Digital Phenotyping Measurement of Smartphone Social Behavior is Associated with Illness Progression Risk Scores in Young People at Clinical High Risk for Psychosis

Abstract

Background

Young people at clinical high risk for psychosis (CHR-p) commonly experience social impairment, which contributes to functional decline and predicts transition to psychotic illness. Although the use of smart phone technology and social media platforms for social interaction is widespread among today’s youth, it is unclear whether aberrant digital social interactions contribute to risk for conversion and functional impairment in CHR-p. The current study sought to characterize the nature of social smartphone and social media use in a CHR-p sample and determine its association with clinical symptoms and risk for conversion to psychosis.

Study Design

CHR-p (n = 132) and HC (n = 61) participants completed clinical interviews and 6 days of digital phenotyping that monitored total smartphone use, ratio of outgoing to incoming text messages and phone calls, social media use, and ecological momentary assessment surveys focused on in-person and electronic social interactions. Study Results: CHR-p did not differ from HC in total smartphone use for social communication or active social media use. However, CHR-p participants reported significantly less daily passive social media use compared to HC peers, and decreased text message reciprocity predicted 1- and 2-year conversion risk.

Conclusions

Results demonstrate a nuanced digital social landscape with divergent relationships from in-person social behavior and suggest online socialization has implications for high-precision identification and intervention strategies among the CHR-p population.

psychosis-risk, social functioning, social media, text messaging, digital phenotyping