The Human Social Brain: How It Goes Awry in Schizophrenia

[Music] funding for this program was provided by the UCLA office of instructional development [Music] [Music] so these are the individuals who've done the work that I'll present today I have the privilege of working every day with these talented dedicated and wonderful individuals many of whom are here today now regarding the research environment at UCLA let me illustrate it to you this way I have only ever had one job I came here as a postdoc my mentors were Steve martyr and Keith nectar line who are here today I continue to work closely with them and they have only ever had one job the lab includes half a dozen junior faculty four senior faculty and all of them have only ever had one job this configuration is so rare is to be virtually unheard of but it happened it happened here it happened at UCLA the rich scientific environment and collaborative culture here at UCLA means that people people who are quite capable of going elsewhere want to stay and want to make their discoveries here and this situation does not arise by accident it happens because of people who have a vision of a superb research university we have people here in this hall who are dedicated to establishing maintaining enhancing and protecting the UCLA research environment please join me in thanking them so let's get started the talk will be divided into two parts and the first part is the social brain how it works and how it doesn't so we'll talk about the kind of networks involved with the social processing how they fail in schizophrenia and I'll make a distinction between ability versus motivation that's the first part and it's the part on which most of our research is has been focused on the last few years we have a lot of data in this first part the second parts a new direction and consequently has much fewer data associated with it it's how we extend this to the community how we would recruit and assess disconnected individuals from the community and how what we've learned in schizophrenia helps us to understand social disconnection although I am the hundred and twenty third recipient of this award and one hundred twenty third person to give this presentation I am the first to speak about mental illness as such the process might not be familiar the process will be that we start with understanding normative process is the normal brain in our case and try to apply it to a particular disease the disease in our case is schizophrenia and then in the second part what we'll do is try to take what we learn any insights from that process and then apply to the general population first a word about the methods are referred to I'll be referring to two kind of brain based methods one is functional magnetic resonance imaging or fMRI I'll just refer to it as scanning many of you have already had MRIs this is a particular one in which it detects minor changes in blood flow and that way you can get a idea of which parts of the brain are active under which particular conditions so this is a workhorse method for the social neuroscience that we'll be talking about we also use EEG so these are scalp recordings of electrical activity and there's particular patterns that you can observe over particular regions and consequently if you average them you can get particular waves these would be waves that would be in response to some social stimuli or in particular social processing conditions so I'll be in today's talk referring to EEG and referring to scanning and these are the two methods we'll talk about because we start with the normal brain I'm going to give you an example of the kind of neuroscience that can be used to study the normal brain and in doing so I'm gonna highlight the work of one of our excellent collaborators Naomi Eisenberger who's right next door in the Department of Psychology and Fran's hall so she and her colleagues have become interested in the regions for social pain or social rejection and this is a interesting area and that it's a little counterintuitive so for example you might think that there's got to be some region that focuses on the kind of pain you feel when you're rejected but in fact there's no special reason for region for that instead evolution was conservative they say it said if it spoke with something like I've got a perfectly good way to process pain physical pain I'll just use it for social pain so the regions and this is not something you can intuit it's something you have to scan the regions associated with physical pain are actually the same as with this kind of social pain or social rejection and if that's so then you should be able to manipulate them both and you can so for example tylenol can work on both physical pain and on social pain so again confirming that these are overlapping regions that there's something conservative about this now you're probably wondering how one studies social rejection in the scanner it's it's it's you know it's not like you can have someone in the scanner and have their girlfriend break up with them you have to sort of manipulate this a little bit so this is done Naomi and her colleagues do this with a game called cyber ball in which there's a cover story the cover story is that you're in the scanner you're you're tossing a ball with two other individuals that are somewhere else on campus or somewhere else they're able to decide where to throw the ball you can decide then you know when you get it to pass it to this person or this person so you have the little figures representing the other people you're playing with and so this is going on for some period of time and then all of a sudden things change a little bit what happens is that the two other people pass the ball back and forth themselves and you're excluded now you might think well that's not much of a social exclusion because I don't even know these people and these are just cartoons I'm looking at and I'm in a scanner anyway but it works it works in other words you can get activation of the regions with this kind of manipulation the regions involved with this and let me pause here for just a minute and say that I know since I've spoken enough that about half of you really want to know where in the brain these events are occurring and the other half of you really would like me to skip that part so so what I'll be doing is something in between which is that I'll identify the regions I won't dwell on them I won't talk about the connections or the networks so that they'll be identified but we won't spend a lot of time the regions been associated with both social pain and physical pain is this dorsal part of the anterior cingulate cortex as well as the anterior part of the insula so those are these regions that's serve this kind of dual purpose so that's sort of an example of how we would benefit from the advances that our colleagues are doing with the normal brain but we want to apply to schizophrenia so I'm going to intersperse from time to time quizzes into this talk and you have to you don't have to do anything but you can guess if you want so schizophrenia is a myth a personal journey a journey of discovery a disease with clear diagnostic criteria or a spectrum of features it's been called all of these it's not a myth that was a older somewhat irresponsible notion it's certainly very real to those of us to study it and those of us who have it in family members on it's not a personal journey of discovery that's an overly romanticized notion but that Oshin does pop up from time to time so neither first or second or correct it's actually both three and four it's both the disease with diagnostic criteria and it's a spectrum and you might say well can't really be both of those and sort of kind of yes it is the the thing is that a diagnosis is always categorical either have it or you don't have the diagnosis and so we'll be talking about the kind of criteria that are used to diagnose schizophrenia but we know and have known for a long time that there's a spectrum of schizophrenia meaning that you can have a tendency to it you can have a little bit of it you can have a watered down version of it it's so even below that sort of severity threshold you can have these kinds of tendencies in the first part of the talk I'll be focusing on diagnostic schizophrenia on the second part of the talk I'll be focusing more on this notion of a spectrum where you can have a little bit of it but not meet the criteria so the diagnosis of schizophrenia is a it's not one thing you have to have a bunch of thing so I'll just spend a minute on this so that you as so that when we go forward you know what I'm referring to so you need at least two of these symptoms some of these are should be familiar to you so delusions will be false beliefs that the person holds on to they could be suspiciousness that you think people are out to get them or grandiose that they have unusual abilities or it could be bizarre that aliens from another planet are affecting them hallucinations are hearing things that aren't there or seeing things that aren't there no one else sees and in schizophrenia its most commonly the hearing voices that we come a disorganized speech is actually a breakdown in the form of speech so it's not exactly what someone's saying it's the structure of speech breaks down so that it's hard to actually understand how the language is structured disorganized behavior is anything that appears to be odd so it does it's not just appears to be threatening or appears to be uncomfortable it appears to be odd and frankly you don't have to go that far you can observe it in westwood villa so this is these are the kinds of things that think make you think someone's not entirely there negative symptoms are attracting a lot of interest from our group have been for years these are what you lose with the disease in other words it's the lack of something the lack of expression the lack of motivation and hadou nee is the lack of wanting to do something having that limp to sort of go out and give something a try so these are negative symptoms and you don't need all of these you just need to you also need Social Work dysfunction and there has to be a minimum duration this is true for everyone with the diagnosis there's a bunch of exclusions which aren't critical for this discussion the first three symptoms here are by definition psychotic symptoms so when people talk about a psychosis psychotic symptoms psychotic features they're talking about these first three things here and most people will say something like yeah but I know someone who has some of these features and they don't have schizophrenia and the answer is that's right these are psychotic features that could appear in a range of psychiatric or neurological conditions it's when you have the whole package that you have the diagnosis of schizophrenia the work and social dysfunction is where we're going to be focused because this is where we have our serious impairment and functioning schizophrenia is disabling it's one of the most disabling disorders for men and women throughout the world this social dysfunction is substantial it's a big problem and consequently we want to understand what the brain basis is for this very large concern that our patients have terrific difficulty in integrating the community and maintaining these kinds of social functions so we want to understand what the brain processes are that underlie these now our lab has spent a fair amount of time identifying processes these are essentially brain systems that relevant for social functioning that we can image or scan or EEG or whatever that we can study them with brain based methods and these tend to have sub processes so at this point I realize that like this is too much and you'd say I don't want to hear about all this stuff we study all of this stuff our lab has worked in all of those boxes but it'd be tedious to go through them so we'll go through an example of social queue perception which is phases we'll talk about experience sharing we'll talk about mentalizing we'll talk about emotion regulation and then we'll move on from there so let's talk about social queue perception so that's the first process we'll talk about we get cues from all kinds of things we get cues from emotion and faces intonation and voices gait gestures we pick up cues we do it fairly easily and our are the people with schizophrenia who we work with don't do it as easily they have trouble in picking up these cues there's very large group differences between individuals with schizophrenia controls and how accurate they are and identifying for example the emotion in faces so you use this you use this ability and you don't think about it because it's too straightforward but here's an example then that we can like let's consider Little Red Riding Hood I mean Little Red Riding Hood definitely looks fearful you can tell that without much effort she's not using by the way prototypic fear expressions but she's using subtle versions of those fear expressions when you came here to Schoenberg hall you walked in you past faces you past faces and you knew that you would come into this hall and find a place to sit and you were going to find a place to sit by looking at faces but when you got into the hall you might realize that it's a little harder to identify individual faces from a distance so you had to get closer when you got closer a couple things happen one is you identify people you knew or you identified faces that were welcoming you did that and I don't think any of you gave it any thought but it's a big deal it's a process that you've mastered and it enables you to function well socially the regions associated with this particularly for face processing are the fusiform gyrus here the amygdala here these regions are more associated with other types of cue perception including this superior temporal sulcus so those would be like identifying emotion and voices but these are the two main regions amygdala and fusiform for identifying emotion in faces so I've already pointed out that our patients aren't great at doing this what does the the scans tell us these data this isn't from our lab all that we've done work in this area this is a meta analysis a meta analysis where you put a bunch of studies together and see what the studies collectively are telling you in this we have group differences in which the individuals with schizophrenia do not activate when they're looking at it emotional faces as much in the amygdala and the fusiform the two regions that I just mentioned to you so they're not doing this as much in the particular contrast they're not they're not sort of calling on these areas that are for face emotion processing the blue regions actually are where they're doing more activity it's kind of like they're activating more in regions that are not typically associated with face processing and they're not activating enough in the regions that are associated with identifying emotion of faces so we see now at a performance level and at a brain-based level that this is an area of which there's some difficulty in our patients here's another quiz for you what does your brain say when you look at this photo let me think if add my arms in that position and was hunched over I'd probably feeling abdominal discomfort mmm that really hits me in the gut since that person is not me I will actively try to not feel any pain the answer is - the answer is - we do this reflexively now you can certainly do one and you can certainly do three but that's not the first thing you're going to do you actually have to try to do those but the sort of gut connection that you get that's fast that's automatic and that's part of experience sharing so experience sharing is this amazing ability that we have which is that when we observe others behaviors it leads us to experience neural activation as if we are doing those behaviors this is one of the most remarkable things about our brains I mean you our brains when they when we observe someone moving or feeling something we get activation as if we ourselves are experiencing or behaving that way I mean this you know we all sit in different chairs in different bodies and different skins and we feel very very different but this part of the brain reaches out and senses what's around it and there's two flavors to experience sharing it's important to keep them separate one is motor resonance which is this sharing that occurs when we see people move when we see a movement so a motor action and ethics sharing is what happens when we see someone experiencing an emotion oftentimes a distressful emotion so for example here are some examples of when we feel this kind of experience sharing here's another example of when we see someone in pain we sense that we get that automatic feeling we feel the pain even if we inflicted the pain so so here's an example of a German POWs Retd by an American meta those of us who are parents are really really good at feeling kids pain we do this so automatically it's so beyond our control that we feel our pets pain and the regions that do this include the for the motor resonance that movement part the inferior parietal lobe and the premotor cortex and those are the regions that are associated with the mirror neurons system the regions associated with effects sharing this kind of I feel your pain those are different regions so these are two different systems but this is the dorsal anterior cingulate cortex and the anterior insula so how do you study this because this is this is a this is a bit difficult to study because you're experiencing you have to measure how someone is experiencing something so we've used an approach with EEG the the study I'm presenting was Bill her and study from our lab mu is a frequency that you measure with EEG it occurs in a you know certain range certain electrodes on and it has this really amazing quality which is that it sort of tracks with how social something is so if you're observing things and there's a sort of imagine a social ladder that as you're observing stimuli and the stimuli become more and more social you actually suppress mu more and more so the more something become social the less mu you have so you can study this with EEG so for example you might show people bouncing balls which is not social and that's our control condition observe a moving hand which isn't social but it's kind of like that motor resonance thing I was talking about how about moving your own hand that again isn't terribly social that's more like the kind of a motor resonance but at least involves another person or your in this case you but then you can show videos of people watching people that are not interacting so they're people but it's not that social because they're not interacting or you can watch people as they're interacting which is more social or then you can watch people as if they're throwing a ball to you so as if they're including you in that so you can think of that as a kind of social ladder or hierarchy in which the MU frequency should become more and more suppressed as we go up to these stimuli and what we see in healthy controls is exactly that we see this tendency to sort of show more and more suppression as the stimuli become more and more social so the question is what do our patients show and the answer is Oh the same thing so this is an area in which when we we we have assisted we have a paradigm that works the controls do exactly what we expect them to do and our patients will collect controls and we see this now not only an EEG but also with fMRI when we look at this experience sharing component we don't find big differences between patients and controls it's an area that's relatively intact it might be that there's some subtle differences entirely possible but considering that it's so easy to find impairment in some areas this is an area that's at least relatively in tracked and that's important it's important to identify areas as strengths in schizophrenia so that we know what to build on so now that's experience sharing the next topic will be mentalizing mentalizing goes by many names it's also called theory of mind or mental state attribution and it's the ability to infer the mental states of other people including their intense tensions their beliefs their emotions I mean as we go through our social world we need to take other people's viewpoints into account to make good guesses as to what's going on in their minds and this is an ability that our patients have considerable difficulty with so we have large differences between patients and controls they have trouble with these kind of inferences being able to put yourself in someone else's shoes take someone else's perspective make inferences about what someone else is thinking this is actually an era in which our are our guys have some difficulty so in terms of examples of mentalizing because you know as I mentioned when you just identify emotion and faces normally that's pretty easy but what if it's not like for example kids eating ice cream are always happy so if the kid was smiling I wouldn't be thinking about it but the kids not smiling so it makes you wonder what's going on so at that point you have to move into something that requires a little bit of inference sometimes faces are intentionally ambiguous sometimes they're just utterly perplexing some sometimes you need to do detective work to figure out what's going on sometimes you don't have enough information and so you need to gather enough information to sort of understand what might be going on and so this is this process of mentalizing and it's this area in which we have performance problems there is a very well identified mentalizing network which includes the temporal parietal junction the temporal pole the precuneus here on the medial surface and the medial prefrontal cortex also in the media so the question becomes the question becomes then if we want to study this in the scanner how do we do that and so Jung Healy from our lab did an experiment in which we created a situation or which we presented individuals the situation in which there's a false belief so I can just read this for you John told Emily that he had a Porsche actually his car is a Ford Emily doesn't know anything about cars though so she believed John when Emily sees John's car she thinks it's a and it's not a hard question to answer but you need to suspend what you know to be true and take Emily's perspective contrast that with Amy made a painting of a tree house three years ago when it was blue that was before the storm we build a new tree house last summer but we painted it red instead the tree house in the painting is and again you need to suspend what you know to be currently true to say what's true in the picture the thing about these is that these are very similar in terms of cognitive processes because if the first condition and the second condition but they're not at all similar in terms of a social process the human mind enters in to that false belief condition it doesn't really enter into the false picture condition so if I contrast these two or if jung-hee does we should expect to see something about this mentalizing system and we do we see it in the key regions we see it in the controls we see it a little bit in the patients as well but you can see there they're substantially less act than what we have in our controls so here again kind of like with social queue recognition or face identification a facial emotion identification we have a situation in which we have performance differences and we also have activation differences between patients and controls the last of these boxes I'll talk about is emotion regulation emotion regulation of processes by which people influence which emotion is experienced when it's experienced in-house experienced and the most extensively studied one is called cognitive reappraisal which is when you change your interpretations or appraisals of stimuli to alter an emotional response so I know that that's not intuitive but I can try to make it intuitive the example I'd like to use is I'm not crazy about flying anymore and I don't think most people are and so I use as an example of how this sort of cognitive reappraisal might be come in handy I mean the reasons why most of us don't like flying is there's these long lines to deal with there's really crowded cabins there's food that's not and and there's like noise and stuff like that and so they're quiet but we thought we still fly weird we're not mean these are stressful think we still fly so how do we manage to keep our composure and not and not just scream at the frustrations that we encounter on these flights because they're pretty routine and the answer is we use emotion regulation we use cognitive appraisal because we say to ourselves something like this is only temporary soon I'll be at UCLA and then we get through it without acting out so this is sort of a common technique so the regions associated with this include lateral regions here at the dorsal lateral and ventral lateral regions as well as the amygdala and this is a reciprocal relationship essentially the lateral regions are telling the amygdala to be quiet and and so that there's a inverse relationship between the two now how do you study it this is another study from Bill her ran in which this is an EEG study you see pictures and you record EEG webserie cord scalp from scalp electrodes so this is an edible mushroom it's a boring picture it's a boring phrase this is a poisonous snake that is very dangerous that's a scary picture that's the scary phrase this snake that is completely harmless it doesn't even have teeth it's the same picture okay it's the same picture but do you think saying something like this is going to make a difference the answer is it does it might you might not think so but we can measure the EEG activity from your brain and your brain tells us that it made a difference so for example this is the late positive potential it's one of the things that bill and others members of our lab study the red line is consistently above the blue line these are the same pictures okay the red line is not regulated the blue line is when you have those neutral phrases the snakes harmless this is just a movie saying nobody got hurt whatever that you there's ways of sort of sort of calming down the emotional response to negative pictures so even though in the case of controls the red lines above the blue line in the case of patients it's not there's not much of a difference than when the waves depart they part in the wrong direction so this is another example where we're seeing some between-group differences so back to our boxes these are the four areas that I talked about today and we can start characterizing the landscape in terms of what's impaired and what's intact and this is important for any condition particularly a serious condition like schizophrenia to be able to identify which processes look like they're working well and which ones look like they're not and this helps us understand sort of how we can develop intervention programs and how we can build upon those strengths the last comment about this this first part about the studies is that there's another part of the social brain that we haven't talked about B we don't understand how to study it very well and that's social motivation now this is the distinction between the abilities that I just talked about and wanting to so you can have a situation in which somebody says my I have no trouble identifying emotion and faces I have no trouble with mentalizing I have no trouble with emotional regulation I just don't want to be with people I don't feel like it it's not that I have a problem doing it or processing it or identifying the cues I just don't want to do it so this is a separation between the ability and the motivation and there's two flavors of motivation one is the motivation to approach other people the other is the motivation to avoid other people and I know all of you are thinking why do you guys make life so complicated it isn't just the same thing in Reverse and the answer is no these are two different systems so we have to be studied separately in schizophrenia the social anhedonia actually has been studied for quite some time it's an it's one of these negative symptoms that this sort of lack of enjoyment of social things it's a long-standing feature a focus of schizophrenia it's a trait feature it's part of the schizophrenia spectrum so we're back to the spectrum concept it exists in people who have risk for schizophrenia and also in individuals before they become schizophrenia in these prodromal states so this is something that's received a lot of attention but we have some scientific challenges to deal with one is individuals with schizophrenia might not want to do things whether they're social or not they might not want to read books or go to movies or do things that aren't particularly social so how do we separate out things that are social from non social the other thing is that we want to study this in the brain we want to study it in the scanner and that's not a terribly easy thing to do sometimes to get the brain to reveal its secrets you have to sneak up on it and that's what Jung Healey from our lab did she snuck up on the brain this is what she did she set up a paradigm in which there's slot machines okay there's three different slot machines and they come out in pairs and you have to pick which slot machine you want you're not told which slot machine is good or not good you have to figure it out yourself as it turns out one is good which means most the time it gives you a payout but not always the other is bad which meaning that most of the time it doesn't give you a pea nut payout or take something away and the other one is completely neutral it does it one third of the time it's good when third time it's bad and when third time doesn't matter so but you're not told that this is called probabilistic learning it approximates how we learn in real life and so this is a way of sort of getting people to learn things without actually telling them there and jung-hee was sneaky in a differ in a second way which is that she manipulated the type of reward so sometimes it was an image of money gained or money lost and sometimes it was a smiling inviting face and sometimes it was an angry face and so the subject would choose between two and so the the better choice of course is to pick a good machine over a neutral one to gain something or neutral machine over a bad one to avoid losing something but now you can look at the effect that type of reward had when those decisions are being made the regions that are associated with this are the ventral striatum and the ventral medial prefrontal cortex these are common areas for social motivation and so the here I'll show you some data its imaging data but it's graph so that you can see the magnitude of the response there's the ventral striatum and you can see that for non social or social reward the healthy controls don't make that much of a difference same thing for the ventral medial prefrontal cortex those are the two regions we talked about they show a little more whatever you want to call activity responsive 'ti sensitivity to the social stimuli but it's not a big difference look at our patients our page and this is a significant interaction our patients are not responding to the social rewards as much as they are to the non social ones and they differ from healthy controls in this regard so this gives you some idea as to how you might start teasing apart not just the abilities which is what we've been focused on for so long but the sense of motivation to engage in one social world which is also important for social functioning that ends the first part of the discussion and so I'll move on to the second part which is a bit shorter because it's new and I don't have as much data to show you so what we'll do is we'll this way you get to see something on which we have a fair amount of data and and as well as things that give an indication as to what direction we're going in so we're now in a situation where we want to take anything that we've learned in schizophrenia and apply it to the general public public health so in order to do that I have another quiz for you having friends is bad for your health I mean after all who needs the aggravation has no effect on your health has a slight beneficial on your beneficial effect on health because they nag you to eat well exercise that sort of thing means that you have a 50% higher chance of being alive in seven years if you're in mid-60s correct this is the size of the effect of being socially connected so the construct of interest is social disconnection which is objective long-standing lack of contact with friends contact with community groups contact with family but its objective we'll talk about subjective in a minute it's really prevalent in individuals with men severe mental illness obviously schizophrenia is not the only one but schizophrenia is the disease we focus on and as I've mentioned social dysfunction is a huge issue for the disorder and it leads to international levels of disability but it's also commonly observed in the general community um and it's a public health problem so first of all what do we mean by the general community where we're not fancy here we just mean that we didn't use clinics we didn't use we just get people sort of unselected through anything through no particular referral network how much social disconnection is there in the general community no one's really sure but it's about five to ten percent it's not trivial it's not trivial that's the number of people that say they don't have confidants is it increasing in the u.s. probably is I mean that there's a feeling that it's increasing but the data does support that the social network size is decreasing over the last few decades is this a problem because of social networking or or online connections and and does it help or hurt and the answer it can do both this doesn't seem to be a strong directional thing in other words the the social networking can help people who want to be connected it can hurt people who don't it this doesn't seem to be the reason for the trend so it's not something we can blame on the rise of social networks now social disconnection is very different from loneliness loneliness is the subjective evaluation of social interactions right so so loneliness is how you feel about your connections social disconnection is an objective rating of how connected you are and the loneliness is associated with depression and it's not strongly correlated with social disconnection the correlation is about 0.25 so this is a really modest correlation and if you think about it for a minute if you think about it for a minute it might not surprise you that people can be surrounded by people and still be lonely and it might not surprise you that many of our individuals with schizophrenia are not around other people and don't feel lonely so the fact that this is a low correlation sort of makes sense when you think about different individuals now what do we know about the social disconnection and early mortality I mean let's be realistic here you know what about smoking what about obesity you know what about poverty I mean I have enough you know public health things to worry about do I really have to worry about social disconnect and these data indicate you do anything to the right of the vertical line is bad for you and you can send the and the further right the worse it is and social disconnection that the two lines are because we have to one line for men and one line for women and social disconnection is at the same level of risk for early mortality as poor health at baseline smoking poverty and it's higher than obesity and hypertension this is one large study but this comes across in many studies so if this is such a big deal you could say Michael okay I understand you're concerned about it but if this is such a big deal how come we don't hear like a warning from the Surgeon General or something like that we got one in response to a question about the biggest disease in America Surgeon General Murthy that's the former Surgeon General says it's not cancer it's not heart disease it's isolation it's the pronounced isolation that so many people are experiencing that is the great pathology of our lives today by isolation he means both subjective and objective so he's talking about both social disconnection as well as loneliness so this is an area of concern but then there's this question like if you want to study this if you really want to study this there's there's a ton of people doing this I mean there's people in public health there's people in sociology there's people in epidemiology and they've done a wonderful job of showing the extent of the problem and the consequences of the problem for health and mortality but if you want to know what's causing the social disconnection if you want to know what's leading to it if you want to know the brain base the within-subject factors that lead to this then you have to come to someone like us this is what we've been doing in schizophrenia so we can try to use the same approach in the general population but then that raises another problem which is how you recruit a sample with social disconnection they're disconnected so how do you actually get them so after giving this a fair amount of thought we realized we can place an ad on Craigslist Annie and we did do you have few friends little contact with family members and typically do activities alone and we get a lot of phone calls and you can say yeah Michael but let's be realistic you're only getting a subset of this sort of universe of socially disconnected individuals people who are online and people willing to come in for a research study we know that okay we know that we're getting a subset but this is the approach we've used we have other approaches that we'll use going forward so now what do I do since this is a new area how do I present data to you that I'm not going to suddenly regret presenting publicly when when something changes the thing is that we have two independent samples at this point we have a pilot study that we did to demonstrate that we could recruit these individuals it was a feasibility study and we also have one ongoing study that's quite large but we're just beginning it but that gives us essentially a replication sample so and we have over 50 self-identified individuals that are disconnected so people that say that they're disconnected so we have now enough experience with this so for the next few minutes what I'll do is I'll present to you anything that we've seen in both samples we're just like any other research group if we see something twice we take it seriously so here's my last before I go on let me give you an example because you might not have a sense for what these individuals are like tl is a 49 year old single female at the time of the interview she was living alone in an apartment employed sporadically as a TV extra and intermittently collecting unemployment disability she completed college with a degree in French language and culture she reported she loves being an actress and feels like dressing up and playing all day is her way of participating in society she spent her time exercising watching cooking and travel shows baking and running errands when asked why she responded to the study ad she stated I have few friends and I prefer to be alone further she reported that she had never been in a close romantic relationship but would like a significant other on measures of social disconnection she endorsed low levels of social approach motivation and moderate levels of loneliness she endorsed some personality disorder traits including preferring to do things alone because it makes her more efficient and expressing ambivalence about physical intimacy but she did not meet criteria for personality disorder if this sounds like someone who might be somewhat familiar the answer is given the base rates you probably do know people who are disconnected and we have a number of case studies that are all sort of different versions of people who are just okay not being with other people so here's my last quiz for you people with social disconnection from the general community have reduced social processing right those abilities social queue detection mentalizing and reduce social motivation they have reduced social processing and normal social motivation they have the reverse of that normal social processing and reduced social motivation or they have normal both social processing and normal and and normal social motivation and the answer is I'm not telling you because because you have to pay attention for the next three minutes and then you'll get your answer so this is again the things that we found in two samples that I feel comfortable enough sharing with you even though we don't have huge samples are the people we recruit really socially disconnected yes they are we have a number of ways of measuring it and this gives you some sense this is a combination of social disconnection skills that occurs in the context of a lengthy interview and you can see that this sample this connected sample is much more shifted to the left this is our comparison sample they're not selected to be connected they're just not selected for any particular social quality so there you can think of them as unselected right there they're not selected to be to have a lot of friends they're just we just don't mention it in the ad but this is a pretty big difference do they have autistic 10 sieze rare only when out of the greater than 50 was in the autism spectrum we were surprised we thought we would get more individuals in autistic spectrum were they lonely only about a third so you know some loneliness but not the majority did they have impairments and social ability we've given a bunch of tests social queue perception including face emotion and mentalizing empathic abilities emotion regulation they're completely normal across two studies they're completely normal they have no apparent deficits in these social processing abilities surprise number two did they have impairment in social motivation yes most definitely here you can see the approach motivation and they're shifted significantly to the left they're just less willing to approach and this is across a number of items that they're just not as willing to engage in terms of avoidance are they more willing to avoid the answer is not really there it's about you know it's not significantly different it's not that impressive but in terms of reduction in approach it's definitely there so now we have a pattern in which there is in fact a big difference in motivation even though there's not a big difference in terms of the abilities did they use online social networking much less than our comparison group so this is sort of across different ways of assessing it they're just not that engaged whether online or in person were they in the schizophrenia spectrum now we're back to the spectrum the answer is many of them were and this is really stunning there's two lines of evidence to indicate that we have tendencies in the siffredi spectrum in our disconnected sample one is that we have high rates of personality disorders that are considered to be in the spectrum disorder schizotypal paranoid these are about one in three of the participants met diagnostic criteria for a person ID disorder in the spectrum in addition you can give a person now DS scale and there's two personality factors that are linked to the schizophrenia spectrum and both are inflated in our disconnected sample now one of them is detachment and that's nice but not terribly informative because they were selected to be disconnected so in some ways an elevation and detachment means that it kind of confirms our recruitment but we also had an elevation and psychoticism these are like below level symptoms of unusual perceptual beliefs unusual our usual perceptions illusions unusual beliefs unusual behaviors we didn't select for that but we got it anyway so think how this played out which is we left schizophrenia to go into the general community to see if we could understand social disconnection in the community but now we're finding schizophrenia spectrum evidence in the general community I mean if this were a novel this would be irony but it's not a novel so we just sort of say gee that's a big surprise so this is sort of where we are now which is we're taking these data as trying to understand the patterns we're also in the process of collecting EEG and fMRI data so we have quite a ways to go in this study we'll have more evidence about the about the brain basis for these but at this point and this is my last slide let me zoom out for a second because I want to talk about the process we started out with a really big problem I mean we were interested in skits I mean if you're going to spend years on something it might as well be a big problem we spent we we focused on schizophrenia because of the social disability the social disconnection and how that's a large part of social disability worldwide for both men and women we learned from colleagues who study normal individuals or normal brains that's not our skill set we work with people like here in the Department of Psychology who understand normal brains so that we can find relevant networks we take those insights and then use them to understand what and send a disease that's our focus we want to understand what's going on in schizophrenia as clinical researchers that's our focused but then we can loop back and take those insights and use them to understand another really big problem in this case it's a public health problem in this case it's social disconnection in the general population I want to acknowledge the work represented here this is our team also with the second generation next generation represented bill who ran Jung Healy and Jonathan Wynn contributed a lot of studies amanda McCleary and Felice Reddy also contributed to this presentation I want to acknowledge my real family my my perfet my professional family and all of the friends and colleagues who came here today thank you very much very nice presentation I'm just curious if if you could might discuss how depression it's in with the social disconnection problem in the general public are they correlated with each other so what on we don't have a great answer for you right now depression most definitely is part of loneliness and loneliness and the cousin center here is one of the outstanding places of study this loneliness has its own public health risk associated with it so it's like being objectively disconnected or subjectively disconnected with loneliness both are have poor health indicators but that's we think depressions more aligned with the lonely component whereas these spectrum schizophrenia spectrum more with the disconnection but we don't have a firm handle on that and we know that as several of our disconnected people have a history of depression although they don't have it at the time and and it's not nearly as common as those spectrum personality disorders that we find it's an excellent question that we're just beginning to get our wrap our arms around can schizophrenia be inherited I love to know who I'm talking to oh okay theory okay okay so so this like many complex disorders has a genetic risk factor associated with it but it's not deterministic it puts one at risk and so there's a lot of work now in identifying those particular risk chains you showed I think the answer to your last quiz you never gave us the answer not explicitly the answer was the abilities are intact but the social motivation is missing in their social disconnection group that differs from the schizophrenia group and that both of those except I read normal what do we know so far about when so that implies that you don't develop schizophrenia unless you also develop the social cognitive ability problems what do we know so far about when those social cognitive abilities start going down yeah so that was Keith nectar line asking as usual a perceptive question you would think that after you know 30 years of talking with him we would have liked work these things out [Laughter] so but the point is a very good one and I didn't actually close the loop as well as I could have which is that there is a contrast in which we were sort of down on abilities and motivation in the clinical condition but we're only down on motivation in this community and when do things start is depends on the social processing domain so for example junkies study of this kind of focus on social versus non social reward that starts in infancy or it should start in infancy that sort of gut connection that should start an infancy mentalizing much later and and so it's it's interesting then that we do have this kind of in tact process for this experience sharing which should start early but we don't seem to have in tact at the at the brain level not at the performance level but at the brain level with something else that should have started earlier so the answer is it's not falling neatly it's not falling neatly into sort of early versus late developing thank you for your questions on behalf of the Academic Senate it is indeed my pleasure to express gratitude to all who made this lecture possible professor green thank you for providing such an extraordinary and stimulating lecture thank you to the special events office and faculty who serve on the faculty research lectureship selection committee without your work this event would not be possible it's been a pleasure being with you this afternoon I now invite everyone to join us at the reception taking place in schanberg Terrace immediately after the lecture thank you and have a good evening [Applause] [Music] you video copies of this program are available for purchase from the UCLA instructional media library call toll-free 1-800

Channel: University of California Television (UCTV)

Views: 284,487

Keywords: schizophrenia, neuroscience, human brain

Id: U4DwtiTSkwA

Length: 57min 30sec (3450 seconds)

Published: Tue Jan 02 2018

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Michael Green, neuroscientist and professor of psychiatry and biobehavioral sciences at UCLA, has been fascinated with the human brain, behavior and mental illness since his undergraduate days. In particular, his research focuses on schizophrenia, a chronic brain disorder that affects about 1 percent of the population. In this UCLA Faculty Research Lecture, he describes how his lab uses discoveries in psychology and social neuroscience about normal brain functioning to inform his schizophrenia research. And now, Green and his colleagues are moving into new territory, studying the causes of social isolation among people who do not have schizophrenia. You’ll learn about the tools they use such as functional MRI, that measures and maps brain activity, and EEG, that detects electrical activity in the brain, and how they do research to answer questions about social isolation in the general public. Recorded on 11.06.2017. Series: "UCLA Faculty Research Lectures" [1/2018] [Show ID: 32573]