Pinkham, Amy E.

Permanent URI for this collectionhttps://hdl.handle.net/10735.1/5618

Amy Pinkham is a Professor and Director of the Schizophrenia and Social Cognition Lab. Dr. Pinkham's research "uses functional neuroimaging (fMRI) and behavioral techniques to examine how the human brain processes social information, how these neural systems may be disturbed in schizophrenia and related disorders, and the behavioral consequences of these impairments."

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    Implicit and Explicit Bodily Emotions and Social Functioning in Schizophrenia
    (Elsevier Science BV, 2019-02-12) Hajduk, M.; Klein, Hans S.; Springfield, Cassi R.; Bass, E.; Pinkham, Amy E.; Klein, Hans S.; Springfield, Cassi R.; Bass, E.; Pinkham, Amy E.
    No abstract available. From the text: "The aim of the present study is to analyze whether explicit and implicit recognition of bodily emotions predicts interpersonal functioning in patients with schizophrenia. The secondary aim was to analyze whether these relationships are present using self - report and objective measures of social functioning."
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    Autism Symptoms, Depression, and Active Social Avoidance in Schizophrenia: Association with Self-Reports and Informant Assessments of Everyday Functioning
    (Elsevier Ltd, 2019-05-09) Harvey, P. D.; Deckler, E.; Jones, M. T.; Jarskog, L. F.; Penn, D. L.; Pinkham, Amy E.
    Autistic traits are a feature of schizophrenia and has been found to impair social functioning and social cognition. Other influences on social outcomes in schizophrenia include depression and social avoidance. However, challenges in self-assessment of abilities and functioning (i.e., introspective accuracy)and self-assessment bias also contribute to disability. Depression has been studied for its association with introspective accuracy and bias, but autistic traits have not. Participants were 177 patients with schizophrenia who self-reported their everyday functioning and social cognitive ability as well as their depression. All were rated with the PANSS and a separate rater generated all-sources ratings of everyday functioning and social cognitive ability. Correlations between self-reported everyday functioning and social cognitive ability, ratings of everyday functioning and social cognitive ability, and the discrepancies between those ratings were examined for correlations with depression, autistic features and social avoidance. Accuracy was defined by the absolute value of the difference between self-reports and all-sources ratings and bias was defined by the direction of discrepancy (positive vs. negative). There was a statistically significant difference between sources on every measure. Bias was not directional on average, but patients with the lowest levels of depression overestimated their abilities on every measure and those with the highest depression underestimated. Autistic traits were associated with impairments in everyday functioning and underestimation of those impairments, while social avoidance was associated with impaired social functioning and accurate self-assessment. Features of schizophrenia have differential implications for impaired functioning and self-assessment, with autistic features and low levels of depression associated with consistent self-assessment biases. ©2019 Elsevier Ltd
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    Social Cognition Psychometric Evaluation: Results of the Final Validation Study
    (Oxford University Press on behalf of the Maryland Psychiatric Research Center. All Rights Reserved.) Pinkham, Amy E.; Harvey, Philip D.; Penn, David L.; Pinkham, Amy E.
    Social cognition is increasingly recognized as an important treatment target in schizophrenia; however, the dearth of well- validated measures that are suitable for use in clinical trials remains a significant limitation. The Social Cognition Psychometric Evaluation (SCOPE) study addresses this need by systematically evaluating the psychometric properties of promising measures. In this final phase of SCOPE, eight new or modified tasks were evaluated. Stable outpatients with schizophrenia (n = 218) and healthy controls (n = 154) completed the battery at baseline and 2-4 weeks later across three sites. Tasks included the Bell Lysaker Emotion Recognition Task (BLERT), Penn Emotion Recognition Task (ER-40), Reading the Mind in the Eyes Task (Eyes), The Awareness of Social Inferences Test (TASIT), Hinting Task, Mini Profile of Nonverbal Sensitivity (MiniPONS), Social Attribution Task-Multiple Choice (SAT-MC), and Intentionality Bias Task (IBT). BLERT and ER-40 modifications incl uded response time and confidence ratings. The Eyes task was modified to include definitions of terms and TASIT to include response time. Hinting was scored with more stringent criteria. MiniPONS, SAT-MC, and IBT were new to this phase. Tasks were evaluated on (1) test-retest reliability, (2) utility as a repeated measure, (3) relationship to functional outcome, (4) practicality and tolerability, (5) sensitivity to group differences, and (6) internal consistency. Hinting, BLERT, and ER-40 showed the strongest psychometric properties and are recommended for use in clinical trials. Eyes, TASIT, and IBT showed somewhat weaker psychometric properties and require further study. MiniPONS and SAT-MC showed poorer psychometric properties that suggest caution for their use in clinical trials.
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    Increased Social Cognitive Bias in Subclinical Paranoia
    (Elsevier Inc.) Klein, Hans S.; Kelsven, S.; Pinkham, Amy E.; 0000 0003 5220 0111 (Pinkham, AE); Klein, Hans S.; Pinkham, Amy E.
    This article has no abstract. Following is the first paragraph: "Recent initiatives have shifted the emphasis from studying pathological illnesses as separate diagnostic entities to examining specific symptoms on a continuum from healthy, to subclinical, to clinical levels (i.e. RDoC, Clark et al., 2017). One of these symptoms, paranoia, has been extensively reported in severe mental illnesses such as schizophrenia, but has also been reported to exist at elevated levels in approximately 10–15% of individuals in general population (Freeman, 2007). Higher levels of subclinical paranoia have been associated with greater social anxiety (Tone et al., 2011), as well as greater depression, self-consciousness, and lower self-esteem (Combs and Penn, 2004). Individuals higher in subclinical paranoia also show measurable deficits as compared to those low in subclinical paranoia, most notably socially relevant domains including emotion perception (Combs et al., 2013) and occupational and social functioning (Rössler et al., 2007)." ©2018 The Authors.
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    Paranoid Individual with Schizophrenia Show Greater Social Cognitive Bias and Worse Social Functioning than Non-Paranoid Individuals with Schizophrenia
    (Elsevier Inc.) Pinkham, Amy E.; Harvey, P. D.; Penn, D. L.; 0000 0003 5220 0111 (Pinkham, AE); Pinkham, Amy E.
    Paranoia is a common symptom of schizophrenia that may be related to how individuals process and respond to social stimuli. Previous investigations support a link between increased paranoia and greater social cognitive impairments, but these studies have been limited to single domains of social cognition, and no studies have examined how paranoia may influence functional outcome. Data from 147 individuals with schizophrenia were used to examine whether actively paranoid and non-paranoid individuals with schizophrenia differ in social cognition and functional outcomes. On measures assessing social cognitive bias, paranoid individuals endorsed more hostile and blaming attributions and identified more faces as untrustworthy; however, paranoid and non-paranoid individuals did not differ on emotion recognition and theory of mind tasks assessing social cognitive ability. Likewise, paranoid individuals showed greater impairments in real-world interpersonal relationships and social acceptability as compared to non-paranoid patients, but these differences did not extend to performance based tasks assessing functional capacity and social competence. These findings isolate specific social cognitive disparities between paranoid and non-paranoid subgroups and suggest that paranoia may exacerbate the social dysfunction that is commonly experienced by individuals with schizophrenia. © 2016 The Authors.
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    Which Levels of Cognitive Impairments and Negative Symptoms Are Related to Functional Deficits in Schizophrenia?
    (Elsevier Ltd) Strassnig, M.; Bowie, C.; Pinkham, Amy E.; Penn, D.; Twamley, E. W.; Patterson, T. L.; Harvey, P. D.; Pinkham, Amy E.
    Background: Negative symptoms and cognitive impairments predict difficulties in aspects of everyday functioning in schizophrenia, with little research to date attempting to determine if there are threshold levels of impairment required to predict the severity of functional deficits. Methods: People diagnosed with chronic schizophrenia (n = 821) were assessed with the MCCB and PANSS, and rated by high contact informants with SLOF. Negative symptoms of reduced emotional experience were specifically targeted for analysis because of their previously identified relationships with social outcomes. We identified patients with moderate negative symptoms (at least one PANSS item ≥4) versus less severe symptoms (PANSS items ≤3) and divided patients on the basis of a single latent-trait global cognition score (neuropsychologically normal vs neuropsychologically impaired; performance at or below 1.0 SD from the normative population mean, T = 40), then examined correlations between cognition, negative symptoms and everyday functioning in the groups with lower and higher negative symptoms and those with/without cognitive impairment. Results: Even low levels of negative symptoms were correlated with ratings of social functioning. Cognitive performance in the neuropsychologically normal range, in contrast, was not correlated with any aspects of everyday functioning while more impaired performance predicted greater functional impairments. Conclusions: Even minimal symptoms may be a target for clinical attention in the domains of negative symptoms, consistent with previous findings regarding social deficits in populations with modest negative symptoms (e.g., schizotypal personality disorder). Cognitive rehabilitation treatments might not improve social functioning if even low levels of negative symptoms (social amotivation) are present. ©2018 Elsevier Ltd
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    Increased Social Cognitive Bias in Subclinical Paranoia
    Klein, Hans S.; Kelsven, Skylar; Pinkham, Amy E.; 0000 0003 5220 0111 (Pinkham, AE); Klein, Hans S.; Pinkham, Amy E.
    Background: Recent analyses from the SCOPE study have revealed significant relationships between measures of social cognitive biases and specific symptoms, such as paranoia, in individuals with schizophrenia (Buck et al, 2016; Pinkham et al. 2016). Although prior research in subclinical populations report that those with high levels of paranoia exhibit deficits in social cognition and social functioning (Combs & Penn 2004, Combs et al 2013), we seek to expand this literature by examining the relationship between paranoia, social cognitive biases, and social functioning to determine whether the same symptom-specific deficits can be seen in a nonclinical population. Methods: Utilizing measures of social cognition identified by a RAND panel in Pinkham et al (2014), undergraduate participants were tested on emotion recognition, Theory of Mind, social perception, and attributional style as well as state paranoia, clinical measures associated with paranoia, and self-assessments of social functioning. Results: Using bivariate correlations, we examined the relationship between subclinical paranoia, social cognition, and social functioning. Self-ratings of subclinical paranoia were validated via significant correlations with clinical measures, supporting the notion that these individuals fall along the paranoia continuum. Moderate correlations were seen between paranoia ratings and AIHQ hostility bias (r = .367), aggression bias (r = .442), and blame score (r = .344), all Ps < .001. Additionally, small correlations were observed between paranoia and emotion perception (ER40; r = −.198, P = .028), Theory of Mind (TASIT; r = −.208, P = .021), and assessments of trustworthiness (P = −.182, P = .044). Paranoia was significantly correlated with social withdrawal (r = −.363, P < .001). Conclusion: This study reveals positive links between increased paranoia and social cognitive bias and demonstrates that paranoia exerts a similar effect on social cognition and social functioning across a continuum spanning from healthy to pathological. Further examination of these deficits in both clinical and subclinical populations will provide information on the mechanisms underlying paranoia.
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    Social Cognitive Impairments in Individuals with Schizophrenia Vary in Severity
    (Elsevier Ltd) Hajdúk, M.; Harvey, P. D.; Penn, D. L.; Pinkham, Amy E.; Pinkham, Amy E.
    Social cognitive deficits are a hallmark feature of schizophrenia and have been confirmed by several meta-analyses; however, the uniformity of these impairments across individuals remains unknown. The present study evaluated the heterogeneity of social cognitive impairment. A secondary aim was to identify a subset of measures to quickly identify those individuals who are most in need of remediation. Two independent samples of people with schizophrenia (n = 176; n = 178) and their respective healthy control groups (n = 104; n = 154) were selected from two phases of the Social Cognition Psychometric Evaluation (SCOPE) project, which assessed multiple domains of social cognition. Latent profile analysis was utilized to identify sub-clusters of performance within each patient sample. Receiver operator curve and discriminant analysis were implemented to identify tasks suitable as screening tools. Three clusters were identified in each sample that differed primarily in severity of impairment. The first showed no social cognitive impairment (∼25% of patients). The second consisted of patients with mild impairment (∼40% of each sample), and the third showed severe SC impairment (∼32%). Patients in the severe cluster were older, less educated, more neurocognitively impaired, and lower functioning. Using the Bell Lysaker Emotion Recognition Task (BLERT) for screening provided sensitivity of 80.15% and specificity 89.13%. Combining BLERT with the Reading the Mind in the Eyes task yielded sensitivity of 91.60% and specificity 75.00% for identifying impaired individuals. These results illustrate the existence of distinct degrees of social cognitive impairment in schizophrenia and indicate that remediation efforts may not be necessary for all individuals.
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    Brief Report: Adults with Autism Are Less Accurate at Predicting How Their Personality Traits Are Evaluated by Unfamiliar Observers
    Sasson, Noah J.; Morrison, Kerrianne E.; Pinkham, Amy E.; Faso, Daniel J.; Chmielewski, Michael; Sasson, Noah J.; Morrison, Kerrianne E.; Pinkham, Amy E.; Faso, Daniel J.
    Social cognitive impairments in autism spectrum disorder (ASD) are well-documented, yet little research has examined whether ASD is also characterized by difficulties in meta-perception, or the ability to gauge how one is perceived. In this study, ASD and TD adults (N=22) largely did not differ on the self-perception of their personality traits or on how they expected to be perceived by unfamiliar observers. However adults with ASD were rated less favorably by TD observers (N=412) on 19 out of 20 personality items, and adults with ASD were less accurate at predicting how they would be perceived. These findings suggest impaired meta-perception in ASD that may serve as a potential mechanism through which reduced social cognitive ability contributes to social impairment.

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