b'Social Avoidance Appears to beFeature of SMI, Not BecauseOf Social IsolationPatients with serious mental illnesses (SMI) such as schizophrenia or bipolar disorder are socially isolated. That was assumed to be the causeof social cognitive deficits and high social avoidance motivation in the cohorts. A recent VA study found, however, that those are actually symptoms of the SMI and not the result of living conditions.By LaTina EmersonLOS ANGELESWhile individuals with schizo- and minimal participation in community activities, phrenia and bipolar disorder often have difficultyaccording to the article.withrelationshipsandbeingpartofacommu- Social cognition and social motivation are impor-nity, a recent study involving U.S. veterans hastant determinants of social integration in people with found that social cognitive deficits and high socialschizophrenia, Michael F. Green, Ph.D., director of avoidance motivation appear to be actual featurestheVARehabilitationR&DCenteronEnhancing of the clinical conditions and not the result of liv- Community Integration for Homeless Veterans, told ing in social isolation. theCompendiumofFederalMedicine.Inother ThestudypublishedinPsychologicalMedicinewords, deficits in these areas predict the level of social investigated whether social cognition or social moti- functioning. However, since people with schizophre-vation impairments are linked to mental health disor- nia and bipolar disorder often are socially isolated, we ders (schizophrenia or bipolar disorder) or to beingdo not know whether the deficits are due to that isola-socially isolated. 1 tion or a core part of the conditions.StudyauthorswereaffiliatedwithVAGreaterThestudycomparedfourgroupsofsubjectson LosAngeles,CA,HealthcareSystemandVAloneliness,socialcognition,approachandavoid-Rehabilitation R&D Center on Enhancing Communityance social motivation. One group had a diagnosis Integration for Homeless Veterans in Los Angeles. of schizophrenia (72 outpatients), and another had a Based on VA data on serious mental illness, whichdiagnosis of bipolar disorder (48 outpatients). Most of includesschizophreniaandbipolardisorder,asofthe participants were part of a registry kept at the VA, the first quarter of fiscal year 2024, the researchersand not all were veterans. The other two groups con-reported that, in the past 12 months across the nation,sisted of people from the community (151 individu-224,232 veterans were diagnosed with serious men- als). One group self-reported being socially isolated, talillnessasdiagnosedbyVANationalPsychosisand another group was socially connected. Registry criteria. The clinical groups were recruited from outpatient On average, people with schizophrenia are moreclinicsattheVAGreaterLosAngelesHealthcare sociallyisolated,lonelier,havemoresocialcogni- System and the University of California, Los Angeles tive impairment, and are less socially motivated than(UCLA), and outpatient board and care facilities in healthy individuals. Individuals with bipolar disordertheLosAngelesarea.Psychiatricdiagnoseswere also have social isolation, but typically less than whatestablishedwiththeStructuredClinicalInterview is seen in schizophrenia. Social isolation is defined asfor DSM-5 (SCID-5) from Modules AE and the the objective lack of peer and family relationshipsPTSD section, and medical records were examined 68'