Metacognitive deficits and social functioning in schizophrenia across symptom profiles: A latent class analysis

Functional deficits are a hallmark of schizophrenia spectrum disorders, but much debate still exists over why and how they originate. One model suggests that disturbances in social functioning are a result of metacognitive deficits or a failure to integrate information to form more complex ideas of themselves and others. It is unclear if this social dysfunction is present across different symptom presentations. We examined the relationship of metacognition, symptoms, and social functioning among a sample of adults with schizophrenia spectrum disorders (N = 334). A latent class analysis produced a four-class model. Groups were classified as follows: diffuse symptoms/moderately impaired social functioning (Class 1), positive and hostility symptoms/mildly impaired social functioning (Class 2), minimal symptoms/good social functioning (Class 3), and negative and cognitive symptoms/severely impaired social functioning (Class 4). Class 3 demonstrated better overall metacognitive capacity than both Classes 1 and 4 but did not differ significantly from Class 2. Classes 2 and 3 both demonstrated better interpersonal functioning than Classes 1 and 4. Together, these findings provide support for models of poor functioning that stem from fragmentation of an individual’s experience, leading to diminished abilities to form meaningful connections with others. Additional interpretations, limitations, and research implications are discussed