Daniel Fulford

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

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...

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...

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...

Background Psychotic spectrum disorders (PSD) are associated with poor social function. In this study, we investigate which of two different types of 2-month long training courses is more effective in improving day-to-day interactions and quality of life. Methods/design Participants with psychotic spectrum disorders will be randomly assigned to on...

Speech emotion recognition (SER) systems often struggle in real-world environments, where ambient noise severely degrades their performance. This paper explores a novel approach that exploits prior knowledge of testing environments to maximize SER performance under noisy conditions. To address this task, we propose a text-guided, environment-aware...

Effort-based decision making (EBDM) is fundamental to human motivation. This cognitive process weighs the effort required to obtain a reward against the magnitude of the reward and the probability of obtaining it. Research suggests both transdiagnostic and disorder-specific patterns of maladaptive EBDM in people with schizophrenia spectrum (SSD) or...

The Experience Sampling Method (ESM) is increasingly used by researchers from various disciplines to answer novel questions about individuals’ daily lives. Measurement best practices have long been overlooked in ESM research, and recent reviews show that item quality is often not reported in ESM studies. The absence of information about item qualit...

Understanding cognitive effort expended during assessments is essential to improving efficiency, accuracy, and accessibility within these assessments. Pupil dilation is commonly used as a psychophysiological measure of cognitive effort, yet research on its relationship with effort expended specifically during language processing is limited. The pre...

Tracy and Robins (Psychological Inquiry, 15(2), 103–125, 2004) theorized that there are two facets of pride: authentic (e.g., “accomplished”) and hubristic (e.g., “arrogant”). While these facets are assumed to function simultaneously over time, it remains unclear whether they differ by gender, given that pride is associated with various social beha...

A speech emotion recognition (SER) system deployed on a real-world application is highly likely to encounter speech contaminated with unconstrained background noise. To deal with this issue, a speech enhancement (SE) module can be attached to the SER system to compensate for the environmental difference of an input. Although the SE module can i...

BACKGROUND Behavioral Activation (BA) is an evidence-based treatment for depression that fosters engagement in values based activities (VBA) to increase access to positive reinforcement. Depressed mood has been shown to hinder smoking cessation. OBJECTIVE This study aims to provide feasibility and preliminary efficacy regarding a mobile app to mot...

Background Behavioral activation (BA) is an evidence-based treatment for depression that fosters engagement in values-based activities to increase access to positive reinforcement. Depressed mood has been shown to hinder smoking cessation. Objective This study determined the feasibility and preliminary efficacy of a mobile app to motivate smokers...

Numerous contextual factors contribute to risky sexual decision-making among men who have sex with men (MSM), with experimental laboratory-based studies suggesting that alcohol consumption, sexual arousal, and partner familiarity have the potential to impact condom negotiations during sexual encounters. The purpose of the current study was to exten...

Background and hypothesis: Some of the most debilitating aspects of schizophrenia and other serious mental illnesses (SMI) are the impairments in social perception, motivation, and behavior that frequently accompany these conditions. These impairments may ultimately lead to chronic social disconnection (ie, social withdrawal, objective isolation,...

Purpose of review People living with serious mental illness (SMI) experience high rates of loneliness, though few evidence-based psychosocial treatments directly target this experience. Mobile and web-based digital health interventions offer unique opportunities to translate psychosocial treatments to address loneliness in daily life. Recent findi...

Black adults in the United States are more likely to be diagnosed as having schizophrenia spectrum disorders and to report experiences of paranoia than are White adults. Cultural mistrust, or marginalized groups' adaptive skepticism toward dominant historically White institutions, is associated with paranoia among Black individuals, suggesting that...

We examined how a sponsored contract model (1) produced products of scholarly impact in childhood disability; (2) built scholarly capacity of rising practitioners/scholars in health-related professions; and (3) can be optimized to maximize impact. Data from select lab records and interviews were content analyzed and fitted to the Research Capacity...

Background and purpose: Few persons with Parkinson disease (PD) appear to engage in moderate-intensity walking associated with disease-modifying health benefits. How much time is spent walking at lower, yet still potentially beneficial, intensities is poorly understood. The purpose of this exploratory, observational study was to describe natural w...

People with schizophrenia often experience impaired social functioning and low satisfaction with relationships. Existing measures of social impairment in schizophrenia primarily assess pleasure derived from social interactions, rather than examining impairments in social motivation, including effortful behavior. We conducted a validation study of a...

BACKGROUND Exposure to natural vegetation (i.e., “greenspace”) is related to beneficial outcomes, including higher positive and lower negative affect, in those with and without mental health concerns. Only recently have researchers started to examine dynamic associations between greenspace exposure and affect within individuals over time. Smartphon...

Background Exposure to natural vegetation (ie, “greenspace”) is related to beneficial outcomes, including higher positive and lower negative affect, in individuals with and those without mental health concerns. Researchers have yet to examine dynamic associations between greenspace exposure and affect within individuals over time. Smartphone-based...

Objective The study examined how clinically measured walking capacity contributes to real-world walking performance in persons with Parkinson's disease (PD). Methods Cross-sectional baseline data (n = 82) from a PD clinical trial were analyzed. The 6-Minute Walk Test (6MWT) and 10-Meter Walk Test (10MWT) were used to generate capacity metrics of w...

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...

Previous research has shown a weak association between self-reported empathy and performance on behavioral assessments of social cognition. However, previous studies have often overlooked important distinctions within these multifaceted constructs (e.g., differences among the subcomponents of self-reported empathy, distinctions in tasks assessing l...

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...

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...

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...

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...

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 (...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...

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...