Daniel Fulford

Daniel Fulford
Boston University | BU · Occupational Therapy and Psychological & Brain Sciences

PhD

About

87
Publications
9,430
Reads
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1,604
Citations
Additional affiliations
July 2013 - July 2015
University of California, San Francisco
Position
  • Professor (Assistant)
August 2005 - May 2010
University of Miami
Position
  • Graduate Researcher

Publications

Publications (87)
Article
Limited quantity and quality of interpersonal exchanges and relationships predict worse symptomatic and hospitalization outcomes and limit functional recovery in people with schizophrenia. While deficits in social skills and social cognition contribute to much of the impairment in social functioning in schizophrenia, our focus on the current review...
Article
Diminished motivation is associated with robust impairment in psychosocial functioning in schizophrenia (SZ). Little is known about the reciprocal relationships between motivation and functioning, particularly following a first episode of psychosis. We tested bidirectional associations between motivation and social and occupational functioning in t...
Article
Experiential negative symptoms—including diminished motivation—have a profound impact on functional outcomes in schizophrenia. Animal research suggests that abnormalities in dopaminergic regulation can negatively impact effort exertion, a translational model that has been applied to individuals with schizophrenia. Paradigms that assess effort-based...
Preprint
Impaired social functioning contributes to reduced quality of life and is associated with poor physical and psychological well-being in schizophrenia, and thus is a key psychosocial treatment target. Low social motivation contributes to impaired social functioning, but is typically examined using self-report or clinical ratings, which are prone to...
Article
Background High negative affect, low positive affect, and limited physical activity figure prominently in psychopathology, but little is known about the interrelatedness of affect and physical activity in emotional disorders. Methods We combined ecological momentary assessment data with a network approach to examine the dynamic relations among pos...
Article
Full-text available
Digital mental health interventions, such as those provided by smartphone applications (apps), show promise as cost-effective approaches to increasing access to evidence-based psychosocial interventions for psychosis. Although it is well known that limited financial resources can reduce the benefits of digital approaches to mental healthcare, the e...
Article
We investigated whether environmental sensitivity, as measured by the Highly Sensitive Person Scale (HSPS), predicts constructs related to interpersonal sensitivity above and beyond Big Five traits. In Study 1 (N = 1475), we first examined the HSPS factor structure and found a two-factor solution to be most optimal. We then found that the two HSPS...
Article
Introduction: Anhedonia is a transdiagnostic construct conceptualized as physical or social, however, the extent to which these subtypes differ across psychotic and mood pathology remains poorly understood. We aimed to quantify the severity of physical and social anhedonia across Major Depressive Disorder (MDD) and Schizophrenia Spectrum Disorder (...
Article
Purpose Youth with disabilities who graduate with a regular high school diploma often continue to have difficulties in their daily functioning that ultimately impact adulthood outcomes. To better understand these functional difficulties and determine how best to address them, it is important to distinguish deficits in discrete skills from difficult...
Article
Psychosocial functioning impairment is prevalent in first-episode psychosis and chronic schizophrenia. The Quality of Life Scale (QLS) is a widely used tool to measure psychosocial functioning; however, given the overlap between negative symptoms and functioning, along with the QLS being conceptualized initially as a measure of the deficit syndrome...
Article
Full-text available
Social communication and executive functioning challenges as well as co-occurring anxiety/depression may make acquiring the skills needed to manage daily life tasks difficult for diploma-track autistic youth, thus limiting their participation in adult roles. This study describes the associations between executive function, social communication skil...
Preprint
Psychosocial functioning impairment is prevalent in first episode psychosis and chronic schizophrenia. The Quality of Life Scale (QLS) is a widely-used tool to measure psychosocial functioning; however, given the overlap between negative symptoms and functioning, along with the QLS being conceptualized initially as a measure of the deficit syndrome...
Article
Background Reduced efforts to form and maintain social bonds can exist in the context of a sufficient desire for social connection. Thus, social impairment common across many psychiatric conditions may often reflect failures in social effort exertion, despite normative levels of social liking and wanting. Although there are many questionnaires avai...
Article
Background and purpose: Walking activity in persons with Parkinson disease (PD) is important for preventing functional decline. The contribution of walking activity to home and community mobility in PD is poorly understood. Methods: Cross-sectional baseline data (N = 69) were analyzed from a randomized controlled PD trial. The Life-Space Assessm...
Article
Objectives The prevalence of neurodegenerative disorders demands methods of accessible assessment that reliably captures cognition in daily life contexts. We investigated the feasibility of smartphone cognitive assessment in people with Parkinson’s disease (PD), who may have cognitive impairment in addition to motor-related problems that limit atte...
Article
Background Preliminary evidence suggests that aerobic exercise may augment the effects of cognitive remediation on improving cognitive functioning in severe mental illness. It has also been hypothesized that increases in cognitive functioning associated with adding exercise are mediated by increases in brain derived neurotrophic factor (BDNF). Howe...
Preprint
BACKGROUND Social distancing measures meant to prevent the spread of COVID-19 in the past year have exacerbated loneliness and depression in the United States. While virtual tools exist to improve social connections, there have been limited attempts to assess community-based, virtual methods to promote new social connections. OBJECTIVE In this pro...
Article
Background: Social distancing measures meant to prevent the spread of COVID-19 in the past year have exacerbated loneliness and depression in the United States. While virtual tools exist to improve social connections, there have been limited attempts to assess community-based, virtual methods to promote new social connections. Objective: In this...
Article
Purpose Little is known about the longitudinal trajectories of employment in people with severe mental illnesses (SMI) in developing countries, including India. We examined stability and change in work status, interest in work, problems and benefits related to work among employed participants, and barriers and desired job supports among unemployed...
Preprint
BACKGROUND People with schizophrenia and other serious mental illnesses often lack access to evidence-based interventions, particularly interventions that target meaningful recovery outcomes, such as social functioning and quality of life. Mobile technologies, including smartphone applications, have the potential to provide scalable supports that p...
Article
Background People with schizophrenia and other serious mental illnesses often lack access to evidence-based interventions, particularly interventions that target meaningful recovery outcomes such as social functioning and quality of life. Mobile technologies, including smartphone apps, have the potential to provide scalable support that places elem...
Article
Background: People with Parkinson's disease (PwPD) are less active than their age-matched peers. Non-motor symptoms, specifically, deficient motivation, may influence decision-making for exercise due to the impaired mesolimbic dopaminergic pathway. Objective: The purpose of this study was to determine if effort-based decision-making for physical...
Preprint
Loneliness, or the subjective experience of social disconnection, is often thought of as a stable characteristic. However, emerging data suggest that experiences of loneliness fluctuate within people over time. Understanding the momentary correlates of state experiences of loneliness can help identify and address the negative consequences of such e...
Article
Full-text available
IntroductionDiminished motivation (e.g., low drive, curiosity, and engagement in activities) is associated with robust impairment in psychosocial functioning in schizophrenia, yet even the most effective evidence-based interventions rarely effect meaningful change in motivation. Individual Resiliency Training (IRT) is a psychosocial treatment for i...
Article
Full-text available
PurposeResearch on employment in people with severe mental illnesses (SMI) in developing countries is sparse and largely limited to employment rates. We conducted a comprehensive study of work, interest in work, and perceived benefits and barriers to work in people with SMI in India.Methods Semi-structured interviews were conducted with 550 individ...
Article
Social impairment is a cardinal feature of schizophrenia spectrum disorders (SZ). Smaller social network size, diminished social skills, and loneliness are highly prevalent. Existing, gold-standard assessments of social impairment in SZ often rely on self-reported information that depends on retrospective recall and detailed accounts of complex soc...
Article
Decreased social functioning and high levels of loneliness and social isolation are common in schizophrenia spectrum disorders (SSD), contributing to reduced quality of life. One key contributor to social impairment is low social motivation, which may stem from aberrant neural processing of socially rewarding or punishing stimuli. To summarize rese...
Article
Full-text available
The worldwide protests against police brutality and racism following the unjust deaths of George Floyd and Breonna Taylor have led many in the scientific community to acknowledge and scrutinize the effect that racism has in our fields. From pathologizing the behaviors of enslaved Africans fleeing their oppressors to the inhumane treatment of Africa...
Preprint
Social impairment is a cardinal feature of schizophrenia spectrum disorders (SZ). Smaller social network size, diminished social skills, and loneliness are highly prevalent. Existing, gold-standard assessments of social impairment in SZ often rely on self-reported information that depends on retrospective recall and detailed accounts of complex soc...
Preprint
Decreased social functioning and high levels of loneliness and social isolation are common in schizophrenia spectrum disorders (SSD), contributing to reduced quality of life. One key contributor to social impairment is low social motivation, which may stem from aberrant neural processing of socially rewarding or punishing stimuli. To summarize rese...
Article
Full-text available
The purpose of this study was to investigate the relationship between effort-based decision making and gross motor performance. Effort-based decision making was measured using a modified version of the Effort Expenditure for Rewards Task (EEfRT), in which participants pressed a button on a keyboard to fill a bar on a screen for monetary reward. Par...
Article
While people with serious mental illness (SMI) endorse clinical pain at rates on par or exceeding those in the general population, the association between pain and functioning remains unclear. In this paper we present data on the cross-sectional association between clinical pain and global functioning in a large, mixed diagnostic sample of people w...
Article
Full-text available
Background: Parkinson disease (PD) is a debilitating and chronic neurodegenerative disease resulting in ambulation difficulties. Natural walking activity often declines early in disease progression despite the relative stability of motor impairments. In this study, we propose a paradigm shift with a "connected behavioral approach" that targets rea...
Article
Full-text available
People with schizophrenia and schizoaffective disorder (SZ) often struggle with social impairment, including small social networks and loneliness. Limitations in social skills and reduced social motivation—effort to engage in social connection—are key contributors to social impairment. While evidence-based approaches to improving social outcomes ar...
Preprint
Full-text available
The purpose of this study was to investigate the relationship between effort-based decision making and gross motor performance. Effort-based decision making was measured using a modified version of the Effort Expenditure for Rewards Task in which participants pressed a button on a keyboard to fill a bar on a screen for a monetary reward. Gross moto...
Preprint
Reduced efforts to form and maintain social bonds can exist in the context of sufficient desire for social connection. This disconnect between social liking/wanting and effortful behavior may contribute to social impairment. Despite many available questionnaires that assess sociability, desire or lack thereof for connection, and perceived social su...
Preprint
Diminished motivation (e.g., low drive, curiosity, and engagement in activities) is associated with robust impairment in psychosocial functioning in schizophrenia, yet even the most effective evidence-based interventions rarely effect meaningful change in motivation. Individual Resiliency Training (IRT) is a psychosocial treatment for individuals f...
Article
Social anxiety interferes with accurate perceptions of others' thoughts and intentions, yet studies examining the association between social anxiety and social cognition have resulted in mixed findings. We examined the association between dimensional levels of social anxiety and assessments of lower- and higher-level social cognition. In Study 1 (n...
Article
Full-text available
People with schizophrenia report positive emotion during social interactions in ecological momentary assessment (EMA) studies; however, few of these studies examine the qualities of social interactions (e.g., intimacy) that may affect emotion experience. In the current EMA study, people with (n = 20) and without schizophrenia (n = 15) answered ques...
Article
Full-text available
As the potential of smartphone apps and sensors for healthcare and clinical research continues to expand, there is a concomitant need for open, accessible, and scalable digital tools. While many current app platforms offer useful solutions for either clinicians or patients, fewer seek to serve both and support the therapeutic relationship between t...
Preprint
UNSTRUCTURED A body of research suggests that within-person variability in cognitive performance may be a sensitive indicator of impairment, compared to scores obtained at one point in time. In this review, we describe the manifestation of within-person variability in healthy populations and its predictive power in clinical populations. To better u...
Article
Full-text available
Background: Research suggests that variability in attention and working memory scores, as seen across time points, may be a sensitive indicator of impairment compared with a singular score at one point in time. Given that fluctuation in cognitive performance is a meaningful metric of real-world function and trajectory, it is valuable to understand...
Article
Background Diminished motivation is associated with robust impairment in psychosocial functioning in schizophrenia. Despite this finding, even the most effective evidence-based interventions rarely improve motivated behavior. Individual Resiliency Training (IRT)--a psychosocial treatment for individuals following a first-episode of psychosis--is no...
Article
Background The network approach to psychopathology has become increasingly popular. Little research has examined the dynamic network structure of mental disorders, and, to date, no study has investigated the network dynamics of positive affect, negative affect, and physical activity in bipolar disorder. This represents the first study to estimate t...
Article
Full-text available
Prior research on the sibling relationship in the context of autism spectrum disorder (ASD) has included only one sibling per family. We used multi-level modeling to examine aspects of the sibling relationship in 207 adults who have a brother or sister with ASD from 125 families, investigating variability in sibling relationship quality and pessimi...
Article
Defeatist performance beliefs are prevalent and linked to decreased motivation in people with psychological disorders. In this study, we investigated whether defeatist performance beliefs were associated with transdiagnostic psychopathology risk in people with no history of formal diagnosis and whether defeatist performance beliefs impacted engagem...
Article
People with serious mental illness (SMI) are at an increased risk for physical health complications, such as cardiovascular disease and obesity. Low levels of physical activity is a major contributor to these health complications. One factor associated with limited physical activity in the broader sedentary population is pain. While preliminary fin...
Article
As a risk factor for psychosis, childhood trauma rates are elevated in the clinical-high-risk (CHR) syndrome compared to the general population. However, it is unknown whether trauma is typically experienced in childhood or adolescence/young adulthood, whether it occurred prior to CHR syndrome onset, and how severe trauma relates to presenting symp...
Presentation
Background: Increasing evidence suggests that childhood trauma confers risk for psychosis, perhaps through later dysregulated stress responsivity. However, few studies have examined this model in “clinical-high-risk” (CHR) individuals, prior to psychosis onset. Methods: We assessed salivary cortisol during the Trier Social Stress Test and across th...
Article
Background Blunted facial affect is a common negative symptom of schizophrenia. Additionally, assessing the trustworthiness of faces is a social cognitive ability that is impaired in schizophrenia. Currently available pharmacological agents are ineffective at improving either of these symptoms, despite their clinical significance. The hypothalamic...
Article
Research on emotion experience in response to valenced stimuli has consistently shown that people with schizophrenia have the capacity to experience emotion. Specifically, people with schizophrenia report similar experiences to both positive and negative emotion-eliciting stimuli as individuals without the disorder. However, it is less clear if peo...
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Full-text available
RationaleThere has been an explosion of research on the potential benefits of the social neuropeptide oxytocin for a number of mental disorders including substance use disorders. Recent evidence suggests that intranasal oxytocin has both direct anti-addiction effects and pro-social effects that may facilitate engagement in psychosocial treatment fo...
Article
Researchers and clinicians have long noted the overlap among features and high comorbidity of bipolar disorder and borderline personality disorder. The shared features of impulsivity and labile mood in both disorders make them challenging to distinguish. We tested the hypothesis that variables related to goal dysregulation would be uniquely related...
Article
Full-text available
Researchers have noted strong parallels in the symptoms of mania—including grandiosity, hostility, goal-driven behavior, and overly sexualized behavior—and dominance. Drawing on these parallels, it has been hypothesized that bipolar disorder might be related to dysregulations of the dominance system, which includes dominance motivation, power, and...
Article
Across two studies we examined the role of emotion perception as a correlate of quality of life and occupational functioning in bipolar I disorder. In Study 1, we tested a multifactorial model of quality of life and occupational functioning, including the role of emotion perception and other established correlates of functional outcomes, among 42 p...
Article
Full-text available
Functional impairment is a defining feature of psychotic disorders and usually appears well before their onset. Negative symptoms play a prominent role in the impaired functioning of individuals with schizophrenia and those at clinical-high-risk (CHR) for psychosis. Despite high rates of depression and anxiety in early psychosis, few studies have e...
Article
Full-text available
Several lines of research have suggested a link between mania and creativity, The goal of the present study was to test whether positive affect moderated the relationship between risk for mania (assessed with the Hypomanic Personality Scale [HPS]) and a variable postulated to be a cognitive component of creativity: cognitive flexibility. Fifty-thre...
Article
A series of studies suggest that bipolar disorder is related to high sensitivity to incentives and that incentive sensitivity (or sensitivity of the approach system) can predict the course of mania. Incentive sensitivity in bipolar disorder seems to be related to two processes: a tendency to invest in difficult-to-attain goals and an over-reactivit...
Article
Full-text available
The tendency to generalize from a single failure to one's entire self-worth is an important correlate and predictor of depression. Despite conceptual overlap between cognitive biases in anxiety and depression, little research has examined whether negative generalization relates to anxiety symptoms. We examined associations of negative generalizatio...
Article
Optimism is expecting good things to occur in one's life. Such positive expectations are associated with higher subjective well-being, even under conditions of stress or adversity. In contrast, pessimists respond to adversity with more intense negative feelings. There are also differences in the manner in which optimists and pessimists try to cope...
Article
Full-text available
Bipolar I disorder (BD) is one of the leading causes of disability among adults. Despite the fact that those with BD are at significantly greater risk for experiencing psychosocial hardship, many with the disorder function quite well. Researchers have shown this variability in quality of life to be partly explained by symptom severity, educational...
Article
Full-text available
In an experience-sampling study, we tested the influence of goal progress on subsequent effort toward that goal among persons with bipolar disorder (BD) and among control subjects without BD. We hypothesized, overall, that unexpectedly low progress toward a goal would lead to an increase in subsequent effort toward that goal, and unexpectedly high...
Chapter
Psychopathology is a term derived from the Greek roots psych (meaning “mind” or “soul”), path (referring to “feeling” or “suffering”), and ology (“the study of”). Thus, one can define the term most broadly as the study of the suffering of the mind. More specifically, psychopathology can be defined as the study of mental illness or the understanding...
Article
Full-text available
We conducted two studies to examine the Cognition Checklist for Mania-Revised (CCL-M-R; Beck, Colis, Steer, Madrak, & Goldberg, 2006). In the first, we gathered data in an undergraduate sample (N = 208) to examine the factor structure of the measure and the correlations of the subscales with the Hypomanic Personality Scale (HPS; Eckblad & Chapman,...
Article
There is strong evidence of a relationship between goal dysregulation and mania. Building on these findings, we examined the feasibility of developing a mania prevention treatment program designed to improve goal regulation skills for those with bipolar disorder. Here, we describe the process of developing a manual, delivering the intervention to a...