(PS13-C72) Correlates and Predictors of Asociality in Schizophrenia-spectrum Disorders

Social isolation ranks alongside smoking as one of the leading causes of premature death in individuals with schizophrenia (SZ) and is one of the most robust predictors of relapse, rehospitalization, and suicidality (Delespaul et al., 2002). Interestingly, SZ are likely to set social goals and rank interpersonal closeness as top priorities in treatment (Blanchard et al., 2015), yet tend not to initiate and maintain social behavior (Gard et al., 2014). The lack of initiation of social behavior, or the negative symptom of asociality, constitutes a valuable treatment target for SZ. Unfortunately, psychopharmacological interventions have been minimally effective in reducing negative symptoms (Leucht et al. 2009). Psychotherapy holds promise in treating negative symptoms by targeting dysfunctional beliefs which inhibit the initiation of action and maintain avoidance of certain behaviors or activities (Beck et al., 2009). The cognitive model of negative symptoms posits that asociality may be partially explained by asocial beliefs (ASB): negative, unrealistic beliefs pertaining to the importance, success, or pleasure in future social and goal-directed activities (Grant & Beck, 2010).

To examine whether ASB predicts behavior, the current study employed the use of six days of ecological momentary assessment (EMA) and scheduling of daily social events to examine time-lagged, within-day predictors of behavior in individuals with SZ (n=20) and demographically-matched healthy controls (HC; n=20) from the community. Predictors of ASB, mindfulness, and symptomatology predicted social behavior, goal-directed (non-social) behavior, and location behavior (whether an individual endorsed being at home or out of the home).

Multilevel modeling revealed that ASB at time t did not predict social behavior (z = -0.397, p = .691, β = -.06), goal-directed behavior (z = 0.149, p = .881, β = .02), or location behavior (z = -0.708, p = .479, β = -.09) at time t+1. Examination of the relationship between ASB and group revealed no differences for social (p = .651), goal-directed (p = .080), or location behavior (p = .550). Exploratory analyses indicated that mindfulness was, however, significantly associated with social (t = 2.957, p = .003), goal-directed (t = 2.059, p = .039), and location behavior (t = -2.389, p = .017).

These findings fail to provide support for the specificity of ASB in predicting behavior and for the cognitive model of negative symptoms for asociality. These findings are aligned with one study known to date examining predictions of social behavior with ASB (Granholm et al., 2013). The information derived from this study regarding the influence of mindfulness contributes critically important knowledge to a growing literature base investigating predictors of negative symptoms in SZ, ultimately serving to inform and improve cognitive and behavioral therapies aimed at increasing social behavior.