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Factor Structure of Social Cognition in Schizophrenia: Is Empathy Preserved?  [PDF]
Silvia Corbera,Bruce E. Wexler,Satoru Ikezawa,Morris D. Bell
Schizophrenia Research and Treatment , 2013, DOI: 10.1155/2013/409205
Abstract: Social cognitive impairments are core features of schizophrenia and are closely associated with poor functional outcome. This study sought to identify specific aspects of social cognition and their relationships to measures of social function, quality of life, and neurocognition. Principal component analysis was performed using social cognitive measures in patients with schizophrenia and healthy matched controls and revealed three factors: Interpersonal Discomfort, Basic Social Cognition, and Empathy. Patients had higher scores on Interpersonal Discomfort and lower scores on Basic Social Cognition than controls, but the two groups were the same on Empathy. Lower social performance was significantly correlated with poor Basic Social Cognition in patients and with high Interpersonal Discomfort in controls. While neurocognition was significantly associated with Basic Social Cognition in both groups, it was not associated with Empathy. Social cognitive interventions should emphasize improving basic social cognitive processing deficits, managing Interpersonal Discomfort, and utilizing preserved capacity for empathy as a potential strength in social interactions. 1. Introduction Patients with schizophrenia have poor social cognitive skills, and these deficits greatly impact their daily functioning [1]. Additionally, social cognition has been found to mediate the relationship between neurocognition and social functioning [2, 3]. Treatment interventions have proliferated to address deficits in social cognition as ways to improve social functioning and several meta-analyses strongly support the efficacy of the interventions [4–6]. However, social cognition and social function are two broad multidimensional constructs and relatively little is known about the relationships among more specific aspects of each, either within or across the two broader spheres, or what aspects of each are most responsive to current treatments. One recent meta-analysis by Kurtz and Richardson [6] compared treatment effects on various measures of social cognition and found the greatest effects on facial affect recognition and lesser effects on measures of other aspects of social cognition. More work is needed to clarify which social cognitive constructs most directly influence social functioning [3] and which are more or less amenable to existing treatments. Understanding the social cognitive constructs that most relate to social functioning would help identify targets to treat in social cognitive interventions. Some studies have attempted to study the relationships between selected
Relationships between neurocognition, emotional processing and social functioning in schizophrenia  [PDF]
Paola Jaramillo,Juan Carlos Ruiz,Inma Fuentes
Psychology, Society & Education , 2011,
Abstract: A series of cognitive deficits in schizophrenia have led to a focus on neuro- and social cognition in current research and professional practice. These deficits have significant implications for social functioning. The aim of the current study is to analyse the relationships between neurocognition, social cognition (evaluated via emotional recognition tasks) and social functioning. Sixty people diagnosed with schizophrenia made up the sample and the following areas were evaluated: executive functioning and cognitive flexibility, attention and vigilance, processing speed, emotion identification and discrimination and community functioning. Results indicate that measures of basic cognition correlate significantly with communal functioning while measures of emotion recognition, especially those identifying facial emotions only correlate positively with one area of communal functioning, namely that of communication and social contact.
Social cognition in schizophrenia  [PDF]
Toti?-Poznanovi? Sanja,Pavlovi? Dragan M.,?or?evi? Jelena R.,Pavlovi? Aleksandra M.
Srpski Arhiv za Celokupno Lekarstvo , 2011, DOI: 10.2298/sarh1112828t
Abstract: Patients with schizophrenia display alterations in social cognition, as well as in the realm of neurocognition. It is still unclear to what extent these two cognitive domains represent two separate dimensions or different expressions of a unified deficit. Tasks used to assess social cognition subcomponents cover basic social cognition, such as mentalisation, data collection and making conclusions, source monitoring and characteristics of life-styles. The variety of findings of various studies is probably related to the fact that most studies considered social cognition as one-dimensional construct represented, for example, by unique measurements of emotional recognition. Research results dealing with social cognition suggest that the impairment of social cognition is the characteristic feature of schizophrenia and have important implications for the development, course and outcome of this disorder.
Can Social Functioning in Schizophrenia Be Improved through Targeted Social Cognitive Intervention?  [PDF]
David L. Roberts,Dawn I. Velligan
Rehabilitation Research and Practice , 2012, DOI: 10.1155/2012/742106
Abstract: Efforts to use cognitive remediation in psychosocial intervention for schizophrenia have increasingly incorporated social cognition as a treatment target. A distinction can be made in this work between “broad-based” interventions, which integrate social cognitive training within a multicomponent suite of intervention techniques and “targeted” interventions; which aim to enhance social cognition alone. Targeted interventions have the potential advantage of being more efficient than broad-based interventions; however, they also face difficult challenges. In particular, targeted interventions may be less likely to achieve maintenance and generalization of gains made in treatment. A novel potential solution to this problem is described which draws on the social psychological literature on social cognition. 1. Introduction Over the past twenty years, it has become clear that front line treatments for schizophrenia, in particular medication, do not yield sufficient improvement in functional outcome in this population [1]. Thus, treatment developers have sought new intervention approaches. Prominent among these has been neurocognitive training (We use the term “neurocognitive” rather than “cognitive” to draw a clearer contrast for the reader between neurocognition and social cognition.), which aims to improve basic cognitive functions (e.g., attention, memory, and executive function) through compensatory strategies and/or remediative practice. Although still a relatively young field, research now suggests that neurocognitive training can enhance cognitive functioning among individuals with schizophrenia, and there is growing evidence that it can improve functional outcomes [2, 3]. Importantly, the effect of neurocognitive training on functional outcomes appears to be greatest when it is bundled within a broader treatment package that includes more functionally proximal interventions, such as vocational placement [4]. Recognizing the importance of targeting functionally proximal domains in treatment, some researchers have incorporated social cognition as an intervention target in psychosocial treatment for schizophrenia. Social cognition refers to the mental operations underlying interpersonal functioning [5]. In schizophrenia research, it most often is seen as comprising emotion perception (the ability to infer others’ emotional states), theory of mind (ToM; the ability to infer others’ mental states), and attributional bias (individual tendencies in explaining the causes of social events [6]). As a treatment target, social cognition has the advantage of being
Social Cognition in Schizophrenia: From Social Stimuli Processing to Social Engagement  [PDF]
Pablo Billeke,Francisco Aboitiz
Frontiers in Psychiatry , 2013, DOI: 10.3389/fpsyt.2013.00004
Abstract: Social cognition consists of several skills which allow us to interact with other humans. These skills include social stimuli processing, drawing inferences about others’ mental states, and engaging in social interactions. In recent years, there has been growing evidence of social cognitive impairments in patients with schizophrenia. Apparently, these impairments are separable from general neurocognitive impairments, such as attention, memory, and executive functioning. Moreover, social cognition seems to be a main determinant of functional outcome and could be used as a guide to elaborate new pharmacological and psychological treatments. However, most of these studies focus on individual mechanisms and observational perspectives; only few of them study schizophrenic patients during interactive situations. We first review evidences of social cognitive impairments both in social stimuli processing and in mental state attribution. We focus on the relationship between these functions and both general cognitive impairments and functional outcome. We next review recent game theory approaches to the study of how social engagement occurs in schizophrenic patients. The advantage of using game theory is that game-oriented tasks can assess social decision making in an interactive everyday situation model. Finally, we review proposed theoretical models used to explain social alterations and their underlying biological mechanisms. Based on interactive studies, we propose a framework which takes into account the dynamic nature of social processes. Thus, understanding social skills as a result of dynamical systems could facilitate the development of both basic research and clinical applications oriented to psychiatric populations.
Social Cognition in Schizophrenia: A Review Study  [PDF]
Neama Kamel, Fryial AlQahtani
Open Journal of Psychiatry (OJPsych) , 2019, DOI: 10.4236/ojpsych.2019.92007
Abstract: Social cognition includes all operations encountered in the process of perceiving, understanding & production of appropriate reactions while confronting with others. These include: social awareness, theory of mind, attributive style, and emotion processing. Social cognition skills have been recognized as a vital component in the rehabilitation process for schizophrenic persons, its strong contributors in social function among individual suffering from schizophrenia. The purpose of this review is to appraise various researches about social cognition and its correlates in addition to evaluating various cognitive interventions targeted toward improving social cognition function among patients group and to find the best techniques to ameliorate social cognitive deficits in schizophrenia. Databases were searched from the period from the year 2000 to October 2018. The search terms used were “Social cognition”, emotional management program, schizophrenia. A total of 85 articles were identified and those who meet inclusion criteria including 27 articles. Finding indicates the efficacy of social intervention that targets cognitive aspect in functional abilities of schizophrenic patients and also emotion processing which are significant mediators of social performance aptitudes in patients group.
Contextual Social Cognition Impairments in Schizophrenia and Bipolar Disorder  [PDF]
Sandra Baez, Eduar Herrera, Lilian Villarin, Donna Theil, María Luz Gonzalez-Gadea, Pedro Gomez, Marcela Mosquera, David Huepe, Sergio Strejilevich, Nora Silvana Vigliecca, Franziska Matth?us, Jean Decety, Facundo Manes, Agustín M. Iba?ez
PLOS ONE , 2013, DOI: 10.1371/journal.pone.0057664
Abstract: Background The ability to integrate contextual information with social cues to generate social meaning is a key aspect of social cognition. It is widely accepted that patients with schizophrenia and bipolar disorders have deficits in social cognition; however, previous studies on these disorders did not use tasks that replicate everyday situations. Methodology/Principal Findings This study evaluates the performance of patients with schizophrenia and bipolar disorders on social cognition tasks (emotional processing, empathy, and social norms knowledge) that incorporate different levels of contextual dependence and involvement of real-life scenarios. Furthermore, we explored the association between social cognition measures, clinical symptoms and executive functions. Using a logistic regression analysis, we explored whether the involvement of more basic skills in emotional processing predicted performance on empathy tasks. The results showed that both patient groups exhibited deficits in social cognition tasks with greater context sensitivity and involvement of real-life scenarios. These deficits were more severe in schizophrenic than in bipolar patients. Patients did not differ from controls in tasks involving explicit knowledge. Moreover, schizophrenic patients’ depression levels were negatively correlated with performance on empathy tasks. Conclusions/Significance Overall performance on emotion recognition predicted performance on intentionality attribution during the more ambiguous situations of the empathy task. These results suggest that social cognition deficits could be related to a general impairment in the capacity to implicitly integrate contextual cues. Important implications for the assessment and treatment of individuals with schizophrenia and bipolar disorders, as well as for neurocognitive models of these pathologies are discussed.
Linking social cognition with social interaction: Non-verbal expressivity, social competence and "mentalising" in patients with schizophrenia spectrum disorders
Martin Brüne, Mona Abdel-Hamid, Claudia Sonntag, Caroline Lehmk?mper, Robyn Langdon
Behavioral and Brain Functions , 2009, DOI: 10.1186/1744-9081-5-6
Abstract: Fifty patients with SSD were videotaped during interviews. Non-verbal expressivity was evaluated using the Ethological Coding System for Interviews (ECSI). Social competence was measured using the Social Behaviour Scale and psychopathology was rated using the Positive and Negative Symptom Scale. Neurocognitive variables included measures of IQ, executive functioning, and two mentalising tasks, which tapped into the ability to appreciate mental states of story characters.Non-verbal expressivity was reduced in patients relative to controls. Lack of "prosocial" nonverbal signals was associated with poor social competence and, partially, with impaired understanding of others' minds, but not with non-social cognition or medication.This is the first study to link deficits in non-verbal expressivity to levels of social skills and awareness of others' thoughts and intentions in patients with SSD.Over the last 25 or so years, research into the nonverbal behaviour of patients with schizophrenia or schizophrenia spectrum disorders (SSD) has demonstrated that patients can be reliably distinguished from unaffected individuals on the basis of their reduced expressivity [1-3]. For example, microanalytic studies of facial movements using the Facial Action Coding System (FACS) [4] revealed that patients with schizophrenia are reduced in their facial expressivity, particularly with regards to the expression of positive emotions that are usually encoded via movements of the upper part of the face [2,5]. Other studies carried out in more "naturalistic" settings on hospital wards have shown that persons with schizophrenia avoid physical proximity to others and display other deficits in engaging in social interaction [1,6,7]. These studies have in common that they are based on ethological methodology. Ethological studies in normal populations have shown that humans use facial expressions, gestures and whole body movements to convey communicative signals that invite social interaction (af
Influence of age at onset on social functioning in outpatients with schizophrenia
Ochoa,S.; Usall,J.; Villalta-Gil,V.; Vilaplana,M.; Márquez,M.; Valdelomar,M.; Haro,J.M.; ,;
The European Journal of Psychiatry , 2006, DOI: 10.4321/S0213-61632006000300003
Abstract: background and objectives: there are different factors that have been found to predict disability in schizophrenia. the aim of our study is to evaluate the influence of age at onset on social functioning in schizophrenia in a large sample of schizophrenic outpatients controlling for gender. methods: two hundred and thirty-one subjects with schizophrenia (dsm-iv criteria) were randomly selected from a register that included all patients under treatment in five mental health care centers (mhcc) in spain. patients were evaluated with a sociodemographic and clinical questionnaire, and the spanish version of the living skills profile (lsp). pearson's analyses were performed between age at onset and lsp, and an anova analysis to compare three groups of age at onset (early, middle and late). gender was introduced as a covariable. results: mean age at onset of the total sample was 23 (sd 7.35), with women having a later age at onset than men (women 24.6 (sd 9.1) ; men 22.2 (sd 5.9) (p<0.05)). the relation between age at onset and social functioning was only significant in the not interpersonal social behavior subscale (p<0.01). early age at onset was positively related to social contact-communication (p<0.05), not interpersonal social behavior (p<0.05) and total lsp score (p<0.05). when including gender as a covariable, a significant relationship between age at onset and social functioning was found in most of the lsp subscales. conclusions: early onset of illness negatively influences psychosocial functioning, especially in the areas of communication, not interpersonal social behaviour and self-care. female gender positively influences most aspects of social functioning.
Influence of age at onset on social functioning in outpatients with schizophrenia  [cached]
S. Ochoa,J. Usall,V. Villalta-Gil,M. Vilaplana
The European Journal of Psychiatry , 2006,
Abstract: Background and Objectives: There are different factors that have been found to predict disability in schizophrenia. The aim of our study is to evaluate the influence of age at onset on social functioning in schizophrenia in a large sample of schizophrenic outpatients controlling for gender. Methods: Two hundred and thirty-one subjects with schizophrenia (DSM-IV criteria) were randomly selected from a register that included all patients under treatment in five mental health care centers (MHCC) in Spain. Patients were evaluated with a sociodemographic and clinical questionnaire, and the Spanish version of the Living Skills Profile (LSP). Pearson's analyses were performed between age at onset and LSP, and an ANOVA analysis to compare three groups of age at onset (early, middle and late). Gender was introduced as a covariable. Results: Mean age at onset of the total sample was 23 (sd 7.35), with women having a later age at onset than men (women 24.6 (sd 9.1) ; men 22.2 (sd 5.9) (p<0.05)). The relation between age at onset and social functioning was only significant in the not interpersonal social behavior subscale (p<0.01). Early age at onset was positively related to social contact-communication (p<0.05), not interpersonal social behavior (p<0.05) and total LSP score (p<0.05). When including gender as a covariable, a significant relationship between age at onset and social functioning was found in most of the LSP subscales. Conclusions: Early onset of illness negatively influences psychosocial functioning, especially in the areas of communication, not interpersonal social behaviour and self-care. Female gender positively influences most aspects of social functioning.
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