Despite advances in the assessment of negative symptoms in schizophrenia (SZ), little is known about how patients and their relatives/caregivers (REL/CARE) subjectively perceive these symptoms and the tools used to measure them. The current study used a combined qualitative and quantitative approach to obtain subjective perceptions on negative symptoms. Participants included 52 outpatients with SZ and 22 REL/CARE who completed structured online surveys with quantitative and qualitative questions evaluating agreement with standard definitions of 6 negative symptom domains (anhedonia, avolition, asociality, blunted affect, alogia, lack of normal distress), the perceived importance of each of the domains, clarity of interview probes used on the Brief Negative Symptom Scale (BNSS), and the level of symptom improvement required for meaningful change on the BNSS. Clinician-rated BNSS scores were compared with SZ and REL/CARE subjective perceptions of negative symptom severity. A subset of participants completed follow-up live, one-on-one qualitative interviews to probe responses further. Participants showed high agreement with BNSS definitions for the five core domains, but less agreement for lack of normal distress. Both groups rated anhedonia, avolition, and asociality as most important to improve. Most BNSS items were considered clear, though lack of normal distress was sometimes misunderstood. Participants rated negative symptom severity higher than clinicians and reported that a 1-2 point reduction on BNSS anchors would reflect meaningful change. Findings provide important insight into subjective perceptions of negative symptoms from stakeholders and suggest that the BNSS assessment approach captures the construct in ways that are meaningful to people with SZ and their REL/CARE.

Background Cultural contexts, such as whether one’s immediate environment is ethnoracially congruent, are known to influence emotional expression, emotional experience, motivation, and social behavior in healthy individuals. However, it is unclear whether such cultural factors play a role in state exacerbations in negative symptoms that occur in schizophrenia (SZ). Aims The current study combined GPS data, environmental geocoding, and ecological momentary assessment (EMA) to test the hypothesis that ethnoracial incongruence encountered in daily-life situations predicts state increases in negative symptoms in SZ. Method Participants included outpatients with SZ (n = 37) and healthy controls (CN: n = 41) with marginalized ethnoracial identities who completed EMA and passive digital phenotyping recordings. Geolocation was used to pair participant GPS location at the time of completing EMA symptom surveys with geocoded measures of that location’s ethnoracial density based on government census records. Ethnoracial congruence was determined in relation to the match between a participant’s identified ethnoracial identity and the ethnoracial density of their location at the time of EMA survey. Results Results indicated that ethnoracially incongruent contexts were associated with state increases in negative symptoms in individuals with SZ, but not CN. Conclusions These findings suggest that interactions between one's own ethnoracial identity and the ethnoracial context of the current environment contributes to negative symptom exacerbations in SZ. Identity factors are not typically considered in the assessment and treatment of negative symptoms in SZ, but it would be beneficial to do so.

Limited progress in treating negative symptoms in schizophrenia (SZ) may stem from an imprecise mechanistic understanding of these symptoms. This study tests a newly proposed hypothesis about a novel psychological mechanism-that negative symptoms result from discrepancies between ideal and actual affect. Greater trait discrepancies between how one wants to feel versus how one actually feels have previously been associated with greater negative symptom severity. This study uses Ecological Momentary Assessment (EMA) to determine whether these effects extend to daily life contexts. Thirty-nine outpatients with SZ and 33 healthy controls (CN) completed 7 days of EMA surveys assessing negative symptoms and ideal-actual affect discrepancies for positive and negative affect. SZ had greater ideal-actual negative but not positive affect discrepancies in daily life, suggesting SZ feel more negative affect than they desire to than CN. A greater discrepancy between one's ideal and actual negative and positive affect was associated with greater concurrent anhedonia and avolition. Time-lagged analyses showed a greater discrepancy between ideal-actual positive and negative affect was uniquely tied to higher levels of prospective anhedonia in SZ. The strength of the discrepancy between ideal and actual affect also varied across activity, social partner, and location contexts. The greater discrepancy between how positive and negative a person with SZ wants to feel may result in feeling defeated and demotivated, contributing to reduced engagement in goal-directed and pleasurable activities. This discrepancy between ideal and actual affect is a novel mechanistic target for negative symptoms that could be targeted with just-in-time digital therapeutics.

Effort-based decision-making (EBDM) impairments predict negative symptoms across multiple psychiatric diagnoses. However, it is unclear whether equifinality is present and different disorders reach the same clinical endpoint of negative symptoms via different mechanistic EBDM processes. This study used computational modeling to isolate processes underlying EBDM in a large severe mental illness-spectrum sample. The Effort Expenditure for Rewards Task, negative symptom measures, and neuropsychological tests were administered to 920 participants: schizophrenia (SZ; n = 147), first-episode psychosis (FEP; n = 54), bipolar disorder (n = 53), depressive disorder (n = 37), clinical high-risk for psychosis (CHR; n = 231), other clinical (n = 99), and healthy control groups (HC; n = 299). Computational modeling identified whether participants' EBDM behavior was best fit by models indexing full or partial subjective value (use reward magnitude and/or probability) or bias (failure to use reward magnitude and probability). Best fitting models significantly differed across diagnostic groups. SZ and FEP were best fit by the bias model and less likely to use reward magnitude and probability to guide EBDM. The CHR, other clinical, depressive disorder, and HC groups were best fit by the full subjective value model and were more likely to use reward magnitude and probability, while the bipolar disorder group’s behavior was more variable. Across groups, participants best fit by the bias model had the greatest negative symptoms and cognitive impairments. Results indicate mood and psychosis-spectrum disorders differentially approach EBDM. Equifinality in the pathway to negative symptoms was not supported; those with difficulty utilizing reward and probability information had the greatest negative symptoms, independent of diagnosis.

Although outcomes are modest, extant studies for bipolar disorder have supported comprehensive behavioral treatments and medication management. These treatments are customarily focused on psychiatric symptom reduction, which may be stigmatizing and overlook the optimal spectrum of functioning. As a novel alternative to traditional treatment, we examined the implementation of Performance Optimization-Focused Family Behavior Therapy (POFFBT) in a performance artist who evidenced bipolar I disorder with psychotic features, social anxiety, and cannabis use disorder as well as psychiatric symptoms and performance anxiety. POFFBT meetings occurred within the context of Coordinated Specialty Care (CSC). In clinical trials POFFBT has decreased psychiatric symptom severity and improved sport performance and relationships in adolescent and emerging adult athletes. However, POFFBT has yet to be evaluated in performance artists or within the context of CSC, which appears to enhance intervention engagement and outcomes for individuals with early serious mental illnesses. A battery of assessment measures was administered at baseline and six-month follow-up. Results indicated a substantial decrease in mental health symptom severity and increased social engagement. Future directions are discussed in light of the results.

OBJECTIVE:Individuals with psychotic disorders routinely display anhedonia when rated on clinical interviews that rely on retrospective reports of pleasure; however, hedonic response is intact on laboratory paradigms measuring self-reported in-the-moment (i.e., consummatory) pleasure. It is currently unclear how to reconcile this apparent discrepancy. In the present study, we examined the possibility that clinician-rated anhedonia is associated with impaired memory for positive information across two experiments. METHOD:In Experiment 1, individuals with schizophrenia or schizoaffective disorder (SZ; n = 28) and healthy controls (CN: n = 21) completed valence and arousal ratings of pleasant, unpleasant, and neutral photograph stimuli, followed by an unprompted recognition test after a 1-week delay. In Experiment 2, individuals with SZ (n = 102) and CN (n = 60) completed the Emotional Verbal Learning Test, which assesses memory for word stimuli from happiness, sadness, anger, and anxiety conditions over five immediate free-recall trials, short-delay free recall, 20-min long-delay free recall, and long-delay yes/no recognition conditions. RESULTS:Results of Experiment 1 indicated that SZ and CN reported similar levels of valence and arousal to visual stimuli; however, SZ had poorer recognition memory for both pleasant and unpleasant stimuli compared with CN. In Experiment 2, CN demonstrated preferential recall for happiness over sadness, anger, and anxiety stimuli. However, this preferential recall advantage for happiness stimuli was less evident in SZ. CONCLUSIONS:Across both studies, reduced recall or recognition for positive stimuli was associated with greater severity of anhedonia. Collectively, findings from these two experiments suggest that clinical ratings of anhedonia are associated with memory deficits for positive stimuli in SZ. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Objectives: There is a need to psychometrically develop self-report measures of substance use in athletes, particularly those that assess the impact substance use has on sport performance. Method: In this study, a four-item measure assessing the extent to which alcohol and illicit drug use interfere with sport performance in training and competition, validated measures of psychiatric symptomology and substance use frequency, and a structured clinical interview assessing substance use diagnostic criteria were administered (N=285 athletes). Results: One-week test-retest reliability of the four-item measure was good, and positive relationships between this set of items and validated measures of psychiatric symptomology, substance use frequency, and age were found. Males demonstrated higher scores on the four-item measure, and its scores were not influenced by ethnicity and athlete type (NCAA, club, intramural). In a sub-sample of 74 participants who reported substance use and interest in pursuing psychological intervention, there was a non-significant trend for participants who were diagnosed with a substance use disorder to demonstrate higher scores on the four-item measure of substance use interference with sport performance than participants who were not diagnosed with a current substance use disorder (p = .08). Conclusion: Results suggest the developed four-item measure may be helpful in determining the extent to which substance use impacts sport training and competition in collegiate athletes.

Studies suggest athletes with ADHD endorse more concussion symptoms than those without, but no studies have used network analysis to determine if symptom relationships also differ. This study examines differences between athletes with and without ADHD on Post-Concussion Symptom Scale (PCSS) item interactions using network analysis. High school athletes (n=1,638; 23% female; Mage=14.8 in each group) who completed the PCSS at baseline were included. Groups were matched on age, gender, and sport type. Network analysis was conducted on PCSS scores, where nodes represented items and edges represented partial correlations. Expected influence was calculated to determine symptom importance. Network comparison tests evaluated differences in structure, connectivity, and expected influence. Group comparisons indicated the ADHD group endorsed significantly more symptoms. Networks did not significantly differ between groups. The network edges for non-ADHD (M=0.036) and ADHD (M=0.039) groups were generally positive, suggesting that increased severity of one PCSS item was associated with increased severity of other items. No significant differences were found between groups, suggesting differences in symptom endorsements do not coincide with differences in symptom interactions. Future research could explore community network analyses to determine if concussive cognitive symptoms cluster more strongly within the ADHD group, potentially revealing differences in symptom interactions not captured by current analyses.

Limited negative symptoms treatment effectiveness may result from environmental resource deprivation that is a barrier for performing goal-directed, recreational, and social activities. This study showed that environmental resource deprivation in the home environment was greater for people with schizophrenia (n = 39) than 32 demographically-matched healthy controls (CN). Greater environmental resource reductions for performing goal-directed, recreational, and social activities were associated with greater negative symptoms, even after controlling for income and secondary negative symptom factors (depression, positive symptoms).

Abstract Objective Individuals with first episode psychosis (FEP) are often dependent on family members to assist with recovery following diagnosis. Family members frequently become caregivers, helping with scheduling and transportation to appointments, medication management, and tasks of daily living. However, such caregiving responsibilities can impact financial resources, employment, family routine, and cause higher rates of stress within the family. The following study examined cognitive, demographic and symptom predictors of self-reported caregiver burden in FEP. Methods Participants included 61 individuals experiencing their first episode of psychosis (26.2% female; mean age = 20.7). IQ was assessed with the WASI-II. Psychosis symptom severity over the past 7 days was assessed using the Structured Clinical Interview for DSM-5 Disorders. Demographic data and social and occupational functioning were also collected. The Family Assessment Scale was completed by the primary caregiver to assess different domains of family burden (e.g., finance, employment, recreational activities, leisure time, stigma, and emotions). Results Multiple regression analyses indicated that severity of delusions was a significant predictor of caregiver burden. However, IQ, race, age, and social and occupational functioning were not significant predictors. Conclusions Current results indicate that for FEP, delusions severity is a stronger predictor of caregiver burden than other factors expected to impact burden, such as IQ and social and occupational functioning. Results provide preliminary evidence indicating that early in the course of psychotic illness, active delusions play a key role in increased caregiver burden.

A recent environmental systems theory of negative symptoms in schizophrenia (SZ) proposes a role for reductions in social networks that exist within microsystems (i.e., the contexts in which social interactions occur). However, it is unclear which aspects of social networks are most impacted in SZ and whether these are differentially associated with specific domains of negative symptoms. The current study aimed to address these gaps in the literature using a novel social network tool in combination with Ecological Momentary Assessment (EMA) and clinical ratings of negative symptoms. Participants included 40 outpatients diagnosed with SZ and 35 demographically matched healthy controls (CN) who completed the sociogram, Brief Negative Symptom Scale (BNSS), and 7 days of EMA surveys assessing anhedonia, avolition, and asociality. ANOVAs examined group differences in social network characteristics. Correlations examined associations between social network characteristics and negative symptoms measured via the BNSS and EMA. Results indicated that: (1) SZ had greater social network reductions than CN, including lower: network density, number of microsystems, people in microsystems, connections across and within microsystems (p’s < 0.05, d-value range 0.58 to 0.74); (2) these social network reductions were associated with greater severity of negative symptoms on the BNSS (r range − 0.28–0.34, p < .05) and asociality measured via EMA surveys (r’s = − 0.24 to − 0.26, p’s < 0.05). Findings clarified the nature of social network dysfunction in SZ and identify novel targets for psychosocial interventions focused on modifying the number of social microsystems and the connections within/across these microsystems.

Abstract Objective Prior literature suggests there may be gender-based differences in Post-Concussion Symptom Scale (PCSS) scores, with girls reporting more symptoms than boys at pre- and post-concussion. PCSS network analysis comparisons on gender have been conducted at pre-concussion but not post-concussion, which can determine whether gender-based differences in symptom relationships exist post-concussion. We conducted network comparisons between boys and girls from a sample of high school athletes at acute post-concussion to analyze differences in symptom relationships. Method Separate network analyses were conducted on acute post-concussion PCSS scores (within 72 hours post-suspected concussion) for boys (n = 2032) and girls (n = 1246), with nodes representing PCSS items and edges representing partial correlations between them. Expected influence was calculated to determine node importance in each network. Network Comparison Tests were used to compare network structure, global connectivity, and expected influence. Results Both networks’ expected influences and edge weights were stable and interpretable. There were no significant differences in network structure, connectivity, and expected influence between the groups. Networks consisted of positive and negative edges; strongest edges connected symptoms within similar domains (e.g., light and noise sensitivity). Conclusions Current results suggest that prior reports of gender-based differences in PCSS scores following concussion do not appear to be accounted for by differences in how PCSS items interact and influence each other. Differences may reflect actual differences in type and severity of post-concussion symptoms experienced by boys and girls or reflect differences in symptom reporting based on cultural influences. Future research could examine cultural or societal factors that influence gender-based differences in symptom reporting.

Transitions between dry and wet hydrologic states are the defining characteristic of non-perennial rivers and streams, which constitute the majority of the global river network. Although past work has focused on stream drying characteristics, there has been less focus on how hydrology, ecology and biogeochemistry respond and interact during stream wetting. Wetting mechanisms are highly variable and can range from dramatic floods and debris flows to gradual saturation by upwelling groundwater. This variation in wetting affects ecological and biogeochemical functions, including nutrient processing, sediment transport and the assembly of biotic communities. Here we synthesize evidence describing the hydrological mechanisms underpinning different types of wetting regimes, the associated biogeochemical and organismal responses, and the potential scientific and management implications for downstream ecosystems. This combined multidisciplinary understanding of wetting dynamics in non-perennial streams will be key to predicting and managing for the effects of climate change on non-perennial ecosystems. This Perspective presents a wetting regime framework that is classified by dominant hydrologic mechanisms and highlights the resulting responses of stream biogeochemistry and community ecology.

Abstract Objective Among the many challenges faced by individuals experiencing their first episode of psychosis (FEP), commencement of public, self-, and structural stigma regarding their symptoms contributes to internalized shame, social exclusion, and discrimination. Individuals with FEP may experience rejection from friends, family, and community members due to misconceptions and fear surrounding mental illness, which can worsen mental health outcomes and hinder recovery. The aim of this study was to evaluate the extent of self-reported stigma and predictors in adults with a first episode of psychosis. Method We measured IQ, stigma, social and occupational functioning, race, sex, and symptoms of psychosis in a sample of 77 individuals with FEP (29% female, mean age 31.8 years). Results Multiple regression analysis indicated that psychotic symptoms delusions were significant predictors of stigma in the model, while race, IQ, sex, and functioning were not significant predictors. The model was statistically significant for symptoms of delusions (p < 0.05). Conclusions Initial findings indicate increased stigma is predicted by increased severity of delusional symptoms among individuals experiencing their first episode of psychosis. Surprisingly, other factors associated with stigma in more chronic illness were not significant predictors in the regression model. It may be that early in the course of psychotic illness, symptoms differentially contribute individuals’ perceptions of stigma by others. While these results offer preliminary insight, further research is necessary to explore additional factors uniquely associated with stigma in FEP, including contributors to internalized, public, and structural stigma, as well as interventions for decreasing negative impacts of stigma.

The Symptom Checklist 90 – Revised (SCL-90-R; Derogatis, 1994) is one of the most widely utilized measures of general psychiatric distress. However, its factor structure varies across populations, and psychometric properties of this scale have yet to be investigated in athletes. In this study several frequently reported factor structures of the SCL-90-R were examined in 311 collegiate athletes. None of the tested models were a good fit based on Confirmatory Factor Analysis (CFI) criteria, although the bi-factor model was reasonable using RMSEA (.06) and AIC (55951) criteria. Explained common variance of the global factor was 73%, reflecting a stronger general factor relative to specific construct factors. Indeed, several items did not significantly load on previously identified factors. Results suggest the SCL-90-R is a good tool to determine general symptom severity of mental health disorders in collegiate athletes.

Objective:Previous studies have found differences between monolingual and bilingual athletes on ImPACT, the most widely used sport-related concussion (SRC) assessment measure. Most recently, results suggest that monolingual English-Speaking athletes outperformed bilingual English- and Spanish-speaking athletes on Visual Motor Speed and Reaction Time composites. Before further investigation of these differences can occur, measurement invariance of ImPACT must be established to ensure that differences are not attributable to measurement error. The current study aimed to 1) replicate a recently identified four-factor model using cognitive subtest scores of ImPACT on baseline assessments in monolingual English-Speaking athletes and bilingual English- and Spanish-speaking athletes and 2) to establish measurement invariance across groups.Participants and Methods:Participants included high school athletes who were administered the ImPACT as part of their standard pre-season athletic training protocol in English. Participants were excluded if they had a self-reported history of concussion, Autism, ADHD, learning disability or treatment history of epilepsy/seizures, brain surgery, meningitis, psychiatric disorders, or substance/alcohol use. The final sample included 7,948 monolingual English-speaking athletes and 7,938 bilingual English- and Spanish-speaking athletes with valid baseline assessments. Language variables were based on self-report. As the number of monolingual athletes was substantially larger than the number of bilingual athletes, monolingual athletes were randomly selected from a larger sample to match the bilingual athletes on age, sex, and sport. Confirmatory factor analysis (CFA) was used to test competing models, including one-factor, two-factor, and three-factor models to determine if a recently identified four-factor model (Visual Memory, Visual Reaction Time, Verbal Memory, Working Memory) provided the best fit of the data. Eighteen subtest scores from ImPACT were used in the CFAs. Through increasingly restrictive multigroup CFAs (MGCFA), configural, metric, scalar, and residual levels of invariance were assessed by language group.Results:CFA indicated that the four-factor model provided the best fit in the monolingual and bilingual samples compared to competing models. However, some goodness-of-fit-statistics were below recommended cutoffs, and thus, post-hoc model modifications were made on a theoretical basis and by examination of modification indices. The modified four-factor model had adequate to superior fit and met criteria for all goodness-of-fit indices and was retained as the configural model to test measurement invariance across language groups. MGCFA revealed that residual invariance, the strictest level of invariance, was achieved across groups.Conclusions:This study provides support for a modified four-factor model as estimating the latent structure of ImPACT cognitive scores in monolingual English-speaking and bilingual English- and Spanish-speaking high school athletes at baseline assessment. Results further suggest that differences between monolingual English-speaking and bilingual English- and Spanish-speaking athletes reported in prior ImPACT studies are not caused by measurement error. The reason for these differences remains unclear but are consistent with other studies suggesting monolingual advantages. Given the increase in bilingual individuals in the United States, and among high school athletics, future research should investigate other sources of error such as item bias and predictive validity to further understand if group differences reflect real differences between these athletes.

Objective: Sport concussion is a common injury, and athletes with attention-deficit/hyperactivity disorder (ADHD) and/or learning disorder (LD) are at increased risk and require specialized attention in clinical settings. Although systematic reviews of the relationship between ADHD/LD and concussion are reported in the literature, these reviews do not include quantitative syntheses. Additionally, no reviews have focused on the most commonly utilized concussion assessment, Immediate Post-Concussion Assessment and Cognitive Testing (ImPACT). The current review provides an update of sport concussion assessment in athletes with ADHD and/or LD from 2000 to 2021 on these topics: baseline and postconcussion performance on ImPACT, baseline and postconcussion symptom reporting using the Postconcussion Symptom Scale, invalid baseline classification on ImPACT, and self-reported history of concussion. Method: Meta-analyses were conducted on baseline ImPACT performance, symptom reporting, invalid baseline classification, and concussion rates. Thirty-four studies were included in systematic review and 19 were included in meta-analyses. Results: Decreased baseline performance was found for athletes with ADHD (trivial to small effects), LD (small-to-medium effects), and ADHD/LD (small-to-medium effects). Increased baseline symptom reporting was found for athletes with ADHD (small effect). Increased odds of invalid baseline performance (trivial effect) and self-reported concussion history (small effect) were found in ADHD. Conclusions: These results provide the first quantitative synthesis of the literature in this area. It is recommended that future research further examines these topics in athletes with LD and co-occurring ADHD/LD (given the focus on ADHD), as well as the effects that all of these conditions may have on concussion recovery and return-to-play decision-making.

The Optimum Performance Program in Sports (TOPPS) is a multi-component, sport-specific Family Behavior Therapy that has demonstrated improved sport performance, relationships, and mental health outcomes in adult and adolescent athletes with, and without, diagnosed mental health disorders in clinical trials. The current case trial demonstrates successful implementation of a novel component of TOPPS (i.e., talk aloud optimal sport performance imagery leading to dream mapping) in a biracial Latina and White adolescent gymnast without a mental health diagnosis. The participant demonstrated significant improvements from baseline to both post-treatment and 3-month follow-up in severity of mental health functioning, factors interfering with sports performance, and her relationships with teammates, coaches, and family. Results suggest it may be possible to optimize mental health through sport performance optimization.

PCSS network connectivity, structure, and symptom influence do not differ between bilingual and monolingual athletes, suggesting differences do not exist in symptom interactions between groups and likely do not underly observed differences in symptom ratings. Future work should examine whether administration language influences symptom networks.