Research

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8 pages, 505 KiB

Open AccessArticle

Exercise Predicts a Good Night’s Sleep: Preliminary Findings from a UCLA Study of First-Episode Schizophrenia

by Kenneth L. Subotnik, Sarah C. McEwen, Joseph Ventura, Luana Rene Turner, Yurika Sturdevant, Trudy L. Niess, Laurie R. Casaus, Margaret G. Distler, Michael F. Zito, Gerhard S. Hellemann, Clara D. Nguyen and Keith H. Nuechterlein

Behav. Sci. 2023, 13(2), 88; https://0-doi-org.brum.beds.ac.uk/10.3390/bs13020088 - 21 Jan 2023

Viewed by 2058

Abstract

Background: Physical exercise can improve sleep quality in the general population. Understanding the negative impact of poor sleep quality on multiple domains of functioning among persons with schizophrenia is a new frontier of exploration. It is also imperative to investigate non-pharmacologic methods to [...] Read more.

Background: Physical exercise can improve sleep quality in the general population. Understanding the negative impact of poor sleep quality on multiple domains of functioning among persons with schizophrenia is a new frontier of exploration. It is also imperative to investigate non-pharmacologic methods to improve sleep quality as these approaches may not carry the side effect burdens associated with medication. Objective: We examined the relationship between regular physical exercise and sleep quality among participants in an intervention consisting of both cognitive training and exercise. Methods: Participants (N = 48) were schizophrenia patients who had a first psychotic episode within two years of study entry. Participants received 4 h/week of internet-based cognitive training and an aerobic exercise program over a 6-month period. Sleep was assessed with the Pittsburgh Sleep Quality Index at baseline and six months later. Results: During the 3 months prior to the 6-month follow-up sleep assessment, participants completed an average of 12.6 group exercise sessions and an average of 12.9 individual at-home exercise sessions. A significant relationship between the number of exercise sessions and global sleep quality was seen at month six, r = −0.44, df = 39, p < 0.01. Group exercise frequency was also associated with improvement in global sleep quality over the six-month intervention, t(34) = −2.84, p = 0.008. Conclusion: We demonstrated that a group of young adults with schizophrenia can be engaged in a regular exercise program, even during the tumultuous early course of the disorder. The number of exercise sessions in which they participated was associated with better sleep quality at six months and pre–postintervention improvement in sleep quality. Key message: Improved sleep quality appears to be a benefit of regular exercise among individuals with serious mental illness. Full article

(This article belongs to the Special Issue Health Behaviors and Outcomes across the Schizophrenia-Spectrum)

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11 pages, 844 KiB

Open AccessArticle

Talking about Health: A Topic Analysis of Narratives from Individuals with Schizophrenia and Other Serious Mental Illnesses

by Tovah Cowan, Zachary B. Rodriguez, Ole Edvard Granrud, Michael D. Masucci, Nancy M. Docherty and Alex S. Cohen

Behav. Sci. 2022, 12(8), 286; https://0-doi-org.brum.beds.ac.uk/10.3390/bs12080286 - 13 Aug 2022

Cited by 1 | Viewed by 1877

Abstract

Individuals with schizophrenia have higher mortality and shorter lifespans. There are a multitude of factors which create these conditions, but one aspect is worse physical health, particularly cardiovascular and metabolic health. Many interventions to improve the health of individuals with schizophrenia have been [...] Read more.

Individuals with schizophrenia have higher mortality and shorter lifespans. There are a multitude of factors which create these conditions, but one aspect is worse physical health, particularly cardiovascular and metabolic health. Many interventions to improve the health of individuals with schizophrenia have been created, but on the whole, there has been limited effectiveness in improving quality of life or lifespan. One potential new avenue for inquiry involves a more patient-centric perspective; understanding aspects of physical health most important, and potentially most amenable to change, for individuals based on their life narratives. This study used topic modeling, a type of Natural Language Processing (NLP) on unstructured speech samples from individuals (n = 366) with serious mental illness, primarily schizophrenia, in order to extract topics. Speech samples were drawn from three studies collected over a decade in two geographically distinct regions of the United States. Several health-related topics emerged, primarily centered around food, living situation, and lifestyle (e.g., routine, hobbies). The implications of these findings for how individuals with serious mental illness and schizophrenia think about their health, and what may be most effective for future health promotion policies and interventions, are discussed. Full article

(This article belongs to the Special Issue Health Behaviors and Outcomes across the Schizophrenia-Spectrum)

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19 pages, 1169 KiB

Open AccessArticle

Social Connectedness in Schizotypy: The Role of Cognitive and Affective Empathy

by Jessica Stinson, Rebecca Wolfe and Will Spaulding

Behav. Sci. 2022, 12(8), 253; https://0-doi-org.brum.beds.ac.uk/10.3390/bs12080253 - 26 Jul 2022

Cited by 6 | Viewed by 3072

Abstract

Social connectedness is increasingly understood to be a resilience factor that moderates vulnerability to poor physical and mental health. This study examines cognitive and affective processes that support normal socialization and social connectedness, and the impact of schizotypy, in well-functioning college students. In [...] Read more.

Social connectedness is increasingly understood to be a resilience factor that moderates vulnerability to poor physical and mental health. This study examines cognitive and affective processes that support normal socialization and social connectedness, and the impact of schizotypy, in well-functioning college students. In this study, a total of 824 college students completed a series of self-report questionnaires, and structural equation modeling was then employed to identify relationships between cognitive and affective empathy, alexithymia, distress tolerance, social connectedness, and schizotypy. Schizotypy is a trait-like condition, presumed to be genetic in origin, associated with the risk for schizophrenia. Like schizophrenia, schizotypy is thought to have three distinct dimensions or categories, termed positive, negative, and disorganized. Results indicate that the respective dimensions of schizotypy have different pathways to social connectedness, through both direct and indirect effects. Positive schizotypy exerts a counterintuitive positive influence on social connectedness, mediated by positive effects on cognitive empathy, but this is obscured by the high correlations between the schizotypal dimensions and the strong negative influences on empathy and social connectedness of the negative and disorganized dimensions, unless all those intercorrelations are taken into account. Overall, the pathways identified by structural equation modeling strongly support the role of empathy in mediating the impact of schizotypy on social connectedness. Implications for the etiology of social impairments in schizotypy, and for interventions to enhance social connectedness to improve quality of life and reduce health disparities in people at risk for severe mental illness, are discussed. Full article

(This article belongs to the Special Issue Health Behaviors and Outcomes across the Schizophrenia-Spectrum)

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26 pages, 686 KiB

Open AccessArticle

Domains of Vulnerability, Resilience, Health Habits, and Mental and Physical Health for Health Disparities Research

by Rebecca M. Wolfe, Katie Beck-Felts, Brianna Speakar and William D. Spaulding

Behav. Sci. 2022, 12(7), 240; https://0-doi-org.brum.beds.ac.uk/10.3390/bs12070240 - 18 Jul 2022

Cited by 1 | Viewed by 2361

Abstract

Health disparities associated with severe mental illness (SMI) have become a major public health concern. The disparities are not directly due to the SMI. They involve the same leading causes of premature death as in the general population. The causes of the disparities [...] Read more.

Health disparities associated with severe mental illness (SMI) have become a major public health concern. The disparities are not directly due to the SMI. They involve the same leading causes of premature death as in the general population. The causes of the disparities are therefore suspected to reflect differences in health-related behavior and resilience. As with other problems associated with SMI, studying non-clinical populations at risk for future onset provides important clues about pathways, from vulnerability to unhealthy behavior and compromised resilience, to poor health and reduced quality of life. The purpose of this study was to identify possible pathways in a sample of public university students. Four domains of biosystemic functioning with a priori relevance to SMI-related vulnerability and health disparities were identified. Measures reflecting various well-studied constructs within each domain were factor-analyzed to identify common sources of variance within the domains. Relationships between factors in adjacent domains were identified with linear multiple regression. The results reveal strong relationships between common factors across domains that are consistent with pathways from vulnerability to health disparities, to reduced quality of life. Although the results do not provide dispositive evidence of causal pathways, they serve as a guide for further, larger-scale, longitudinal studies to identify causal processes and the pathways they follow to health consequences. Full article

(This article belongs to the Special Issue Health Behaviors and Outcomes across the Schizophrenia-Spectrum)

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12 pages, 246 KiB

Open AccessEditor’s ChoiceArticle

A Longitudinal Examination of Real-World Sedentary Behavior in Adults with Schizophrenia-Spectrum Disorders in a Clinical Trial of Combined Oxytocin and Cognitive Behavioral Social Skills Training

by Julia Browne, Philip D. Harvey, Robert W. Buchanan, Deanna L. Kelly, Gregory P. Strauss, James M. Gold, Jason L. Holden and Eric Granholm

Behav. Sci. 2022, 12(3), 60; https://0-doi-org.brum.beds.ac.uk/10.3390/bs12030060 - 23 Feb 2022

Cited by 2 | Viewed by 2969

Abstract

Sedentary behavior contributes to a shortened life expectancy in individuals with schizophrenia-spectrum disorders (SSDs), highlighting the need for effective interventions to improve health. This study examined whether reduced ecological momentary assessment (EMA) measures of sedentary activities were observed in individuals with SSDs who [...] Read more.

Sedentary behavior contributes to a shortened life expectancy in individuals with schizophrenia-spectrum disorders (SSDs), highlighting the need for effective interventions to improve health. This study examined whether reduced ecological momentary assessment (EMA) measures of sedentary activities were observed in individuals with SSDs who participated in a 24-week randomized trial of cognitive behavioral social skills training (CBSST) and either intranasal oxytocin or placebo (NCT01752712). Participants (n = 57) were prompted with EMA surveys seven times per day for seven days during the baseline, 12-week, and 24-week timepoints to sample sedentary behavior ratings, positive and negative affect, interpersonal interactions, and interpersonal interaction appraisals. Results revealed that sedentary behavior and social interactions did not significantly change over the 24-week clinical trial; however, positive and negative affect and defeatist interaction appraisals improved with treatment, and oxytocin produced modest additional improvements in these EMA outcomes. Greater momentary positive affect was significantly associated with greater activity and greater frequency of interactions. Overall, CBSST was effective at improving functioning, momentary affect, and defeatist interaction appraisals, although it did not reduce sedentary behavior; therefore, targeting these factors is not sufficient to reduce sedentary behavior, and adjunct interventions are needed. Full article

(This article belongs to the Special Issue Health Behaviors and Outcomes across the Schizophrenia-Spectrum)

15 pages, 537 KiB

Open AccessArticle

Schizotypy, Lifestyle Behaviors, and Health Indicators in a Young Adult Sample

by Thomas J. Dinzeo and Uma Thayasivam

Behav. Sci. 2021, 11(12), 179; https://0-doi-org.brum.beds.ac.uk/10.3390/bs11120179 - 16 Dec 2021

Cited by 5 | Viewed by 2541

Abstract

Problematic lifestyle behaviors and high rates of physical illness are well documented in people with schizophrenia, contributing to premature mortality. Yet, there is a notable absence of research examining general lifestyle and health issues in participants at risk for psychosis. This form of [...] Read more.

Problematic lifestyle behaviors and high rates of physical illness are well documented in people with schizophrenia, contributing to premature mortality. Yet, there is a notable absence of research examining general lifestyle and health issues in participants at risk for psychosis. This form of research may help identify concerns that exist during prodromal periods related to future outcomes. Accordingly, the current study examined lifestyle and health in a nonclinical sample of 530 young adults with varying levels of schizotypy. Increasing symptom severity was associated with greater somatic symptoms and poorer sleep quality across positive, negative, and disorganized domains. Elevated negative and disorganized symptoms were associated with significantly reduced health-related quality of life, while evidence for reduced engagement in health behaviors was largely limited to those with elevated negative schizotypy. No relationships emerged between symptom presentation/severity and body mass index or substance use, although zero-order correlations suggested an association between disorganized schizotypy and nicotine use. The pattern of relationships in the current study was consistent with findings from the ultra-high risk and clinical literature suggesting that lifestyle and health concerns may exist on a continuum with psychosis. Future research should seek to clarify if these patterns are associated with long-term physical or mental health outcomes. Full article

(This article belongs to the Special Issue Health Behaviors and Outcomes across the Schizophrenia-Spectrum)

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Review

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25 pages, 891 KiB

Open AccessReview

Nutrition, Sleep, and Exercise as Healthy Behaviors in Schizotypy: A Scoping Review

by Keri Ka-Yee Wong and Adrian Raine

Behav. Sci. 2022, 12(11), 412; https://0-doi-org.brum.beds.ac.uk/10.3390/bs12110412 - 26 Oct 2022

Cited by 1 | Viewed by 1796

Abstract

This scoping review identifies the role of nutrition, sleep, and exercise as healthy behaviors in non-clinical individuals with schizotypy throughout the lifespan. Methods: We systematically reviewed the existing literature on these topics through databases including: PsycINFO, Scopus, APA PsycNet, ScienceDirect [...] Read more.

This scoping review identifies the role of nutrition, sleep, and exercise as healthy behaviors in non-clinical individuals with schizotypy throughout the lifespan. Methods: We systematically reviewed the existing literature on these topics through databases including: PsycINFO, Scopus, APA PsycNet, ScienceDirect, Wiley Online Library, and SpringerLink. Results: Of the 59 studies found, a total of 29 studies met the inclusion criteria on the review topic. Included studies reflect varying study designs (cross-sectional, multiple time-point, intervention, randomized-placebo controlled trials), assessment of schizotypy and associated healthy behaviors, focus on various samples and lifespan (e.g., undergraduates, adolescents, at-risk individuals), and stem from different countries. Conclusion: While a moderate number of studies address the role of nutrition, sleep, and physical exercise in relation to schizotypy, studies intersecting these topics are limited. Of the limited studies that do exist, the majority are correlational with the beginnings of causal support from intervention studies. As such, more research is needed on the topics of nutrition, sleep, and exercise in relation to schizotypy. Specifically, future research should focus on providing a more holistic understanding of schizotypal traits and its subtypes, and which specific or combination of behaviors may reduce levels of schizotypy. Full article

(This article belongs to the Special Issue Health Behaviors and Outcomes across the Schizophrenia-Spectrum)

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11 pages, 263 KiB

Open AccessReview

Smoking Cessation Apps for People with Schizophrenia: How Feasible Are m-Health Approaches?

by Chelsea Sawyer, Lamiece Hassan, Daniel Guinart, Luis Martinez Agulleiro and Joseph Firth

Behav. Sci. 2022, 12(8), 265; https://0-doi-org.brum.beds.ac.uk/10.3390/bs12080265 - 01 Aug 2022

Cited by 4 | Viewed by 2470

Abstract

Background: The large health disparities among those diagnosed with schizophrenia urgently need to be addressed. These disparities are partially caused by adverse health behaviours such as smoking. Smoking cessation apps vary in efficacy across various populations, and there are concerns regarding the accessibility [...] Read more.

Background: The large health disparities among those diagnosed with schizophrenia urgently need to be addressed. These disparities are partially caused by adverse health behaviours such as smoking. Smoking cessation apps vary in efficacy across various populations, and there are concerns regarding the accessibility and usability of apps for people with schizophrenia. Objective: This review identifies and examines the feasibility of using apps for smoking cessation in people with schizophrenia. Methods: A non-systematic narrative literature review of smoking cessation apps for individuals with schizophrenia was performed. Results: Eight studies were included in this review. Conclusion: Smoking cessation apps can be acceptable and feasible, but may need to be tailored to the needs of people with schizophrenia. Key messages: (1) Smoking cessation apps could be acceptable and feasible for use in people with schizophrenia; (2) Lack of motivation was perceived as the main potential barrier with regard to people with schizophrenia engaging with smoking cessation apps; (3) In order to improve motivation of people diagnosed with schizophrenia, apps could include games, rewards, and/or social support; (4) Smoking cessation apps with a simple interface seem to be beneficial for this population; (5) Apps may need to be tailored to consider this population’s mental health needs. Full article

(This article belongs to the Special Issue Health Behaviors and Outcomes across the Schizophrenia-Spectrum)

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