*I was curious about the idea of using smartphone sensors, tracking of calls and messages as a proxy to infer a person's sociability.* # How is Sociability Related to Mental Wellness or Illness? Some terminology difference 1. **Sociability** - Sociability is defined as people’s capacity and tendency to be sociable, to recognize and respond positively to others’ mental states [[23](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9737223/#B23-ijerph-19-15441)]. Sociability is a key factor that affects social connection 1. [The Moderating Role of Sociability and Social Connection for the Relationship between Soccer Participation and Teamwork Ability among Chinese College Students - PMC (nih.gov)](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9737223/) 2. **Social life** - the activities person engage in such as going out. 3. **Social connection** 1. Social connection refers to the structural and functional aspects of social relationships that make up an individual's perception of meaningful social interaction 1. [Social Connectedness - an overview | ScienceDirect Topics](https://www.sciencedirect.com/topics/psychology/social-connectedness) 2. Feeling connected affect mental wellness 1. [How Does Social Connectedness Affect Health? | CDC](https://www.cdc.gov/emotional-wellbeing/social-connectedness/affect-health.htm) **Sociability affects social connections. A person with low sociability or little social life can still feel socially connected.** Social Connection is more important than sociability (Quality vs Quantity) [Depressive symptoms are associated with social isolation in face-to-face interaction networks | Scientific Reports (nature.com)](https://www.nature.com/articles/s41598-020-58297-9) - Withdrawal from social life may be a sign of illness but it is not a diagnostic criteria. - We compare to the patient's "baseline", or **Premorbid** Personality to look for changes. - ![[20220107 My current understanding of treatment rationale and theories#^d5d8ca]] - But what is "normal?" ==What if their patient's premorbid baseline is false== - [[Book - Guide to Psychiatry Singapore Perspective Dr Chee Kuan Tsee]] - Page 7 - Concept of Normality. "...There is also a tendency to pathologise existential human imperfections and sufferings or habits. For the individual, normality may refer to his/her **premorbid baseline**." - However, we know that "*The human person has physical, psychological, social, and spiritual attributes that are inter-related, interactive, and integrated in function" (page 2), "there is constant inter-relation, interaction, and integration/dissociation between - *(a) individual and environment - endogenous and exogenous factors, (b) body/brain and mind.. (c) mental functions and neural circuits (d) past and present life events and experiences (e) downloading from culture, education, social media, lifestyle, politics, policy, values..."* (page 10-11) - Is it a problem for the patient which require intervention? If it's not a problem for them, then it's not a problem. - ![[202111211107 Diagnosis of psychopathology are based on functional impairments expressed in real-world settings#^67db0e]] - Social Connections, is a different concept, it is about relationships and meaning. How *social* the individual is can be related to personality, social cognition, meta-cognitive ability, social skills, roles, opportunities, and psychology. - [[202210122005 Barrier for Connectedness]] - The quality or stability of social life in relation to bipolar disorder - [[Theoretical Foundation of IPSRT]] # What's the current science regarding tracking Sociability ? - In this article: Decrease socialisation before relapses in Schizophrenia ![[Article - Relapse prediction in schizophrenia with smartphone digital phenotyping during COVID-19 - a prospective, three-site, two-country, longitudinal study#^a72fbe]] - Link to persecutory delusions and relapse ![[Link between phone use and relapse#^6245f4]] - Also "![[Digital Phenotype Signals associated with Psychosis#^86d66f]] - In this article, changes in the number of text messages and calls made have been correlated to picking up Bipolar Disorder symptoms. - [[Digital Phenotype Signals associated with Bipolar Disorder]] - It can also predict social anxiety. ![[Digital Phenotype Signals associated with Anxiety#^f92bb5]] # Why is tracking this helpful in Digital Phenotyping? - [[Digital Phenotyping]] as a moment-to-moment quantification... - The papers will advocate that if we can track patients, we can study how diseases change or develop in real-world setting, - Early detection means early interventions. # How is sociability tracked? - What are the relevant digital phenotyping signals to use? - Sensor Data are a proxy of the real thing. What is the real thing? How does one measure sociability? Is there even such a thing? # How can we track Social Connections? It's Quality vs Quantity **The Importance of Social Connections:** Grounded in theoretical understanding, enhanced social connections play a pivotal role in elevating mood and promoting overall health. Therefore, isn't it more helpful to directly measure and intervene in bolstering these connections? **The Value of Tracking Sociability:** While tracking sociability can offer insights into an individual's social behaviour patterns, it's essential to approach this data critically. Proxies for sociability may not always accurately or comprehensively reflect the quality of one's social connections. # How can it be used in a Clinical Setting? In other words, what is the clinical significance? - The study also found that certain behaviours and symptoms were more strongly associated with relapse than others. For example, ==reduced physical activity decreased socialisation, and increased severity of negative symptoms were all predictive of relapse.== - [[Article - Relapse prediction in schizophrenia with smartphone digital phenotyping during COVID-19 - a prospective, three-site, two-country, longitudinal study]] ---- Both **sociability** and **Social Connections** are significant. ## Sociability and Mental Illness Recovery Several studies have investigated the relationship between sociability and mental illness recovery. Here are some relevant research findings: 1. A study published in Sage Journals in 2009 found that social relationships are a decisive factor in recovering from severe mental illness[1]. The study emphasized the importance of social support and social networks in the recovery process. 2. A study published in PMC in 2008 found that social support plays a crucial role in recovery from severe mental illness[2]. The study highlighted the need for mental health services to provide social support to patients. 3. A longitudinal study published in Springer Link in 2022 investigated the associations between social factors and personal recovery in patients with psychosis[3]. The study found that social factors, such as social support and social relationships, were positively associated with personal recovery. 4. A study published in PubMed in 2011 examined the relationship between social support and recovery from serious mental illness[4]. The study found that social support was positively associated with recovery, and that self-efficacy mediated the relationship between social support and recovery. 5. A scoping review published in Taylor & Francis Online in 2021 explored the role of social support in the development of, experience of, and recovery from mental health problems[6]. The review found that social support is a crucial factor in mental health recovery, and that mental health services should incorporate social support in their practice. In summary, research suggests that sociability and social support are important factors in mental illness recovery. Social relationships, social support, and social factors are positively associated with personal recovery and mental health outcomes. Mental health services should incorporate social support in their practice to help patients recover from mental illness. Citations: [1] https://journals.sagepub.com/doi/10.1177/0020764008093686 [2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2682629/ [3] https://link.springer.com/article/10.1007/s10597-022-01007-8 [4] https://pubmed.ncbi.nlm.nih.gov/15672690/ [5] https://mind.help/topic/sociability/ [6] https://www.tandfonline.com/doi/full/10.1080/2156857X.2020.1868553 ## Social Connections and Mental Illness Here are some studies that explore the relationship between social connections and mental illness: 1. A study published in the journal BMC Psychiatry in 2012 found that social connections may paradoxically increase levels of mental illness symptoms among women with low resources, especially if such connections entail role strain[1]. The study highlights the importance of considering the quality of social connections in mental health interventions. 2. A scoping review published in the journal BMC Public Health in 2022 explored the role of social connectedness as a determinant of mental health[2]. The review found that social connectedness is a crucial factor in mental health, and that social networks and social support are the most protective aspects of social connectedness. 3. A review published in the journal Health Affairs in 2015 found that social isolation has a negative effect on health and can increase depressive symptoms as well as mortality[3]. The review highlights the importance of social connections in promoting health and well-being. 4. An overview published in ScienceDirect Topics explores the relationship between social connectedness and mental health[4]. The overview suggests that social connectedness can improve mental health and that social disconnection and loneliness can worsen mental health. 5. A review published in the journal American Psychologist in 2010 found that social ties influence multiple and interrelated health outcomes, including mental health[5]. The review highlights the importance of social relationships in promoting health and well-being. 6. A study published in the journal Australian and New Zealand Journal of Psychiatry in 2018 found that social connectedness improves public mental health[6]. The study found that social connectedness was a stronger and more consistent predictor of mental health year-on-year than mental health was of social connectedness. In summary, research suggests that social connections are crucial for mental health and well-being. Social connections can improve mental health, while social isolation and loneliness can worsen mental health. Social networks and social support are the most protective aspects of social connectedness. Citations: [1] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3455910/ [2] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9560615/ [3] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6125010/ [4] https://www.sciencedirect.com/topics/psychology/social-connectedness [5] https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3150158/ [6] https://journals.sagepub.com/doi/full/10.1177/0004867417723990 ----- # What are the factors that may affect patient sociability? There are both internal and/or external barriers. [What gets in the way of social engagement in schizophrenia? - PMC (nih.gov)](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7805250/) - The article aims to investigate how people with schizophrenia describe factors that impede and promote social engagement, such as social barriers and motivations. The article uses interviews and coding methods to analyze the responses of people with and without schizophrenia. ==The article reports that people with schizophrenia were less likely to interact with friends, but not family, than people without schizophrenia and that they reported more internal and conflict-based barriers, but similar motivations, for social engagement. The article also finds that social barriers and motivations were related to functioning and symptoms for people with schizophrenia. The article concludes that understanding social barriers and motivations can help improve social engagement in schizophrenia. - Moreover, evidence suggests that people with schizophrenia lose connections with close friends early in the course of illness[[51](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7805250/#B51)], which may contribute to limited social engagement over the illness course[[53](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7805250/#B53)]. # General caution about digital phenotyping and inferring too much from sensor data. - [[Can digital data diagnose mental health problems A sociological exploration of ‘digital phenotyping’]] - This article questions the assumptions on using sensors as a proxy for sociability or connection. - DP signals showing a change in the number of text messages or phone calls are only one piece of the puzzle. It shows a change in patterns but doesn't explain how come. - An early relapse sign is when one becomes more socially withdrawn and isolated. - The patient might have engaged in more face-to-face interactions, - Are they occupied by work? Life? - Went holiday? - Quality of messages/contact vs Quantity - About the standard or definition of normality - There is no one standard, an idealised quantity of sociability. - Related to personality, temperamental difference - cultural - life circumstances - preference - mental and physical health - environment / social economic factors - [[Passive Data are not always a direct proxy for symptoms. The use of digital phenotype data must be guided by theory]]. - Sensor data do not provide a complete picture of human interactions and behaviour ![[Article - Relapse prediction in schizophrenia with smartphone digital phenotyping during COVID-19 - a prospective, three-site, two-country, longitudinal study#^f46e1b]] - - ==So they are saying that some digital phenotyping signals correlate to clinical scales (or patient's mental state), it may not explain why, but it's just showing the pattern. == - Beyond detecting and picking up changes, returning to how does this "makes sense", "make meaning" for the patient, and what can be done about it? Only labelling doesn't make it better without interventions. ![[202009071534 Notes Reading Wittgenstein and Psychotherapy. From Paradox to wonder. John M. Heaton#^eadb65]] ---