Neural Basis of Social Cognition Deficits

Trial statusRecruiting
Trial phaseNot applicable
Trial typeInterventional
Biological sexAll
Age12-18
SponsorLoma Linda University

About this trial

Difficulties in reciprocal social interaction are hallmark features of several neuropsychiatric disorders, most notably autism spectrum disorder (ASD) and schizophrenia spectrum disorder (SSD). While recent studies have demonstrated substantial overlap in genetic etiology between ASD and SSD, little is known about common versus unique neural mechanisms that may underlie these downstream social deficits that cross diagnostic boundaries. Thus, a comprehensive imaging study examining social deficits in youth with ASD and adolescent- onset SSD at the neurochemical, connectivity, as well as functional activation level will be crucial in furthering our understanding of these underlying neural mechanisms. Specifically, the current project aims to examine how targeted social skills interventions may impact the organization of large-scale functional brain networks implicated in social cognition in these disorders, leading to improved outcomes. Thirty adolescents with ASD and 30 adolescents with SSD will undergo the Program for the Education and Enrichment of Relational Skills (PEERS), which is a 16-week parent-assisted social skills intervention that aims to improve friendship quality and social skills in teens with social difficulties. All participants will receive pre- and post-treatment MRI scans including functional MRI and magnetic resonance spectroscopy to quantify neural changes resulting from the intervention. All participants will also receive behavioral and social cognition assessments pre- and post-intervention to quantify real- world gains in social behaviors resulting from the intervention. Additionally, 30 typically developing adolescents will be recruited to serve as control participants and undergo two MRI and behavioral assessment sessions 16-weeks apart with no intervention in between. Specific aims include (1) examining inter-group disruptions in connectivity patterns, activation levels, and neurometabolite concentrations in key social brain regions pre-treatment in ASD and SSD groups, (2) examining inter-group changes in connectivity patterns, activation levels, and neurometabolite concentrations in key social brain regions in response to treatment in ASD and SSD groups, and, (3) dimensionally identifying intra-group differences in brain responses and how they relate to real-world treatment outcomes.

Eligibility criteria

This trial does not accept healthy volunteers

Qualifiers

None

Disqualifiers

None

Trial design

Design model

Single group

Treatments tested in this trial

  • PEERS social skills intervention

    Behavioral

    The PEERS treatment program consists of 90-minute sessions, delivered once a week over the course of 16- weeks. Parents and children/adolescents attend separate concurrent sessions that instruct them on key elements about making and keeping friends. Among others, this parent-assisted, social skills intervention provides explicit instruction to target verbal and nonverbal communication skills, appropriate use of humor and resolving peer conflict, as well as expanding and developing friendship networks38. The candidate, Dr. Nair, has been trained on the PEERS social skills intervention extensively for the past five years, and is a certified provider for the adolescent program. The PEERS program will be provided by Dr. Nair's research team (consisting of Dr. Nair, lab co-ordinators, and clinical psychology doctoral students) through the LLU Department of Psychology.

Treatment groups

90 Participants
are divided into 2 treatment groups
Group A: Control armNo intervention 0 interventions
Group B: Patient armExperimental treatment 1 intervention

Trial outcomes

Primary outcomes

1

The Awareness of Social Inference Test (TASIT)

This is a Theory of Mind (ToM) measure containing 16 videotaped scenes. After each scene, subjects respond to questions about the characters' intentions, beliefs about the situation, and emotional state.

Time frame
Change between baseline and final visit at week 16
2

The Social Attribution Task - Multiple Choice (SAT-MC, SAT-MC-II)

his test uses a 64- second video of geometric shapes set in motion to portray themes of social relatedness and intentions. Considered a test of "Theory of Mind," the SAT-MC and its alternative form SAT-MC-II assesses implicit social attribution formation while reducing verbal and basic cognitive demands.

Time frame
Change between baseline and final visit at week 16
3

The computerized Penn Emotion Identification Task (PennCNB)

The PennCNB Emotion Identification Test (EMI) measures the ability to correctly identify facial expressions of emotion. Participants are shown 40 faces one at a time on the computer, and must identify the emotion expressed by the actors face from multiple choice options provided.

Time frame
Change between baseline and final visit at week 16

Secondary outcomes

1

Functional MRI

rs-fcMRI indices within social brain networks will look more improved (similar to TD adolescents) post-treatment compared to pre-treatment for the both ASD and SSD groups (e.g., greater connectivity in social brain networks in ASD group, lower connectivity of extraneous regions in SSD group). Rate of connectivity ranges from -3 low to +3 high connectivity.

Time frame
Change between baseline and final visit at week 16

Other outcomes

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