in compensatory cautiousness, sacrificing response speed to preserve accuracy. Moreover, biases at the belief and perceptual levels may relate to symptoms and functioning. Computational modeling can, therefore, be used to achieve a more nuanced, cognitive process-level understanding of the mechanisms of social cognitive difficulties, including gaze perception, in individuals with SZ and BD.

Multivariate Association between Functional Connectivity Gradients and Cognition in Schizophrenia Spectrum Disorders.

BACKGROUND: Schizophrenia Spectrum Disorders (SSDs), which are characterized by social cognitive deficits, have been associated with dysconnectivity in "unimodal" (e.g., visual, auditory) and "multimodal" (e.g., default-mode and frontoparietal) cortical networks. However, little is known regarding how such dysconnectivity relates to social and non-social cognition, and how such brain-behavioral relationships associate with clinical outcomes of SSDs. METHODS: We analyzed cognitive (non-social and social) measures and resting-state functional magnetic resonance imaging data from the 'Social Processes Initiative in Neurobiology of the Schizophrenia(s) (SPINS)' study (247 stable participants with SSDs and 172 healthy controls, ages 18-55). We extracted gradients from parcellated connectomes and examined the association between the first 3 gradients and the cognitive measures using partial least squares correlation (PLSC). We then correlated the PLSC dimensions with functioning and symptoms in the SSDs group. RESULTS: The SSDs group showed significantly lower differentiation on all three gradients. The first PLSC dimension explained 68.53% (p<.001) of the covariance and showed a significant difference between SSDs and Controls (bootstrap p<.05). PLSC showed that all cognitive measures were associated with gradient scores of unimodal and multimodal networks (Gradient 1), auditory, sensorimotor, and visual networks (Gradient 2), and perceptual networks and striatum (Gradient 3), which were less differentiated in SSDs. Furthermore, the first dimension was positively correlated with negative symptoms and functioning in the SSDs group. CONCLUSIONS: These results suggest a potential role of lower differentiation of brain networks in cognitive and functional impairments in SSDs.