Social Cognition and Psychosocial Functioning in Schizophrenia

Ability for empathy and theory of mind are diminshed in patients with schizophrenia. These kinds of social cognition are, however, necessary to interact with other people and obtain a well-balanced psychosocial functioning level, i.e. to have friends, to go for work, to be in partnership and so on. Own studies revealed that disturbances in social cognition are accompanied by fMRI activation deficits in distinct regions of the underlying neuronanatomical loop in schizophrenia. The most significant difference compared to healthy controls was found in the region of the anterior cingulate cortex (ACC) and medial prefrontal cortex (mPFC). We think that training of social cognition would improve both the neurobiological hypoactivation and the ability for empathy and theory of mind. As consequence, psychosocial functioning of the patients should be become better as measured e.g. by the personal and social performance scale (PSP). To emphazise the close relationship between social cognition, ist underlying neuobiology and psychosocial functioning is the main purpose of this lecture.

Download Full-text

Understanding of Self and Others: Neurobiological Underpinnings of Social Cognition

Cognitive Dimensions of Major Depressive Disorder ◽

10.1093/med/9780198810940.003.0016 ◽

2019 ◽

pp. 197-210

Author(s):

Franziska K. Goer ◽

Rebecca Elliott

Keyword(s):

Social Cognition ◽

Theory Of Mind ◽

Neural Substrates ◽

Moral Emotions ◽

Anterior Cingulate ◽

Subgenual Anterior Cingulate Cortex ◽

Processing Theory ◽

Moral Content ◽

Healthy Control ◽

Social Decision Making

This chapter examines the processes underlying interpersonal interactions in both healthy control individuals (HC) and those with major depressive disorder (MDD). The chapter focuses on four key types of social cognition that give rise to the intricate and dynamic nature of human social functioning, including self-referential processing, other-processing (‘theory of mind’), moral emotion, and social decision-making. It reviews studies investigating the neural substrates of social cognition in HC and MDD, most commonly using functional magnetic resonance imaging. Key brain areas identified include prefrontal cortex (PFC; including, most prevalently, the orbitolateral, medial–lateral, and dorsolateral PFC), temporal–parietal regions (in relation to theory of mind), and subgenual anterior cingulate cortex (in relation to both specific moral emotions, such as guilt, and moral content more generally).

Download Full-text

Are Impairments in Theory of Mind Specific to Borderline Personality Disorder?

Journal of Personality Disorders ◽

10.1521/pedi_2019_33_417 ◽

2020 ◽

Vol 34 (6) ◽

pp. 827-841 ◽

Cited By ~ 3

Author(s):

Eivind Normann-Eide ◽

Bj⊘rnar Torske Antonsen ◽

Elfrida Hartveit Kvarstein ◽

Geir Pedersen ◽

Anja Vaskinn ◽

...

Keyword(s):

Social Cognition ◽

Borderline Personality Disorder ◽

Personality Disorder ◽

Theory Of Mind ◽

Personality Disorders ◽

Interpersonal Problems ◽

Borderline Personality ◽

Healthy Controls ◽

Per Se ◽

The Relationship

Impaired theory of mind (ToM) is an assumed feature of borderline personality disorder (BPD). Yet, no studies have compared ToM abilities in patients with BPD, other personality disorders, and healthy controls, or investigated the relationship between ToM and severity of psychopathology and interpersonal problems. In this study, ToM was investigated by the Movie for the Assessment of Social Cognition. No differences were found between the three groups in overall ToM abilities. The BPD group was, however, characterized by more excessive ToM (interpreted as hypermentalization). Yet, when differentiating between BPD and further severity indicators, excessive ToM was not specifically associated with a BPD diagnosis per se. Finally, there was a moderate association between hypermentalization and interpersonal problems in the BPD group. This study suggests that BPD patients tend to hypermentalize when they misinterpret social information, and that this tendency is related to the severity of their psychopathology.

Download Full-text

Social functioning and cognition in patients with schizophrenia, their unaffected siblings and healthy controls: impact on quality of life

European Psychiatry ◽

10.1016/s0924-9338(11)73103-0 ◽

2011 ◽

Vol 26 (S2) ◽

pp. 1398-1398

Author(s):

D.D. Achaval ◽

K. Buglioni ◽

J. Lopez ◽

J. Douer ◽

E. Costanzo ◽

...

Keyword(s):

Quality Of Life ◽

Social Skills ◽

Social Cognition ◽

Social Functioning ◽

Social Performance ◽

Adaptive Behaviour ◽

Healthy Controls ◽

Cognitive Screening ◽

Intermediate Phenotypes

BackgroundPatients with schizophrenia show deficits in many cognitive domains and social functioning, social skills, and self management skills in their daily life activities.ObjectiveTo evaluate the relationship between general-social cognition, mental state and social functioning, and impact on quality of life.MethodsTwenty patients with chronic disorder of schizophrenia were evaluated and compared with 20 siblings and 20 healthy controls regarding performance in a series of tests: Cognitive Screening: Word Accentuation Test, MCCB (Matrics Consensus Cognitive Battery) Social Functioning: UPSA (University of California Performance Skills Assessment), TABS (Test of Adaptive Behaviour in Schizophrenia), SSPA (Social Skills Performance Assessment), Beck and Hamilton depression scales, Scale for Positive and Negative Syndrome of Schizophrenia, and SF-36 as indicator of quality of life.ResultsPatients showed significant differences from controls and siblings in MCCB total score (p < 0.001), whereas siblings showed significant differences compared to controls in MCCB total score (p = 0.053). Siblings performed differently from patients (p < 0.001) and controls (p = 0.019) in social functioning measured with TABS. A series of correlations between general cognition and social functioning were demonstrated for patients and their unaffected siblings (not shown).ConclusionResults suggest that the performance of nonpsychotic siblings is located between patients and healthy controls, suggesting that social performance measures are (or associated with) intermediate phenotypes of the disease. General and social cognition have a complex relationship with social functioning and quality of life.

Download Full-text

Intrinsic cerebellar functional connectivity of social cognition and theory of mind in first-episode psychosis patients

npj Schizophrenia ◽

10.1038/s41537-021-00193-w ◽

2021 ◽

Vol 7 (1) ◽

Author(s):

Soo Hwan Park ◽

Taekwan Kim ◽

Minji Ha ◽

Sun-Young Moon ◽

Silvia Kyungjin Lho ◽

...

Keyword(s):

Social Cognition ◽

Theory Of Mind ◽

Resting State ◽

Mirror Neuron System ◽

First Episode Psychosis ◽

Anterior Cingulate ◽

First Episode ◽

Episode Psychosis ◽

Crus I ◽

The Right

AbstractNeuroimaging studies have revealed how intrinsic dysconnectivity among cortical regions of the mentalizing network (MENT) and the mirror neuron system (MNS) could explain the theory of mind (ToM) deficit in schizophrenia patients. However, despite the concurrent involvement of the cerebellum with the cortex in social cognition, the dysfunction in intrinsic interplay between the cerebellar nodes of MENT/MNS and the cortex in schizophrenia patients remains unknown. Thus, we aimed to investigate whether resting-state cerebello–cortical dysconnectivity exists in first-episode psychosis (FEP) patients in relationship with their ToM deficit. A total of 37 FEP patients and 80 healthy controls (HCs) underwent resting-state functional magnetic resonance imaging. Using a priori-defined cerebellar seeds that functionally connect to the MENT (right crus II) and MNS (right crus I), we compared cerebello–cortical functional connectivities (FCs) in FEP patients and HCs. Correlations between cerebello–parietal connectivities and ToM performance were investigated in FEP patients. FEP patients showed hyperconnectivity between the right crus II and anterior cingulate gyrus and between the right crus I and supplementary motor area, bilateral postcentral gyrus, and right central/parietal operculum (CO/PO). Hypoconnectivity was found between the right crus II and left supramarginal gyrus (SMG) in FEP patients. FCs between the right crus II and left SMG and between the right crus I and right CO/PO were significantly correlated with ToM scores in FEP patients. In accordance with the “cognitive dysmetria” hypothesis, our results highlight the importance of cerbello-cortical dysconnectivities in understanding social cognitive deficits in schizophrenia patients.

Download Full-text

Increased activation of the pregenual anterior cingulate cortex to citalopram challenge in migraine: an fMRI study

BMC Neurology ◽

10.1186/s12883-019-1478-0 ◽

2019 ◽

Vol 19 (1) ◽

Author(s):

Andrea Edit Edes ◽

Shane McKie ◽

Edina Szabo ◽

Gyongyi Kokonyei ◽

Dorottya Pap ◽

...

Keyword(s):

Anterior Cingulate Cortex ◽

Brain Area ◽

Region Of Interest ◽

Cingulate Cortex ◽

Stress Sensitivity ◽

Anterior Cingulate ◽

Healthy Controls ◽

Significant Difference ◽

Acute Increase ◽

The Right

Abstract Background The anterior cingulate cortex (ACC) is a key structure of the pain processing network. Several structural and functional alterations of this brain area have been found in migraine. In addition, altered serotonergic neurotransmission has been repeatedly implicated in the pathophysiology of migraine, although the exact mechanism is not known. Thus, our aim was to investigate the relationship between acute increase of brain serotonin (5-HT) level and the activation changes of the ACC using pharmacological challenge MRI (phMRI) in migraine patients and healthy controls. Methods Twenty-seven pain-free healthy controls and six migraine without aura patients participated in the study. All participant attended to two phMRI sessions during which intravenous citalopram, a selective serotonin reuptake inhibitor (SSRI), or placebo (normal saline) was administered. We used region of interest analysis of ACC to compere the citalopram evoked activation changes of this area between patients and healthy participants. Results Significant difference in ACC activation was found between control and patient groups in the right pregenual ACC (pgACC) during and after citalopram infusion compared to placebo. The extracted time-series showed that pgACC activation increased in migraine patients compared to controls, especially in the first 8–10 min of citalopram infusion. Conclusions Our results demonstrate that a small increase in 5-HT levels can lead to increased phMRI signal in the pregenual part of the ACC that is involved in processing emotional aspects of pain. This increased sensitivity of the pgACC to increased 5-HT in migraine may contribute to recurring headache attacks and increased stress-sensitivity in migraine.

Download Full-text

Cognitive and affective theory of mind in Korsakoff’s syndrome

Acta Neuropsychiatrica ◽

10.1017/neu.2018.35 ◽

2018 ◽

Vol 31 (03) ◽

pp. 128-134 ◽

Cited By ~ 2

Author(s):

Rolinda Drost ◽

Albert Postma ◽

Erik Oudman

Keyword(s):

Social Cognition ◽

Theory Of Mind ◽

Anterograde Amnesia ◽

Large Degree ◽

Mental States ◽

Healthy Controls ◽

Korsakoff’S Syndrome ◽

Korsakoff's Syndrome ◽

Executive Deficits ◽

And Gender

AbstractObjectiveKorsakoff’s syndrome (KS) is a chronic neuropsychiatric disorder characterised by severe anterograde amnesia and executive deficits. Theory of Mind (ToM) is the capacity to represent others’ mental states such as their knowledge, thoughts, feelings, beliefs, and intentions in order to explain and predict their behaviour. Surprisingly this topic has received hardly any attention in research on KS, although the severity of behavioural problems in KS suggest possible ToM difficulties. The aim of the present study was therefore to assess whether cognitive and affective ToM are impaired in patients with KS.MethodsWe examined 21 KS patients and 21 age- and gender-matched healthy controls on three standardised tests that assess cognitive and affective ToM, including the subtests of the mini-Social Cognition and Emotional Assessment battery and a specialised version of the Sally–Anne Test.ResultsKS patients showed largely impaired cognitive and affective ToM compared to healthy controls, as reflected in large effect sizes on both cognitive and affective ToM tests. Executive deficits explained problems in emotion recognition, but not other ToM aspects.ConclusionKS patients have large impairments in both cognitive and affective aspects of social cognition. Their ability to recognise emotions, take the perspective of others, and understand socially awkward situations is vastly compromised. The impairments in ToM functioning are to a large degree functionally discrepant from executive disorders that are commonly present in KS. This study therefore highlights the importance to properly index ToM functioning in neuropsychological assessments for individuals with a possible KS diagnosis.

Download Full-text

Brain activity during social cognition tasks in individuals with schizophrenia, their unaffected siblings, and healthy controls

European Psychiatry ◽

10.1016/s0924-9338(11)73102-9 ◽

2011 ◽

Vol 26 (S2) ◽

pp. 1397-1397

Author(s):

D. de Achaval ◽

M. Villarreal ◽

E. Costanzo ◽

J. Douer ◽

K. Buglioni ◽

...

Keyword(s):

Social Cognition ◽

Theory Of Mind ◽

Inferior Frontal Gyrus ◽

Emotion Processing ◽

Group Analysis ◽

Brain Structures ◽

Mental States ◽

Healthy Controls ◽

Brain Lateralization ◽

Measuring Signal

BackgroundSeveral studies have shown that patients with schizophrenia have impaired performance in various aspects of social cognition including emotion processing and theory of mind. Most available neuroimaging studies have compared patients and healthy controls during such mental.ObjectiveTo determine whether alterations in brain activation associated with social cognition reflects a heritable trait in schizophrenia.MethodsSixteen patients with schizophrenia (age 31.3 ± 6.5), 16 non-psychotic siblings (age 31.8 ± 3.5, 6 females) and 16 healthy subjects (age 30.1 ± 9.2, 6 females) underwent BOLD fMRI during emotion processing (Ekman Faces Test) and Theory of Mind (ToM) paradigms: Faces and Reading the Mind in the Eyes tasks. In all cases a gender condition was used as a control task. Random effects analysis was done for each task within groups, measuring signal changes between the target and control conditions of each paradigm, and later a group analysis was done.ResultsIn patients, social cognition tasks brought about activations in language areas (left inferior frontal gyrus and structures near tempo parietal junction). The intensity of the activations was minimum in the emotional processing task (basic emotions), and maximum in the detection of complex mental states in eyes. Healthy controls also activated symmetric brain structures on the right side. Unaffected siblings also showed bilateral activation in the same brain structures but asymmetrically distributed (left > right).DiscussionThese results support the idea that schizophrenia is an illness characterized by abnormalities in the process of brain lateralization.

Download Full-text

Internal and external responsiveness of the personal and social performance scale in patients with schizophrenia

European Psychiatry ◽

10.1016/j.eurpsy.2017.01.2114 ◽

2017 ◽

Vol 41 (S1) ◽

pp. S189-S189

Author(s):

E.C. Chiu ◽

C.L. Hsieh

Keyword(s):

Social Functioning ◽

Outcome Measure ◽

Social Performance ◽

Global Score ◽

Clinical Global Impression Severity ◽

Significant Difference ◽

External Responsiveness ◽

Competing Interest ◽

Performance Scale ◽

Domain Scores

IntroductionThe Personal and Social Performance scale (PSP) is widely used to assess social functioning with 4-domain scores and a global score in patients with schizophrenia. However, internal and external responsiveness of the PSP is largely unknown limiting its use as an outcome measure.ObjectivesThe purpose of this study was to examine internal and external responsiveness of the PSP in inpatients with schizophrenia receiving treatments in the acute phase.MethodsEighty patients were conducted the PSP and the Clinical Global Impression-Severity (CGI-S) at admission and at discharge. The standardized effect size (ES), the standardized response mean (SRM), and paired t-test were used for examining internal responsiveness. We estimated correlations between the changes in scores of the PSP and those of the CGI-S using Pearson's r for investigated external responsiveness.ResultsFor internal responsiveness, the ESs and the SRMs of the domains were 0.74–1.74 and 0.68–1.72, respectively. The values of the ES and the SRM in the global score were 1.72 and 1.74, respectively. The paired t-tests showed statistically significant difference (P < 0.001) for the score changes of the four domains and the global score. Regarding external responsiveness, fair and moderate to good correlations (r = 0.35–0.74) were found among the changes in the 4-domain scores and the global score with the those of the CGI-S.ConclusionsThe PSP has sufficient internal responsiveness and substantial external responsiveness in inpatients with schizophrenia receiving treatments at the acute wards. The PSP is useful as an outcome measure for detecting changes of social functioning over time.Disclosure of interestThe authors have not supplied their declaration of competing interest.

Download Full-text

Faux Pas Test in schizophrenic patients

Jornal Brasileiro de Psiquiatria ◽

10.1590/0047-2085000000098 ◽

2016 ◽

Vol 65 (1) ◽

pp. 17-21 ◽

Cited By ~ 1

Author(s):

Juliana Negrão ◽

Henrique Teruo Akiba ◽

Vivian Renne Gerber Lederman ◽

Álvaro Machado Dias

Keyword(s):

Social Cognition ◽

Recognition Test ◽

Cross Sectional Study ◽

Short Version ◽

Healthy Controls ◽

Cross Sectional ◽

Significant Difference ◽

Schizophrenic Patients ◽

Valid Test ◽

The One

ABSTRACT Objective The aim of this study is to validate the adult version of “Faux Pas Recognition Test” created by Stone and colleagues (1998) as a reliable instrument assess and discriminate social cognition among schizophrenia patients and healthy controls. Methods This is a cross-sectional study with a total of 196 participants (mean age = 26.45; CI (95%) [25.10; 27.83]) 51% male. From those, 44 (22.4%) patients with schizophrenia and 152 (77.6%) healthy controls. The participants answered a short version of the Faux Pas Recognition Test, composed by 10 stories. Results Significant differences were found between both groups regarding their scores on Faux Pas Recognition Test (p = 0.003). Patients with schizophrenia had lower score, compared to healthy controls. Story 14 was the best to distinguish both groups, and Story 16, the worst. Among the questions of Faux Pas stories, the one related to intuition presented the most significant difference between the groups (p = 0.001), followed by the one related to understanding (p = 0.003). Conclusion The Brazilian version of the Faux Pas Recognition Test is a valid test to assess social cognition in schizophrenia and can be an important instrument to be used on the clinical practice.

Download Full-text

Interplay among positive and negative symptoms, neurocognition, social cognition, and functional outcome in clinically stable patients with schizophrenia: a network analysis

F1000Research ◽

10.12688/f1000research.74385.1 ◽

2021 ◽

Vol 10 ◽

pp. 1258

Author(s):

Thammanard Charernboon

Keyword(s):

Social Cognition ◽

Network Analysis ◽

Emotion Recognition ◽

Functional Outcome ◽

Negative Symptoms ◽

Social Performance ◽

Positive Symptoms ◽

Impairment In Functioning ◽

The Mind ◽

Performance Scale

Background: Schizophrenia has a broad range of interrelated symptoms and impairment in functioning. The objective of the study was to explore the interplay between positive symptoms, negative symptoms, neurocognition, social cognition and functional outcome in patients with schizophrenia using network analysis. Methods: Participants were 64 clinically stable patients with schizophrenia. Psychopathologic, neurocognition, social cognition, and functional outcome were measured using the Scale for the Assessment of Positive Symptoms, Scale for the Assessment of Negative Symptoms, Addenbrooke’s Cognitive Examination III, Faces test, Reading the Mind in the Eyes test, and Personal Social Performance scale. Results: The network analysis suggested that functional outcome was the most central in the network followed by avolition and asociality. Functioning was directly connected to avolition, asociality, blunted affect, neurocognition and emotion recognition. The positive symptoms were the most remote and therefore the least important node. Conclusion: The high centrality of functioning suggests the need for improving of everyday life skills for patients with schizophrenia. Moreover, treatment of specific negative symptoms, neurocognition and emotion recognition could also enhance functional outcome.

Download Full-text