Decrease social interactions

Mental illnesses as disorders of social interaction

Research Report 2015 - Max Planck Institute for Psychiatry

Max Planck Institute for Psychiatry, Munich
Mental illness can affect the ability to interact successfully and satisfactorily with other people. The brain mechanisms of social interaction and those of cross-disease social impairments can only now be investigated due to methodological developments in imaging. In the future, this interaction-based, functional brain imaging, which scientists at the MPI for Psychiatry use, could help in the selection and improvement of therapies for mental illnesses.

Social interaction and mental health

A wide variety of mental illnesses influence the ability to come into contact with other people. Conversely, difficulties in interpersonal contact can also lead to mental illnesses [1]. Problems in social relationships can include: B. arise when people cannot correctly interpret the gestures and facial expressions of other people and this leads to misunderstandings. Other people, on the other hand, react very strongly to such non-verbal signals and find them so uncomfortable that they get excited and / or withdraw. For some people, on the other hand, “small talk” is a particular problem and still others think they notice that they have no influence on other people and that social interactions are therefore unsatisfactory. In addition, disorders of social interaction can also be due to the fact that people with mental illness are unable to follow the implicit conventions and rules of social interaction that normally exist, which in turn leads to negative reactions on the part of those who are not ill and further exacerbates symptoms can lead.

On the other hand, there are indications that the success of social interaction and relationships depends largely on the similarities of the interaction partners, which can be personality variables as well as the presence of psychiatric diagnoses [2]. In other words: Even in the case of a social interaction disorder, such as autism, social interaction can also work well, namely when there are two people with autism. Social contacts can thus - depending on the individual fit - represent both a significant stress factor and a protective factor. Against the background of increasing prevalence figures for mental illnesses and a global increase in urban living conditions with a growing number of social contacts, this dimension of mental illness is gaining more importance in an explosive manner.

The team of the independent research group "Social Neuroscience" at the MPI for Psychiatry assumes that neuroscientific investigations into the mechanisms of social interaction make an important contribution to the reconstruction of mental illnesses as disorders of social interaction and to their neurobiological basis. Such a bridge between psychiatric and neuroscientific aspects appears against the background of the brain as interface or "relationship organ" to influence internal and external factors is particularly desirable [3].

Neuroscience of you

Neuroscientists have been studying the neural mechanisms of social processes since the 1990s [4]. In this area of ​​“social” neuroscience, functional brain imaging techniques, such as functional magnetic resonance imaging (fMRI), have made significant contributions to characterizing the underlying brain processes of social perception and cognition. Two brain networks in particular seem to be relevant here: on the one hand the so-called “mirror neuron system” and on the other hand the so-called “mentalization network”. These are brain networks that z. B. be activated when people observe the actions of others (or imitate comparable actions) or when people think about the mental states of others. In other words: the neural correlates of social perception from the “observer's perspective” are quite well characterized. What is much less well understood, however, is what influence participation in social interaction - that is, social perception from the "participant's perspective", which is probably much more important in everyday life - has on activity in the two networks [5]. The relationship between social perception from the “observer perspective” and the “participant perspective” and the respective underlying brain processes has not yet been well investigated [6].

These limitations in the field of social neuroscience are explained, among other things, by methodological limitations: For example, the examination situation in the context of imaging studies using functional magnetic resonance imaging (fMRI) is severely limited: it usually only allows the examination of a person who is as motionless as possible in the magnetic resonance imaging scanner. A “second-person neuroscience” [5], in turn, suggests further developing social neurosciences in such a way that they can actually contribute to the investigation of the neural mechanisms of social interaction. It aims to study the brain processes of a person who is interacting (as opposed to a person who is just observing other people). From a neuroscientific point of view, a declared aim of this approach is to find out how participation in social interaction modulates brain network activities, what role the course and the experiences made in the context of social interaction have on network processes and how they change them. In other words, the aim of a “neuroscience of the you” is to investigate the neurobiological anchoring of psychosocial experiences in the context of social interaction.

One approach pursued by the independent Max Planck research group is to create interactive real-time tasks so that the influence of the reciprocity of social interaction on a person's brain processes can be examined: For this purpose, the eye movements of a test participant can be examined in the magnetic resonance tomograph evaluated in real time and used so that a computer-generated agent, which is shown to the test participant on a screen, "reacts" to the test participant in real time (Fig. 1A). This is how the face reacts on the presentation screen e.g. B. whether it is viewed by the subject or not and whether the subject is looking at other objects on the screen. This experimental set-up can be used, for example, to examine the brain processes of “mutual attention”. This means that the question can be asked whether it makes a difference at the brain level whether one looks at objects “alone” or “together” with another person. Interestingly, the scientists were able to show that the joint viewing of objects leads to activation of brain regions of the "mentalization network", although conscious thinking about the mental states of the other in the task was not necessary (Fig. 1B, [7]). In addition, it was shown that the initiation of mutual attention - i.e. when the test person succeeded in directing the other's gaze to an object - activated the brain's reward system (Fig. 1C), which in turn was related to the subjective experience of the situation as being particularly pleasant. There were no comparable effects when the other looked at the subject.

These and other studies indicate that taking into account the reciprocity of social interaction, which characterizes interaction processes in everyday life, enables new insights in the field of neuroscience. It also contributes to the characterization of the brain networks and mechanisms that are relevant for social perception and cognition from the “participant's perspective”. This further development of neural science could also be particularly helpful, argue Schilbach and colleagues, when it comes to fully exploiting this area for research into the neurobiological foundations of mental illnesses. This is due to the fact that a wide variety of mental illnesses are associated with social impairments. These impairments in turn affect the social perception from the “participant's perspective” rather than the social perception from the “observer's perspective, which is often relatively intact [1].

Mental illnesses as disorders of social interaction using the example of addiction disorders

Dependency disorders are not typically described as disorders of social interaction. Nonetheless, the neglect of social (and other) interests in favor of substance use is an important criterion for diagnosing a disorder caused by psychotropic substances, i.e. substances that affect the human psyche. In the case of cocaine abuse and addiction, it is a group of people who have hardly any impairment in non-interactive tests of social cognition. On the other hand, from a clinical perspective, patients with cocaine addiction show a significantly reduced motivation for social contacts, which is also reflected in the size of their social networks, and a strongly self-centered behavior.

With regard to the conceivable underlying neurofunctional changes caused by the influence of cocaine, changes in the “reward system” of the brain have been postulated. Specifically, it was assumed that cocaine consumption leads to the reward system becoming less responsive to other (e.g. social) reward stimuli. In order to investigate this empirically, the interaction-based fMRI experiment described above was used for “mutual attention” [8]. It was shown that cocaine users in the context of social interaction actually show reduced activation in the area of ​​the "reward system" and that there is a connection between the reduced responsiveness of the "reward system" and the reduced size of the social network (Fig. 2C). The latter is all the more important because therapeutic interventions aim to support patients in their real environment.

Summary and Outlook

Mental illness affects the ability to interact with other people and to participate in social networks. Conversely, difficulties in interpersonal contact can also lead to mental illnesses. The understanding of mental illnesses can thus be significantly enriched by taking into account aspects of social perception and, in particular, social interaction.

This reconstruction of mental illnesses as disorders of social interaction also opens up new perspectives for so-called “social” neuroscience: Here it seems desirable that limitations are overcome in order to research the neural mechanisms of participation in social interaction in real time and under everyday conditions . In addition to the increase in basic scientific knowledge, these further development steps in the field of neuroscience could be helpful so that this research area can fully exploit its potential for research into the neurobiological basis of mental illness.

For example, interaction-based, functional brain imaging could help investigate disorder-associated changes in brain activity in people with mental illnesses that are related to the ability and motivation to actually participate in social interactions. In the future, this interaction-based functional brain imaging, which scientists at the MPI for Psychiatry use, could help in the selection and improvement of therapies for mental illnesses.

Bibliography

Toward a second-person neuropsychiatry
Philosophical Transactions of the Royal Society B. 371 (1686) pii: 20150081. doi: 10.1098 / rstb.2015.0081 (2016)
Nordstetten, A. E .; Larsson, H .; Crowley, J. J .; Alqvist, C .; Lichtenstein, P .; Mataix-Cols, D.
Patterns of Nonrandom Mating Within and Across 11 Major Psychiatric Disorders
JAMA Psychiatry. 2016 Feb 24. doi: 10.1001 / jamapsychiatry.2015.3192 [Epub ahead of print]
The brain - a relational organ. A phenomenological-ecological concept
Interacting minds - a biological basis
Science, 286 (5445), 1692-1695 (1999)
Schilbach, L .; Timmermans, B .; Reddy, V .; Costall, A .; Bente, G .; Schlicht, T. et al.
Toward a second-person neuroscience
Behavioral and Brain Sciences 36 (4), 393-414 (2013)
On the relationship of online and offline social cognition
Frontiers in Human Neuroscience 8, 278 (2014)
Schilbach, L .; Wilms, M .; Eickhoff, S. B .; Romanzetti, S .; Tepest, R .; Bente, G. B .; Shah, N. J .; Fink, G. R .; Vogeley, K.
Minds made for sharing. Initiating joint attention recruits reward-related neurocircuitry
Journal of Cognitive Neuroscience 22 (12), 2702-15 (2010)
Preller, K. H .; Herdener, M .; Schilbach, L .; Stampfli, P .; Hulka, L. M .; Vonmoos, M. et al.
Functional changes of the reward system underlie blunted response to social gaze in cocaine users
Proceedings of the National Academy of Sciences USA 111 (7), 2842-2847 (2014)