ABSTRACTObjective: Humans are social creatures, with desires to connect or belong, producing loneliness when isolated. Individuals with schizophrenia are often more isolated than healthy adults and demonstrate profound social communication impairments such as vocal affect perception (prosody). Loneliness, levels of desire for social connectedness (need to belong, NTB), and their relationship to perception of social communications have not been investigated in schizophrenia.Method: In a sample of 69 individuals (36 SZ), we measured endorsements of loneliness and NTB, and evaluated their putative relationships to clinical symptoms and social communication abilities, as indexed by emotional prosody and pitch perception.Results: Loneliness endorsement was highly variable but particularly so in patients, whilst patients endorsed NTB at levels equivalent to healthy controls. In schizophrenia, pitch and prosody acuity were reduced, and prosody perception correlated with NTB. Loneliness, but not desire for social connectedness, correlated with negative symptoms.Conclusion: Loneliness and negative symptoms likely exert bidirectional effects on each other. Loneliness and desire to form interpersonal attachments may be pivotal in shaping and stimulating social interactions and, subsequently, the ability to perceive social intent through prosody. Intact NTB levels in patients augurs well for cognitive remediation which, target vocal-communication processing to improve social skills.Significant OutcomesPatients with schizophrenia endorsed higher levels of loneliness than controls, but ratings of desire for social connectedness were at normal levels.Pitch acuity and prosody perception were correlated, confirming the importance of basic sensory processing in recognizing prosodic emotions.Socio-cognitive perceptual ability (emotional prosody perception) correlated with increased desire for social connections, implying that they may still be motivated to find social interactions reinforcing. Thus interventions to improve perceptual deficits could still be an effective means of improving social function.LimitationsCausal relationships between desire for social connections, loneliness, and emotional prosody perception cannot be inferred through correlations and cross-sectional studies alone.Subjective endorsements of loneliness through self-report are not the same thing as objective indices of loneliness. New and more extensive tools for measuring desire for both loneliness and social connectedness may be needed.Direct experimental comparison of the interrelations between desire for social connectedness, loneliness, pitch acuity and emotional prosody perception in patients with schizophrenia and other populations such as autism will enable a more accurate comparison of the likely success of remediating socio-cognitive perceptual impairment in neuropsychiatric disorders.
Maintaining Social Connections in Dementia: A Qualitative Synthesis
