Ivy Fei Tso

Prior research indicates that social functioning is impacted by both social engagement and subjective experience regarding social interactions. The goal of this study was to examine the extent to which each component, as well as their interaction, contributes to social dysfunction in a combined nonclinical and transdiagnostic psychiatric sample. A sample of young adults (n=193) spanning the social dysfunction spectrum completed measures that capture different forms of psychopathology relevant to social dysfunction, from which two dimensions – Subjective Psychosocial Difficulties (SPD) and Observed Social Difficulties (OSD) – were extracted using Principal Components Analysis. Participants additionally completed a variety of clinician-rated and self-reported social functioning measures that were aggregated into one overall social functioning score. Hierarchical regression was used to examine the unique contribution of SPD and OSD and their interaction on overall social functioning. SPD and OSD explained unique variance (Δr2=61.0%), indicating that elevated SPD and OSD levels predicted worse social functioning. The SPD-by-OSD interaction was positive and explained significant additional amounts of variance (Δr2=1.9%), indicating a less-than-additive effect on social dysfunction. The findings suggest that examining observable social behaviors and subjective psychosocial experience simultaneously is important for understanding social functional outcomes in clinical populations.

Background. Individuals with schizophrenia (SZ) and bipolar disorder (BD) often misjudge whether social cues, like eye contact, are meant for them, which can fuel symptoms and functional impairment. These difficulties appear to stem from disruptions in how social information is dynamically processed (“evidence accumulation”). We used neurocognitive joint modeling to investigate which neural signals shape evidence accumulation during gaze perception and whether these brain-behavior links help explain disrupted self-referential social processing.Methods. Leveraging EEG data from N=99 SZ, BD, and healthy controls (HC) during a self-referential gaze perception task, we built joint drift-diffusion models characterizing how different trial-level EEG features translated to evidence accumulation and behavior. Joint models were compared against each other (and models using task-averaged EEG or behavior only) for their ability to predict task behavior and relevant clinical dimensions, including paranoia, functioning, and cognition. We examined whether the best-performing model differentiated patients and HC.Results. The best-performing joint model explained evidence accumulation through trial-level fluctuations—not task averages—in two neural signals: CPP and frontal midline theta, implicated in subjective deliberation/certainty and top-down modulation, respectively. Less reliable translation of trial-level CPP signals to evidence accumulation impaired gaze perception in SZ and BD. Mapping how trial-level theta dynamics translated to evidence accumulation captured paranoia and functioning better than behavior or task-averaged neural metrics alone.Conclusions. Model-based approaches that embrace the within-person variability of neural signals may reveal more nuanced, clinically relevant perspectives on the pathophysiology of SZ and BD than those using task-averaged brain activity or behavior alone.

Individuals with schizophrenia-spectrum (SZ) and bipolar-spectrum disorders (BD) report experiencing heightened negative affect (NA), which can be operationalized as stable traits and dynamic states. While cognitive control is a potential underlying mechanism, identifying neural underpinning of NA has been challenging. This could be due to the lack of such investigation, but also a comprehensive framework to investigate the association specificity. Data were collected from 105 participants (34 SZ, 34 BD, 37 healthy control [HC]) on the five-factor model of personality traits, cognitive control electroencephalography (EEG), and self-reported mood and contexts via ecological momentary assessment (EMA). Cognitive control indices of EEG were extracted as event-related potentials (ERPs) and time-frequency theta-band activities from three flanker tasks varying in valence (neutral, unpleasant, and pleasant). Participants with SZ and BD generally reported higher NA traits, lower Extraversion, lower Conscientiousness traits, higher Psychoticism, and high average and fluctuation in EMA NA-related experiences than HC participants. Participants with SZ experienced more EMA unpleasant events, were more upset by them, and put more effort into avoiding them. EEG theta-band power from the arrow task was associated mostly with NA-related traits and tendency, and theta-band power from the unpleasant task was associated with EMA unpleasant event occurrence and reactions. ERPs and theta phase activities did not relate to any traits or daily experiences, and no other traits and experiences were related to EEG measures. Cognitive control EEG theta-band power was associated with trait and state NA specifically, potentially reflecting a transdiagnostic indicator of cognitive control and neural mechanism underlying stress-vulnerability in SZ and BD.

BackgroundSocial dysfunction is widespread across psychiatric disorders, but treatments remain limited. Identifying underlying mechanisms could inform novel treatment approaches that meaningfully improve clinical outcomes. We previously showed that basic visual processing deficits cascade through gaze perception and emotion recognition to impair theory of mind. Here, we test an extended model assessing whether this cascade ultimately predicts real-world social dysfunction via theory of mind in an expanded sample.MethodsA combined sample of 202 psychiatric patients with varying levels of social dysfunction and healthy individuals completed basic visual processing tasks, a multi-level social cognition battery that included measures of gaze perception, emotion recognition, and theory of mind, and clinical assessments of social functioning. A five-level path model evaluated the sequential cascade from visual processing to gaze perception, emotion recognition, theory of mind, and social functioning.ResultsThe extended five-level path model demonstrated good fit to the data. Poorer basic visual processing sequentially predicted deficits across intermediate social cognitive domains, culminating in theory of mind, which directly predicted worse social functioning.ConclusionThese findings indicate that basic visual deficits cascade through social cognitive steps to impair everyday social functioning. As a candidate shared mechanism contributing to social dysfunction, basic visual processing represents a promising target for psychiatric interventions.

Research suggests there are sex differences in social cognitive abilities, with females typically performing better on tasks involving emotion recognition and mental state attribution. However, many prior studies have demonstrated limited replicability, perhaps due to differences in methods employed or samples studied. Given that social cognition is a key determinant of social functioning, and that social dysfunction represents a transdiagnostic issue in neuropsychiatric populations, understanding sex differences in social cognition among individuals with varying levels of social functioning should broaden our understanding of the etiology, expression, and treatment of psychopathology. The present study examined sex differences in gaze perception, perceptual theory of mind, and social inference abilities in a sample ( n = 212; 58.5% female) of adolescents and young adults (ages 14–30) ranging from minimal to clinical levels of social dysfunction. Females performed better on tasks involving perceptual theory of mind, social inferencing, and eye gaze perception, and most sex differences remained even after accounting for general cognition, age, and psychopathology. The one exception is that females and males did not differ on a complex, dynamic social inferencing task once accounting for psychopathology. Our findings suggest that females may generally be more sensitive to social signals related to the eyes and may more accurately identify social signals when there is subtle or limited information available. Findings indicate the importance of recognizing sex differences in the presentation of social functioning and, by extension, socially relevant psychopathology. Such differences may have implications for tailoring treatments for social dysfunction.

Background: Psychosis, social anxiety, and autism are clinical constructs that share important phenotypic features, particularly social dysfunction. A critical determinant of social functioning is an individual’s ability to recognize when social cues, such as eye gaze, are meant for them. Emerging computational modeling data in psychosis suggest that altered gaze perception stems from deficits in evidence accumulation – the process of gathering and integrating information – when processing social cues. We investigated whether aberrant evidence accumulation during gaze perception is associated with social functioning or, as a secondary aim, with psychopathology in a transdiagnostic sample with varying levels of psychotic, socially anxious, or autistic characteristics. Methods: We examined gaze perception in 111 individuals (aged 14–30) with varying levels of social dysfunction, psychosis proneness, social anxiety, and autistic traits. Drift diffusion models (DDM) characterized key processes driving perceptual judgements in a self-referential gaze perception task, including the efficiency of evidence accumulation. We tested whether evidence accumulation was associated with social functioning, social cognition, and these different psychopathology dimensions. Results: Impaired evidence accumulation during gaze perception showed strong associations with impaired social cognition and modest associations with diminished social functioning and elevated psychosis and social anxiety symptoms. Evidence accumulation was not associated with autism traits. Conclusions: Evidence accumulation for social cues relates to social cognition – a key determinant of social functioning. It may also be relevant to real-world social functioning and multiple psychopathology dimensions, including psychosis and social anxiety. Therefore, evidence accumulation should be investigated as a mechanism supporting social difficulties and related psychopathology.

The ability to accurately perceive gaze direction is an essential social skill but is impaired across psychopathologies exhibiting social dysfunction (e.g., schizophrenia, social anxiety disorder, autism spectrum disorder). Disrupted sensory processing and self-referential processing may both lead to aberrant gaze perception, but their respective contributions in different psychopathologies are unclear. A general population sample of 106 participants completed an online psychophysical gaze perception task and a battery of psychopathology trait questionnaires. Participants viewed face images with 9 gaze angles, superimposed with 3 levels (no, low, high) of sensory noise and in 2 (forward, deviated) head orientations, and indicated perceived self-directed gaze (yes/no) for each face. Psychophysical properties of the gaze perception curve (width, threshold) were used to index perceptual imprecision and self-referential bias, respectively. Decreased precision was associated with higher autism traits but lower social anxiety, supporting differential contributions of sensory processing among psychopathology dimensions. Subjects showed decreased precision and increased self-referential bias, when viewing stimuli with added visual noise or incongruent gaze-head directions, resembling performance previously observed in patients with schizophrenia. Additionally, higher levels of social anxiety statistically predicted a greater decrease in precision when sensory noise was added. Findings are discussed in relation to the experimental psychopathology literature and in the context of self-referential gaze perception as an adaptive default in ambiguous contexts. Overall, this work enhances our basic scientific understanding of the cognitive components that contribute to gaze perception, while advancing our knowledge of how these components are disrupted as a function of subclinical psychopathology.

Background. Psychosis, social anxiety, and autism are clinical constructs that share important phenotypic features, particularly social dysfunction. A critical determinant of social functioning is an individual’s ability to recognize when social cues, like eye gaze, are meant for them. Emerging computational modeling data in psychosis suggest that altered perception of gaze direction stems from deficits in evidence accumulation – the process of gathering and integrating information – when processing social cues. Here, we investigated whether aberrant evidence accumulation during eye gaze processing are associated with social functioning or, as a secondary aim, with other measures of psychopathology, in a transdiagnostic sample enriched for psychotic, socially anxious, or autistic characteristics.Methods. We examined gaze perception in a sample of 111 adolescents and young adults (ages 14-30) with varying levels of social dysfunction and enriched for psychosis proneness, social anxiety, and autistic traits. We used drift diffusion models (DDM) to characterize key processes driving perceptual judgements in a self-directed gaze discrimination task, including the efficiency of evidence accumulation. We tested whether evidence accumulation was associated with social functioning, social cognition, and these different psychopathology dimensions.Results. Impaired evidence accumulation during gaze processing showed strong associations with impaired social cognition and modest associations with diminished social functioning and elevated psychosis and social anxiety symptoms. However, evidence accumulation sensitivity was not associated with autism traits.Conclusions. Evidence accumulation for subtle social cues relates to social cognition—a key determinant of social functioning. It may also be relevant to real-world social functioning and multiple psychopathology dimensions, including psychosis and social anxiety. Therefore, evidence accumulation should be investigated as a mechanism supporting social difficulties and related psychopathology.

Background: When confronted with ambiguous stimuli, the ability to utilize contextual information is crucial for survival. Context processing involves the ability to discriminate new information from previously encountered information and to recognize something as previously encountered, even briefly or partially. Deficits in context processing are a key feature across a number of psychiatric conditions. Existing tasks only examine the discrimination and recognition of cues as opposed to contextual information. Thus, new tasks using complex scenes are urgently needed. Objective: We developed the Context Discrimination and Recognition Task (CDRT) and established baseline performance in healthy adults. Methods: Final analyses included 44 participants (mean age 30.27, SD 11.78) who completed the CDRT to characterize memory performance for (1) discrimination between previously viewed and never viewed complex scenes (Discrete Discrimination Score [DDS]), (2) recognition of previously viewed complex scenes (Discrete Recognition Score [DRS]), (3) sensitivity to distinctions across a gradient of complex scenes (width), and (4) bias in recognition of complex scenes (bias). Pearson correlations were conducted to examine associations between these scores. Results: The results revealed a significant positive relationship between DDS and DRS scores, r (41)=0.71, P <.001, and between DDS and modified recognition scores, r (41)=0.71, P <.001. Width was also negatively correlated with DDS, r (41)=−0.31, P =.04; DRS, r (41)=−0.47, P =.001; and DRSmid, r (41)=−0.35, P =.02 Conclusions: We found that the CDRT is sensitive to a range of discrimination and recognition levels and is uniquely positioned to probe context processing. Additionally, both recognition and discrimination scores increased with decreased ambiguity of complex scenes, demonstrating the sensitivity of the task in detecting variability of performance across participants. Better recognition of complex scenes was associated with greater sensitivity to differences between contexts. This novel task can be used to assess memory-associated processes for complex scenes in future studies aiming to elucidate neural functions underlying context processing in psychiatric conditions.