iTBS to Enhance Social Cognition in People With Psychosis

Inclusion Criteria:

1. Age 18-39 years.

2. DSM-5 diagnosis of schizophrenia, schizoaffective disorder, schizophreniformdisorder, or psychotic disorder not otherwise specified (documented by SCID-5).

3. Prescription of antipsychotic medication for at least 60 days and constant dose for 30 days prior to study entry (either first- or second-generation antipsychoticspermitted).

4. Able to participate in the informed consent process and provide voluntary informedconsent.

Exclusion Criteria:

1. A history of a DSM-5 substance use disorder (other than cannabis, caffeine, ortobacco) within the past six months; or a positive baseline urine drug screen. Onlyparticipants meeting for moderate to severe cannabis use disorder will be excluded.

2. Type 1 diabetes mellitus (i.e., insulin-dependent diabetes mellitus with onset < 35years of age and/or diabetes mellitus that has been complicated by a priordocumented episode of ketoacidosis)

3. Acute or unstable medical illness (e.g., delirium, cancer, uncontrolled diabetes,decompensated cardiac, hepatic, renal or pulmonary disease, stroke, or myocardialinfarction), whose pathology or treatment could alter the presentation or treatmentof schizophrenia or significantly increase the risk associated with the proposedtreatment protocol

4. Neurological disease associated with extrapyramidal signs and symptoms (e.g.,Parkinson's disease); epilepsy, if the person has had one or more grand mal seizuresin the past 18 months; history or physical signs of stroke; any diagnosis of aCentral Nervous System (CNS) disorder

5. Requires a benzodiazepine with a dose equivalent to lorazepam 2 mg/day or higher dueto the potential of these medications to limit the efficacy of iTBS

6. Suspected DSM-5 intellectual disability based upon clinical interview andpsychosocial history

7. Prior Psychosurgery

8. Presence of MRI contraindications (e.g., pacemakers)

9. Pregnancy

10. TMS treatment in the past three months