Social cognition: The key factor predicting social outcome in people with Schizophrenia?

Dr. Harvey is Professor of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, Georgia.
Psychiatry 02/2010; 7(2):41-4.
Source: PubMed


Impairments in different cognitive abilities have been found to be correlated with reduced real-world functioning in people with schizophrenia. A number of other features of the illness, such as depression and negative symptoms, contribute to the overall prediction of these outcomes. Impairment in social cognition is of particular interest as a mediating influence between cognition and social outcomes. Social cognition is a set of cognitive processes applied to the recognition, understanding, accurate processing, and effective use of social cues in real-world situations. In schizophrenia research, social cognition comprises the following domains: emotion perception, theory of mind (ToM), and attributional style. While substantial research has indicated that these abilities are clearly related to social outcomes, research has been slowed by problems in the measurement of these abilities. In this article, I will describe these abilities, discuss how they are currently measured, and how research could improve the current measurement of these abilities to make them more clinically useful.

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    • "Now we clearly know that the signature of cognitive impairment is not markedly different prior to the onset of diagnosable illness. We also know that, in the absence of the relatively rare phenomenon of nearly complete treatment resistance in older age, there is little consistent evidence of cognitive decline (Harvey et al., 2010). "
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    ABSTRACT: Schizophrenia Research: Cognition will serve an important function – a place where interests converge and investigators can learn about the recent developments in this area. This new journal will provide rapid dissemination of information to people who will make good use of it. In this initial article, we comment globally on the study of cognition in schizophrenia: how we got here, where we are, and where we are going. The goal of this first article is to place the study of cognition in schizophrenia within a historical and scientific context. In a field as richly textured as ours it is impossible to hit all the important areas, and we hope the reader will forgive our omissions. Phrased in cognitive terms, our limited presentation of the past is a matter of selective memory, the present is a matter of selective attention, and the future is a matter of selective prospection. This broad introduction emphasizes that cognition in schizophrenia provides clues to pathophysiology, treatment, and outcome. In fact, the study of cognitive impairment in schizophrenia has become wholly intertwined with the study of schizophrenia itself.
    Full-text · Article · Mar 2014 · Schizophrenia Research: Cognition
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    • "A range of tasks has been developed to map these core mentalizing domains. Deficits in social cognition may explain most or all of the relationship between neurocognition and social outcomes (Harvey and Penn, 2010). Our study aimed to explore the perception of specific facial emotions in young people at ultra high-risk of psychosis compared to a first episode of psychosis and multi-episode schizophrenia. "
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    ABSTRACT: Individuals with schizophrenia experience problems in the perception of emotion throughout the course of the disorder. Few studies have addressed the progression of the deficit over time. The present investigation explores face emotion recognition (FER) performance throughout the course of schizophrenia. The aim of the study was to test the hypotheses that: 1) FER impairment was present in ultra high-risk (putatively prodromal) individuals, and that 2) impairment was stable across the course of the illness. Forty-three individuals with a putative prodromal syndrome, 50 patients with first episode of schizophrenia, 44 patients with multi-episode schizophrenia and 86 unaffected healthy control subjects were assessed to examine emotion recognition ability. ANCOVA analysis adjusted for possible confounder factors and subsequent planned contrasts with healthy controls was undertaken. The results revealed deficits in recognition of sadness and disgust in prodromal individuals, and of all negative emotions in both first-episode and multi-episode patients. Furthermore, there were no significant differences between clinical groups. Within the framework of the neurodevelopmental model of schizophrenia, our results suggest the presence of emotional recognition impairment before the onset of full-blown psychosis. Moreover, the deficit remains stable over the course of illness, fitting the pattern of a vulnerability indicator in contrast to an indicator of chronicity or severity.
    Full-text · Article · Dec 2012 · Schizophrenia Research
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    • "The second is the related construct of Theory of Mind (ToM; Brüne, 2005) which may be understood as the ability to form ideas about the things other people are thinking, grasp the subtle context-dependent meaning of others' words and gestures, and elucidate others' covert intentions. Deficits in emotion recognition and ToM, by definition, limit persons' abilities to understand the mental states of others, rendering social exchanges opaque, and, as such, could conceivably result in negative symptoms such as diminished affect or volition (Harvey and Penn, 2010; Salvatore et al., 2007; Salvatore et al., 2008). In other words, if social situations are confusing, those situations may fail to elicit basic psychological responses such as affect and desire. "
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    ABSTRACT: Although negative symptoms are a barrier to recovery from schizophrenia, little is understood about the psychological processes that reinforce and sustain them. To explore this issue, this study used structural equation modeling to test whether the impact of social withdrawal and emotion recognition deficits upon negative symptoms is mediated by the richness or poverty of personal narratives. The participants were 99 adults with schizophrenia spectrum disorders. Social cognition was assessed using the Bell-Lysaker Emotional Recognition Task; social withdrawal, using the Quality of Life Scale; narrative coherence, using the Scale To Assess Narrative Development; and negative symptoms, using the Positive and Negative Syndrome Scale. The findings reveal that although social cognition deficits and social withdrawal are significantly associated with negative symptom severity, these relationships become nonsignificant when personal narrative integrity is examined as a mediating factor. These results indicate that the development of personal narratives may be directly linked to the severity of negative symptoms; this construct may be a useful target for future interventions.
    Full-text · Article · Apr 2012 · The Journal of nervous and mental disease
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