Emma Parrish

• Master of Science
• PhD Student at University of California, San Diego

Background and Hypothesis People with serious mental illness (SMI) have an increased risk of suicide ideation (SI) and suicide behavior (SB). Longitudinal studies on factors contributing to SI/SB in SMI are lacking. Interpersonal biases (ie, perceived burdensomeness and thwarted belongingness) are cross-sectionally related to SI/SB, but do they rel...

Poor introspective accuracy (IA), defined as inaccurate judgments of one’s abilities and performance, is a strong and independent predictor of functional impairment in people with psychotic disorders. However, there are currently no treatments that directly target IA in this population as a primary outcome. We describe a protocol for a clinical tri...

Although it is well established that individuals living with psychosis are at increased risk for suicidal ideation, attempts, and death by suicide, several gaps in the literature need to be addressed to advance research and improve clinical practice. This Call-to-Action highlights three major gaps in our understanding of the intersection of psychos...

Social isolation is a common problem faced by individuals with serious mental illness (SMI), and current intervention approaches have limited effectiveness. This article presents a blended intervention approach, called mobile Social Interaction Therapy by Exposure, to address social isolation in individuals with SMI. The approach combines brief in-...

Background and Hypothesis People with serious mental illness (SMI; psychotic and affective disorders with psychosis) are at an increased risk of suicide, yet there is limited research on the correlates of suicide in SMI. Social cognitive impairments are common among people with SMI and several studies have examined social cognition and suicidal ide...

Objective Suicide risk among individuals with psychosis is elevated compared to the general population (e.g., higher rates of suicide attempts [SA] and completions, more severe lethality of means). Importantly, suicidal ideation (SI) seems to be more predictive of near-term and lifetime SAs in people with psychosis than in the general population. Y...

Models of affect, like the tripartite model, suggest that positive affect (PA) and negative affect (NA) are independent between subjects and negatively correlated within. Correlations may differ in bipolar disorder (BD) and schizophrenia. Using ecological momentary assessment (EMA) and clinical ratings, this secondary analysis evaluated the tripart...

Psychiatric symptoms experienced by people with serious mental illness (SMI; schizophrenia, bipolar and other psychotic disorders) may impact suicide safety planning. This study examined safety plan self-knowledge, or an individual’s own knowledge and awareness of their safety plan, in a sample of people with SMI. Participants (N = 53) with SMI at...

Introduction: Many people with schizophrenia report low levels of negative affect (NA), which may reflect biases in emotion processing. In the general population there is an inverse correlation between positive affect (PA) and NA. It is possible that this relationship is different among people with schizophrenia. This study aims to understand the...

Objective: People with serious mental illnesses (SMIs) are at high risk for suicidal ideation and behavior, and yet few suicide prevention interventions have been customized for this group. We describe the outcomes of a pilot trial of Mobile SafeTy And Recovery Therapy (mSTART), a four-session suicide-focused cognitive behavioral intervention for S...

Background: Childhood trauma is associated with a variety of negative outcomes in psychosis, but it is unclear clear if childhood trauma affects day-to-day social experiences. We aimed to examine the association between childhood trauma and functional and structural characteristics of real-world social relationships in psychosis. Methods: Partic...

Aim People with serious mental illness (SMI) are at an increased risk for suicide. Social approach and avoidance motivations are linked to social functioning, and social isolation is a risk factor for suicide. This study uses ecological momentary assessment (EMA) to understand social approach and avoidance motivations in relation to symptoms and su...

Background Emotion recognition deficits are linked with social dysfunction in psychosis, as is inaccurate self-assessment of emotion recognition abilities. However, little is known about the link between ER and real-time social appraisals and behavior. Methods In 136 people with psychotic disorders or affective disorder with psychosis we administe...

Objective: Safety planning is a suicide prevention intervention that relies partly on an individual's social relationships as distractions during or help in a suicidal crisis. The primary objectives of this study were to estimate rates of missingness on social aspects of safety plans to determine whether rates differ by demographic characteristics...

Objective Psychosis is associated with increased suicide risk. Safety planning is a suicide prevention practice that is associated with decreased suicidal behavior and psychiatric hospitalizations. A common feature of safety planning is listing of crisis line numbers. The primary purpose of this study was to compare Veterans with and without psycho...

Cognitive impairments are core features of first-episode psychosis (FEP). A cognitive strengths based approach to treatment in FEP are one complimentary yet relatively unexplored method of intervention. This study explored the perspectives of experts in the field of cognition or FEP on the usefulness of a cognitive strengths-based approach in FEP....

Background: As smartphone technology has become nearly ubiquitous, there is growing literature to suggest ecological momentary cognitive testing (EMCT) offers advantages to traditional pen-and-paper psychological assessment. We introduce a newly developed platform for self-administration of cognitive tests in ecologically valid ways. Objective: To...

Individuals with schizophrenia who have high negative symptoms are at high risk for poor functional outcomes. However, the determinants of psychosocial functioning in this group are not well understood. We aimed to examine modifiable predictors of both objective, performance-based functional capacity and social skills, and self-reported functioning...

Objective The COVID-19 pandemic has had potentially severe psychological implications for older adults, including those in retirement communities, due to restricted social interactions, but the day-to-day experience of loneliness has received limited study. We sought to investigate sequential association, if any, between loneliness, activity, and a...

Childhood trauma (CT) is associated with suicidal ideation and behaviors (SI/SB) in people with psychosis. The interpersonal psychological theory of suicide (IPTS) suggests that there are four factors that increase suicide risk: thwarted belongingness, perceived burdensomeness, acquired capacity for suicide, and hopelessness. The IPTS constructs an...

Contextual influences on social behavior and affective dynamics are not well understood in schizophrenia. We examined the role of social context on emotions, and the motivation to interact in the future, using dynamic network analysis of ecological momentary assessment (EMA) data. Participants included 105 outpatients with schizophrenia or schizoaf...

About one in 100 people worldwide are diagnosed with schizophrenia. Many people advocate for a name change for the condition, pointing to the stigma and discrimination associated with the term "schizophrenia", as well as to how the name poorly characterizes features of the illness. The purpose of this project was to collect opinions from a broad, d...

Objective Neuropsychological impairments are observed in individuals with Bipolar Disorder (BD), yet knowledge of how cognitive deficits unfold in real-time remains limited. Given intraindividual variability in mood observed in people with BD, and the potential for mood and cognition to be mutually influential, we employed ambulatory assessment tec...

Aim Treatment for youth exhibiting signs of clinical high risk for psychosis (CHR-P) has been emphasized in recent years, but there is need for a greater understanding of the course of symptoms and functioning across treatment. The aim of this study is to describe 10 years of naturalistic treatment outcomes in a real-world, specialized CHR-P outpat...

Aim Early intervention for psychosis has been of high interest in the past two decades. Research demonstrates that clinical high risk for psychosis (CHR-p) populations experience impairments in role functioning. Although several vocational and cognitive interventions exist for people living with psychosis, there are no known evidence-based treatmen...

Background People with psychotic disorders are at an increased risk of suicide, but there is little understanding of suicidal ideation (SI) in this population. The Interpersonal Psychological Theory of Suicide posits that perceived burdensomeness (PB) and thwarted belonginess (TB) contribute to SI. To our knowledge there are no studies using ecolog...

Background: Mental health (MH) apps are growing in popularity. While MH apps may be helpful, less is known about how crises such as suicidal ideation are addressed in apps. Aims: We examined the proportion of MH apps that contained language mentioning suicide or suicidal ideation and how apps communicated these policies and directed users to MH res...

Background Cognitive tasks delivered during ecological momentary assessment (EMA) may elucidate the short-term dynamics and contextual influences on cognition and judgements of performance. This paper provides initial validation of a smartphone task of facial emotion recognition in serious mental illness. Methods A total of 86 participants with ps...

Objective: The development and deployment of technology-based assessments of clinical symptoms are increasing. This study used ecological momentary assessment (EMA) to examine clinical symptoms and relates these sampling results to structured clinical ratings. Methods: Three times a day for 30 days, participants with bipolar disorder (n=71; BPI) or...

Emerging technologies, including artificial intelligence (AI), are creating immense and unprecedented new frontiers. Complex systems supported by AI and utilized in our day-to-day lives include airline reservation systems, loan eligibility programs, college admissions, transportations systems, judicial decisions, and, more recently, healthcare. Thr...

Smartphone-based ecological mobile cognitive tests (EMCTs) can measure cognitive abilities in the real world, complementing traditional neuropsychological assessments. We evaluated the validity of an EMCT of recognition memory designed for use with people with serious mental illness, as well as relevant contextual influences on performance. Partici...

Background Previous research employing global positioning satellite (GPS) data and ecological momentary assessment (EMA) has shown a smaller life-space (distance traveled from home) was associated with poorer community functioning and more severe negative symptoms in people with schizophrenia. Momentary emotional experiences may influence how much...

Background: Cognitive deficits are present in individuals at clinical high risk for psychosis (CHRP). We developed Cognition for Learning and for Understanding Everyday Social Situations (CLUES), an integrated social- and neurocognitive remediation intervention for CHRP, and examined its feasibility and efficacy compared to an active control inter...

Background Previous research employing global positioning satellite (GPS) data and ecological momentary assessment (EMA) has shown that greater aggregated time at home and less distance traveled (diminished life-space) were associated with poorer community functioning and with more severe negative symptoms in people with schizophrenia. Emotional ex...

Objective: Cognitive compensatory interventions aim to alleviate psychosocial disability by targeting functioning directly using aids and strategies, thereby minimizing the impact of cognitive impairment. The aim was to conduct a systematic review and meta-analysis of cognitive compensatory interventions for psychosis by examining the effects on f...

Background: Cognitive deficits, a core feature contributing to disability in schizophrenia, are present in milder form in individuals at clinical high risk (CHR) for psychosis. This study investigated the feasibility of Cognition for Learning and Understanding Everyday Social Situations (CLUES), an integrated neurocognitive and social cognitive tr...

Poor vocational engagement is well documented among young people experiencing first-episode psychosis (FEP). The aim of the present study was to establish and compare rates of vocational engagement across young people with first-episode psychosis, depression, and borderline personality pathology. A file audit was used to collect vocational data of...

Aim Most mental disorders have their onset by age 25, disrupting normative vocational engagement. Factors associated with vocational disengagement at first contact with specialist treatment are important for service planning. The aim of this paper was to investigate the association between theoretically important factors and vocational disengagemen...

Aim To compare rates of vocational engagement for youth entering specialist mental health treatment with the general population. Methods A file audit retrieved vocational data for 145 youth aged 15 to 25 entering treatment. Clinical and population data were stratified by age and sex and compared between cohorts. Results Compared to the population...

Aim Schizophrenia is a highly stigmatized disorder. Identification of youth at high risk for psychosis has the potential for improved outcomes. However, identifying youth at risk could subject them to increased public stigma. Using an experimental vignette design, this study examined relative levels of public stigma elicited by the labels “schizoph...

Background: Depression is among the most common mental health problems for young people. In adults, depression is associated with neurocognitive deficits that reduce the effectiveness of treatment and impair educational and vocational functioning. Compared to adults, less is known about the neurocognitive functioning of young people with depressio...

Background Cognitive impairments in domains such as attention, memory, processing speed and executive functions are a central feature of psychotic disorders that have significant negative consequences for daily functioning, including activities of daily living, social and vocational roles. Compensatory approaches aim to minimise the impact of cogni...

Background Previous reviews suggest there is minimal evidence for an association between duration of untreated psychosis (DUP) and neurocognition. This is based on tallied findings of studies with small samples and neurocognition viewed as a single construct. We aimed to conduct a systematic review and meta-analysis examining the association betwee...

Study aims were to 1) determine the characteristics and reasons for referral for Clinical Neuropsychological Assessment (CNA) and 2) characterize the findings and recommendations contained in the CNA reports, of clients attending a youth mental health service. File audit of all CNA reports (N = 140) of youth attending a mental health service. Cogni...

Objective: The allocation of neuropsychology services in Victoria's public youth mental health system is very limited. The objective of this study was to evaluate the utility of a youth mental health neuropsychology service over a 16-month period, and to evaluate referrer feedback about the service. Methods: A 16-month clinical data audit and refer...