Social cognition in psychosis: multidimensional structure, clinical correlates, and relationship with functional outcome.

Department of Psychiatry and Biobehavioral Sciences, Geffen School of Medicine at University of California, Los Angeles, CA 90095-6968, USA.
Schizophrenia Research (Impact Factor: 4.43). 02/2011; 125(2-3):143-51. DOI: 10.1016/j.schres.2010.11.007
Source: PubMed

ABSTRACT Social cognitive impairments are common, detectable across a wide range of tasks, and appear to play a key role in explaining poor outcome in schizophrenia and related psychotic disorders. However, little is known about the underlying factor structure of social cognition in people with psychotic disorders due to a lack of exploratory factor analyses using a relatively comprehensive social cognitive assessment battery. In a sample of 85 outpatients with psychosis, we examined the factor structure and clinical/functional correlates of eight indexes derived from five social cognition tasks that span the domains of emotional processing, social perception, attributional style, and Theory of Mind. Exploratory factor analysis revealed three factors with relatively low inter-correlations that explained a total of 54% of the variance: (1) Hostile attributional style, (2) Lower-level social cue detection, and (3) Higher-level inferential and regulatory processes. None of the factors showed significant correlations with negative symptoms. Factor 1 significantly correlated with clinical symptoms (positive, depression-anxiety, agitation) but not functional outcome, whereas Factors 2 and 3 significantly correlated with functional outcome (functional capacity and real-world social and work functioning) but not clinical symptoms. Furthermore, Factor 2 accounted for unique incremental variance in functional capacity, above and beyond non-social neurocognition (measured with MATRICS Consensus Cognitive Battery) and negative symptoms. Results suggest that multiple separable dimensions of social cognition can be identified in psychosis, and these factors show distinct patterns of correlation with clinical features and functional outcome.

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    Early Intervention in Psychiatry 01/2015; · 1.65 Impact Factor
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    ABSTRACT: a b s t r a c t Social cognition is a functionally relevant predictor of capacity in schizophrenia (SZ), though research concerning its value for bipolar disorder (BD) is limited. The current investigation examined the relationship between two social cognitive factors and functional capacity in bipolar disorder. This study included 48 individuals with bipolar disorder (24 with psychotic features) and 30 patients with schizophrenia. Multiple regression controlling for estimated IQ scores was used to assess the predictive value of social cognitive factors on the UCSD Performance-Based Functional Skills Assessment (UPSA). Results found that for the bipolar with psychosis and schizophrenia groups, the social/emotion processing factor predicted the UPSA. The theory of mind factor only predicted the UPSA for the schizophrenia group.. Findings support the clinical utility of evaluating emotion processing in individuals with a history of psychosis. For BD, theory of mind may be better explained by a generalized cognitive deficit. In contrast, social/emotion processing may be linked to distinct neurobiological processes associated with psychosis.
    Psychiatry Research 08/2014; · 2.68 Impact Factor
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    ABSTRACT: While the role of impaired neurocognition in accounting for functional outcome in schizophrenia is generally established, the influence of social cognition on this relationship is far from clear. This study aims to explore in depth the nature of the relationship between neurocognition, social cognition and daily functioning in people with schizophrenia. Twenty-one individuals diagnosed with schizophrenia and 15 controls completed the assessment of symptom severity, neuropsychological status, social cognition (Theory of Mind and affect processing) and other functional measures. A statistical mediation model based on hierarchical regression analyses was used to establish the mediation path with significant variables. Social cognition played a mediating role between neurocognition and functioning, accounting for significant trends in incremental variance in specific functional indexes (interpersonal behavior and employment/occupation). Consequently, this study adds to the evidence underlining the importance of targeting not only social cognitive or neurocognitive functions but to combine both interventions to reveal the best daily functioning results in schizophrenia patients.
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