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Perceiving social salience


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Presentation made by Dr. Ralph Hoffman at the May 28, 2014 Live Webinar hosted by the Schizophrenia Forum -

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Perceiving social salience

  1. 1. Perceiving social salience: a research domain linking normal and pathological hallucination Ralph Hoffman MD Department of Psychiatry Yale University School of Med 28 May 2014
  2. 2. AVHs in Sz achieve high “social salience” • Acoustic “voiceprint” connotes specific speakers; • particular sounding voices have distinctive characteristics – “their own personality…” • attributed to specific persons/agents, angels, God, the dead, or the devil, often given names; • typically patient has conversations with voices…
  3. 3. Normal AHs prompted by ↑ social salience • Erroneously hearing one’s name in public (57% college students; Posey and Losch 1983); • vibration and pager tone hallucinations – 80-90% of medical interns, not correlated with anxiety or depression (Lin et al. 2013). • Bereavement hallucinations, typically AVHs; fills in for lost loved one
  4. 4. Social withdrawal precedes and is possible risk factor for AVHs • 87% of first-episode patients w/SZ reported prior social withdrawal vs 3% for non-psychotic patients (Tan 2001); • 71% of SZ pts with AVHs report significant drop-off in social involvement 1-6 month before first onset • Move to new city, new school, solo travel in Europe or across the US, peace corp duty, dissertation takes over…
  5. 5. • Phantom limb following amputation • Charles Bonnet Syndrome Sensory deafferentation: hallucinations due to network reorganization filling in for absent percepts
  6. 6. What about “social deafferentation?” • Brain is dedicated to social meaning; • high levels of plasticity in “social brain” regions • What happens when brain deprived of social experience?? • Could AVHs with high social salience “fill in” for absent social connection
  7. 7. Suggestive evidence • Baseline active social avoidance (ASA) during the prodrome correlated with hallucinations (PRIME study, unpublished) • at baseline, correlation = 0.18; • at 1 year, correlation = 0.54. • Prisoners in solitary confinement: 36% had auditory/verbal hallucinations (Grassian Am J Psychiatry 1983); mean age 28, 11 days to 10 months SC • What other factors besides social disconnection might come into play???
  8. 8. Greater dendritic length in amygdala neurons in socially isolated rats (Wang et al. 2011)
  9. 9. New-born hippocampal neurons after knockdown of DISC-1 gene expression Duan et al. Cell, 2007 oncoretrovirus- mediated RNA interference