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

ArticleinSchizophrenia Research 125(2-3):143-51 · February 2011with14 Reads
DOI: 10.1016/j.schres.2010.11.007 · Source: PubMed
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.
    • "The Social Cognition Psychometric Evaluation (SCOPE) study identified four core domains of social cognition, namely emotion processing, social perception, theory of mind/mental state attribution, and attributional style/bias (Pinkham et al., 2014). Social cognition appears to be a multi-dimensional construct that is overlapping and yet distinct from social skills and neurocognition (Mancuso et al., 2011; van Hooren et al., 2008). It has been found to mediate a significant indirect relationship between neurocognition and functional outcomes (Martínez-Domínguez et al., 2015; Schmidt et al., 2011). "
    [Show abstract] [Hide abstract] ABSTRACT: Social cognition is the mental process which underpins social interactions. Increasingly, it has been recognized to be impaired in people with schizophrenia, resulting in functional problems. Correspondingly, the past ten years have seen huge developments in the study of interventions to ameliorate social cognitive deficits among people with schizophrenia. In the present review, we systematically reviewed published studies on social cognitive interventions from 2005 to 2015. Of the 61 studies included in this review, 20 were on broad-based social cognitive interventions, which incorporated neurocognitive training, specialized learning technique or virtual reality social skills training. On the other hand, 31 studies on targeted interventions either focused on specific social cognitive domains, or a range of domains. Improvements in emotion processing and theory of mind were often reported, while social perception and attributional style were less frequently measured. Both broad-based and targeted interventions achieved gains in social functioning, albeit inconsistently. Lastly, nine studies on the use of oxytocin and one study on transcranial direct current stimulation reported positive preliminary results in higher-order cognition and facial affect recognition respectively. This review revealed that a wide range of social cognitive interventions is currently available and most have shown some promise in improving social cognition outcomes. However, there is a need to use a common battery of measurements for better comparisons across interventions. Future research should examine combination therapies and the sustainability of gains beyond the intervention period.
    Full-text · Article · Sep 2016
    • "Mind (ToM), the ability to infer other people's intentions, beliefs, and mental states, and 4) Attributional Style (AS), or the types of attributions individuals make about the causes of events, with individuals who have psychosis being more likely to blame others for negative events. Although attributional style and theory of mind are separable domains (Mancuso, Horan, Kern & Green, 2011), it has been suggested that these two domains may be closely related, with deficits in the ability to correctly infer other people's intentions and mental states related to the types of attributions individuals make about the causes of events (Penn, Sanna, & Roberts, 2008; Randall, Corcoran, Day, & Bentall, 2003; Taylor & Kinderman, 2002). "
    [Show abstract] [Hide abstract] ABSTRACT: Objectives: In this proof-of-concept trial, we examined the feasibility and preliminary efficacy of Understanding Social Situations (USS), a new social-cognitive intervention that targets higher level social-cognitive skills using methods common to neurocognitive remediation, including drill and practice and hierarchically structured training, which may compensate for the negative effects of cognitive impairment on learning. Method: Thirty-eight individuals with schizophrenia spectrum disorders completed the same baseline assessment of cognitive and social-cognitive functioning twice over a 1-month period to minimize later practice effects, then received 7-10 sessions of USS training, and then completed the same assessment again at posttreatment. Results: USS training was well tolerated and received high treatment satisfaction ratings. Large improvements on the USS Skills Test, which contained items similar to but not identical to training stimuli, suggest that we were effective in teaching specific training content. Content gains generalized to improvements on some of the social-cognitive tasks, including select measures of attributional bias and theory of mind. Importantly, baseline neurocognition did not impact the amount of learning during USS (as indexed by the USS Skills Test) or the amount of improvement on social-cognitive measures. Conclusions and implications for practice: USS shows promise as a treatment for higher level social-cognitive skills. Given the lack of relationship between baseline cognition and treatment effects, it may be particularly appropriate for individuals with lower range cognitive function. (PsycINFO Database Record
    Article · Jun 2016
    • "Patients who had worked at some time in the previous two years had higher ToM and lower JTC scores compared with the unemployed group. The model estimated that social-cognitive abilities had a significant impact (0.41) on work performance, which is much larger than the estimate of 0.26 between social cue detection and work functioning in a recent study [36]. The estimated path coefficient between socialcognitive abilities and work performance was negative in the model, as well as the paths from these abilities to ToM, EP and neurocognitive measures. "
    Dataset · May 2016 · Psychiatric Rehabilitation Journal
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