. 2023 Jun 17;9(1):38. doi: 10.1038/s41537-023-00362-z

Table 5.

Interpersonal sensitivity: characteristics of studies meeting inclusion criteria (n = 5).

Author (date) location	Study design sample (number & diagnosis) (gender ratio: M/F) (CHR/controls)	Mean age (SD) ethnicity (CHR/controls)	Diagnosis and manual used & comorbidities (CHR/controls)	Outcome measures	Main findings and clinical implications
Hodges et al.¹¹⁸	Cross-sectional 100 CHR 32 HC 52 M/48 F 16 M/16 F	21.6 (2.8) 21.1 (2.2) Ethnicity not recorded.	Present State Examination (PSE) Schedule for Affective Disorders and Schizophrenia - Lifetime Version (SADS-L) CHR Comorbidities Major depressive syndrome: 1%, Minor depressive disorder: 4%, Alcohol dependency: 1%, obsessive-compulsive disorder: 1%, Suicidal behavior: 3%, GAD/Panic: 2% Antisocial personality disorder: 2% No comorbidities reported in HCs	Structured Inventory for Schizotypy (SIS)	Compared to HCs, CHR individuals demonstrated a trend towards significance for the following variables of the SIS: Childhood social isolation P = 0.08), Interpersonal sensitivity (P = 0.09), Social isolation (P = 0.09), Suicidal ideation (P = 0.09), Restricted affect (P = 0.08), Oddness (P = 0.05) and a significant association with Disordered speech (P = 0.04).
Masillo et al.¹²²	Cross-sectional 62 CHR 39 HC 37 M/25 F 20 M/19 F	22.63 (4.05) 24.03 (4.22) Caucasian 51.6%/56.4% Asian 3.2%/12.8% Black 30.6%/23.1% Others 14.5%/7.7%	Prodromal Questionnaire (PQ)	Interpersonal Sensitivity Measure (IPSM) Ways of Coping Questionnaire (WCQ) Depression and Anxiety Stress Scale (DASS)	Compared to HCs, CHR individuals demonstrated higher scores on interpersonal sensitivity total score (U = 577.0, P < 0.001), interpersonal awareness (U = 592.0, P < 0.001), separation anxiety (U = 474.5, P < 0.001) and fragile inner self (U = 644.5, P < 0.001). Compared to HCs, CHR individuals demonstrated higher levels depression (U = 203.0, P < 0.001), anxiety (U = 241.0, P < 0.001) and stress (U = 335.5, P < 0.001) DASS subscales scores, and escape/avoidance WCQ (U = 537.0, P = 0.001). The higher the interpersonal awareness (rs=0.52, P = 0.001), separation anxiety (rs=0.71, P < 0.001), fragile inner self (rs=0.51, P < 0.001) and total IPSM (rs=0.52, P < 0.001) scores among CHR participants, the higher the level of paranoid ideas and suspiciousness. Higher sensitivity to interpersonal interactions, anxiety about separation from significant others and sense of having an inner or core self that is unlikeable and needs to be hidden from others were all associated with higher numbers of positive prodromal symptoms. Among participants with an CHR, total IPSM score (rs=0.40, P < 0.01), interpersonal awareness (rs=0.34, P < 0.01), separation anxiety (rs=0.50, P < 0.01) and fragile inner self (rs=0.35, P < 0.01) were significantly positively correlated with escape/avoidance WCQ subscale scores.
Masillo et al.¹²³	Longitudinal 39 CHR 108 HC 21 M/18 F 48 M/60 F	17.36 (5.58) 18.51 (6.26) Ethnicity not recorded.	Prodromal Questionnaire (PQ) 20.5% prescribed psychiatric medication.	Interpersonal Sensitivity Measure (IPSM) Global Functioning: Social (GF: SS) Global Functioning: Role (GF: RS)	CHR individuals showed higher IPSM scores and lower GF: SS and GF:RS scores than HCs. A statistically significant negative correlation between two IPSM subscales (Interpersonal Awareness and Timidity) and GF: SS was found in both groups. Statistically significant correlations were found between interpersonal sensitivity and negative prodromal symptoms in both groups. In CHR individuals, the higher the sensitivity to interpersonal interactions (rs =0.292, P = 0.002), the anxiety about separation from significant others (rs =0.480, P = 0.002) and the sense of having an inner or core self that is unlikeable and needs to be hidden from others (rs =0.320, P = 0.047), the higher the level of negative prodromal symptoms. Interpersonal awareness and Timidity aspects of interpersonal sensitivity were associated with low levels of social functioning. Assessing and treating interpersonal sensitivity may be a promising therapeutic target to improve social functioning in CHR individuals.
Masillo et al.¹³⁴	Longitudinal 18 month follow up 85 CHR 45 M/40 F	16.6 (5.05) Ethnicity not recorded.	Structured Interview for Prodromal Syndromes (SIPS) APS: 33.3% GRDS: 1.2% BLIPS: 0%	Interpersonal Sensitivity Measure (IPSM)	Interpersonal awareness (P ≤ 0.005) and separation anxiety (P ≤ 0.05) significantly correlated with SIPS general subscale at the 18-month follow-up, while fragile inner self showed a significant correlation with SIPS-positive subscale (P ≤ 0.05). Baseline need for approval and fragile inner self subscale’s scores explained 11% of the variance in the level of attenuated positive symptoms at follow-up (F (1, 81) = 2.753, P = 0.007, R² = 0.115, R² Adjusted =0.093). The analysis showed that fragile inner self was significantly associated with higher levels of attenuated positive symptoms at follow-up (b =0.306, t(2, 82) = 2.89, P = 0.005). Need for approval inversely influenced the level of attenuated positive symptoms at follow-up (b = −0.214, t(2, 82) = −2.01, P = 0.047). Baseline need for approval and interpersonal awareness subscale’s scores explained 16.3% of the variance in the level of general SIPS symptoms at follow-up (F (2, 81) = 7.95, P = 0.001, R² = 0.163; adjusted R² = 0.142.).
Mushtaq et al.¹²⁴	Cross-sectional 25 CHR 25 HC Total sample 23 M/27 F	Total sample 24.38 (3.9) Ethnicity not recorded.	Schizophrenia proneness inventory-adult version (SPI-A). 26% Family history of psychiatric illness 74%. No family history of psychiatric illness	Interpersonal Sensitivity Measure (IPSM)	CHR demonstrated significantly higher levels of interpersonal sensitivity compared to HCs (t = −5.049, P < 0.00). Increased sensitivity to social interactions appears to be manifestation of the early phase of psychosis. Early intervention to those identified as sensitive to interpersonal relations may prevent transition to psychosis.

Author (date) location

Study design sample (number & diagnosis)
(gender ratio: M/F) (CHR/controls)

Mean age (SD) ethnicity
(CHR/controls)

Diagnosis and manual used & comorbidities
(CHR/controls)

Outcome measures

Main findings and clinical implications

Hodges et al.¹¹⁸

Cross-sectional

100 CHR

32 HC

52 M/48 F

16 M/16 F

21.6 (2.8)

21.1 (2.2)

Ethnicity not recorded.

Present State Examination (PSE)

Schedule for Affective Disorders and Schizophrenia - Lifetime Version (SADS-L)

CHR Comorbidities

Major depressive syndrome: 1%,

Minor depressive disorder: 4%,

Alcohol dependency: 1%,

obsessive-compulsive disorder: 1%,

Suicidal behavior: 3%,

GAD/Panic: 2%

Antisocial personality disorder: 2%

No comorbidities reported in HCs

Structured Inventory for Schizotypy (SIS)

Compared to HCs, CHR individuals demonstrated a trend towards significance for the following variables of the SIS:

Childhood social isolation P = 0.08),

Interpersonal sensitivity (P = 0.09),

Social isolation (P = 0.09),

Suicidal ideation (P = 0.09),

Restricted affect (P = 0.08),

Oddness (P = 0.05) and a significant association with Disordered speech (P = 0.04).

Masillo et al.¹²²

Cross-sectional

62 CHR

39 HC

37 M/25 F

20 M/19 F

22.63 (4.05)

24.03 (4.22)

Caucasian

51.6%/56.4%

Asian

3.2%/12.8%

Black

30.6%/23.1%

Others

14.5%/7.7%

Prodromal Questionnaire (PQ)

Interpersonal Sensitivity Measure (IPSM)

Ways of Coping Questionnaire (WCQ)

Depression and Anxiety Stress Scale (DASS)

Compared to HCs, CHR individuals demonstrated higher scores on interpersonal sensitivity total score

(U = 577.0, P < 0.001), interpersonal awareness

(U = 592.0, P < 0.001),

separation anxiety (U = 474.5, P < 0.001)

and fragile inner self (U = 644.5, P < 0.001).

Compared to HCs, CHR individuals demonstrated higher levels depression (U = 203.0, P < 0.001),

anxiety (U = 241.0, P < 0.001) and stress (U = 335.5, P < 0.001) DASS subscales scores, and escape/avoidance WCQ

(U = 537.0, P = 0.001).

The higher the interpersonal awareness

(rs=0.52, P = 0.001), separation anxiety (rs=0.71, P < 0.001), fragile inner self (rs=0.51, P < 0.001) and total IPSM (rs=0.52, P < 0.001) scores among CHR participants, the higher the level of paranoid ideas and suspiciousness.

Higher sensitivity to interpersonal interactions, anxiety about separation from significant others and sense of having an inner or core self that is unlikeable and needs to be hidden from others were all associated with higher numbers of positive prodromal symptoms.

Among participants with an CHR, total IPSM score (rs=0.40, P < 0.01), interpersonal awareness (rs=0.34, P < 0.01), separation anxiety

(rs=0.50, P < 0.01) and fragile inner self (rs=0.35, P < 0.01) were significantly positively correlated with escape/avoidance WCQ subscale scores.

Masillo et al.¹²³

Longitudinal

39 CHR

108 HC

21 M/18 F

48 M/60 F

17.36 (5.58)

18.51 (6.26)

Ethnicity not recorded.

Prodromal Questionnaire (PQ)

20.5% prescribed psychiatric medication.

Interpersonal Sensitivity Measure (IPSM)

Global Functioning: Social (GF: SS)

Global Functioning: Role (GF: RS)

CHR individuals showed higher IPSM scores and lower GF: SS and GF:RS scores than HCs. A statistically significant negative correlation between two IPSM subscales (Interpersonal Awareness and Timidity) and GF: SS was found in both groups.

Statistically significant correlations were found between interpersonal sensitivity and negative prodromal symptoms in both groups. In CHR individuals, the higher the sensitivity to interpersonal interactions (rs =0.292, P = 0.002), the anxiety about separation from significant others (rs =0.480, P = 0.002) and the sense of having an inner or core self that is unlikeable and needs to be hidden from others (rs =0.320, P = 0.047), the higher the level of negative prodromal symptoms.

Interpersonal awareness and Timidity aspects of interpersonal sensitivity were associated with low levels of social functioning. Assessing and treating interpersonal sensitivity may be a promising therapeutic target to improve social functioning in CHR individuals.

Masillo et al.¹³⁴

Longitudinal

18 month follow up

85 CHR

45 M/40 F

16.6 (5.05)

Ethnicity not recorded.

Structured Interview for Prodromal Syndromes (SIPS)

APS: 33.3%

GRDS: 1.2%

BLIPS: 0%

Interpersonal Sensitivity Measure (IPSM)

Interpersonal awareness (P ≤ 0.005) and separation anxiety (P ≤ 0.05) significantly correlated with SIPS general subscale at the 18-month follow-up, while fragile inner self showed a significant correlation with SIPS-positive subscale (P ≤ 0.05).

Baseline need for approval and fragile inner self subscale’s scores explained 11% of the variance in the level of attenuated positive symptoms at follow-up (F (1, 81) = 2.753, P = 0.007, R² = 0.115, R² Adjusted =0.093). The analysis showed that fragile inner self was significantly associated with higher levels of attenuated positive symptoms at follow-up (b =0.306, t(2, 82) = 2.89, P = 0.005). Need for approval inversely influenced the level of attenuated positive symptoms at follow-up (b = −0.214, t(2, 82) = −2.01, P = 0.047).

Baseline need for approval and interpersonal awareness subscale’s scores explained 16.3% of the variance in the level of general SIPS symptoms at follow-up (F (2, 81) = 7.95, P = 0.001, R² = 0.163; adjusted R² = 0.142.).

Mushtaq et al.¹²⁴

Cross-sectional

25 CHR

25 HC

Total sample

23 M/27 F

Total sample

24.38 (3.9)

Ethnicity not recorded.

Schizophrenia proneness inventory-adult version (SPI-A).

26% Family history of psychiatric illness

74%. No family history of psychiatric illness

Interpersonal Sensitivity Measure (IPSM)

CHR demonstrated significantly higher levels of interpersonal sensitivity compared to HCs (t = −5.049, P < 0.00).

Increased sensitivity to social interactions appears to be manifestation of the early phase of psychosis. Early intervention to those identified as sensitive to interpersonal relations may prevent transition to psychosis.

APS Attenuated Positive Syndrome, AS attenuated symptoms, BLIPS brief limited intermitted psychotic symptoms, CHR Clinical High Risk, GRDS Genetic Risk & Deterioration Syndrome.