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Social disability is a defining characteristic of schizophrenia and a substantial public health problem. It has several components that are difficult to disentangle. One component, social disconnection, occurs extensively in the general community among nonhelp-seeking individuals. Social disconnection is an objective, long-standing lack of social/family relationships and minimal participation in social activities. It is associated with negative health effects, including early mortality, and is distinct from subjective loneliness. These 2 topics, social disability in schizophrenia and social disconnection in the general community, have generated entirely distinct research literatures that differ in their respective knowledge gaps and emphases. Specifically, the consequences of social disability in schizophrenia are unknown but its determinants (ie, nonsocial cognition, social cognition, and social motivation) have been well-examined. Conversely, the health consequences of social disconnection in the general community are well-established, but the determinants are largely unknown. Social disconnection is a condition that presents substantial public health concerns, exists within and outside of current psychiatric diagnostic boundaries, and may be related to the schizophrenia spectrum. A comparison of these 2 literatures is mutually informative and it generates intriguing research questions that can be critically evaluated.

The present study examined the expression of the Diagnostic and Statistical Manual of Mental Disorders, fifth edition (DSM-5) schizotypal, schizoid, and paranoid personality disorder (PD) traits in daily life using experience sampling methodology in 206 nonclinically ascertained Spanish young adults oversampled for risk for schizophrenia-spectrum psychopathology. This study examined the overlap and differentiation of pathological personality traits in daily life settings, according to both diagnostic and multidimensional models. Daily life outcomes differentiated among schizophrenia-spectrum disorders. The assignment of Cluster A personality traits to positive, negative, paranoid, and disorganized dimensions provided an alternative to the traditional PD diagnoses. Positive, disorganized, and paranoid schizotypy were associated with elevated stress reactivity, whereas negative schizotypy was associated with diminished reactivity in daily life. The current diagnostic model is limited by the considerable overlap among the PD traits. Nonetheless, experience sampling methodology is sensitive enough to detect differences in day-to-day impairment and can be a powerful research tool for the examination of dynamic constructs such as personality pathology. (PsycINFO Database Record, ((c) 2017 APA, all rights reserved).)