S121. REAL-WORLD FUNCTIONING IN SCHIZOPHRENIA: NEGATIVE SYMPTOMS AS A BRIDGE IN PATHWAYS FROM NEUROCOGNITION, SOCIAL COGNITION, AND FUNCTIONAL COMPETENCE

A growing body of research has shown that two domains of cognition, neurocognition and social cognition, predict different domains of real-world outcomes in people with schizophrenia. Social cognition has been shown to predict social outcomes but not non-social outcomes (e.g. living independently), and neurocognition provides minimal prediction of social outcomes (e.g. interpersonal relationships). The differing predictive value of neurocognition and social cognition has led to an exploration of potential factors that interact with cognition to influence everyday outcomes. Functional skills, negative symptoms, and self-assessment have shown particularly promising relationships with cognitive ability. Several consensus studies have pinpointed valid performance-based assessments. High-contact informant ratings have additionally been shown to be highly accurate. The emerging understanding of divergent patterns of predicting outcomes and reliable assessments present an opportunity to improve treatment targets and real-world outcomes for individuals with schizophrenia. In particular, a recently defined component of metacognition has shown particular promise. Introspective accuracy (IA) addresses how well individuals evaluate their own abilities. Emerging research has found that IA of neurocognitive ability better predicts everyday functional deficits than scores on performance-based measures of neurocognitive skills and has found that IA of social cognition accounts unique variance in real world disability above social cognitive abilities. Intriguingly, IA of neurocognition appears to preferentially predict non-social outcomes while IA of social cognition predicts social outcomes.

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Clinical symptoms, mainly negative symptoms, mediate the influence of neurocognition and social cognition on functional outcome of schizophrenia

Schizophrenia Research ◽

10.1016/j.schres.2013.02.009 ◽

2013 ◽

Vol 146 (1-3) ◽

pp. 231-237 ◽

Cited By ~ 97

Author(s):

Chieh-Hsin Lin ◽

Chieh-Liang Huang ◽

Yue-Cune Chang ◽

Po-Wei Chen ◽

Chun-Yuan Lin ◽

...

Keyword(s):

Social Cognition ◽

Functional Outcome ◽

Negative Symptoms ◽

Clinical Symptoms

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Memory in health and in schizophrenia

Dialogues in Clinical Neuroscience ◽

10.31887/dcns.2013.15.4/rgur ◽

2013 ◽

Vol 15 (4) ◽

pp. 399-410 ◽

Cited By ~ 2

Keyword(s):

Sex Differences ◽

Social Cognition ◽

Episodic Memory ◽

Cognitive Neuroscience ◽

Negative Symptoms ◽

Behavioral Science ◽

Present Evidence ◽

Memory Processing ◽

Flat Affect ◽

History Of

Memory is an important capacity needed for survival in a changing environment, and its principles are shared across species. These principles have been studied since the inception of behavioral science, and more recently neuroscience has helped understand brain systems and mechanisms responsible for enabling aspects of memory. Here we outline the history of work on memory and its neural underpinning, and describe the major dimensions of memory processing that have been evaluated by cognitive neuroscience, focusing on episodic memory. We present evidence in healthy populations for sex differences-females outperforming in verbal and face memory, and age effects-slowed memory processes with age. We then describe deficits associated with schizophrenia. Impairment in schizophrenia is more severe in patients with negative symptoms-especially flat affect-who also show deficits in measures of social cognition. This evidence implicates medial temporal and frontal regions in schizophrenia.

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Autistic Symptoms and Social Cognition Predict Real-World Outcomes in Patients With Schizophrenia

Frontiers in Psychiatry ◽

10.3389/fpsyt.2020.00524 ◽

2020 ◽

Vol 11 ◽

Cited By ~ 2

Author(s):

Giacomo Deste ◽

Antonio Vita ◽

Gabriele Nibbio ◽

David L. Penn ◽

Amy E. Pinkham ◽

...

Keyword(s):

Social Cognition ◽

Real World ◽

Autistic Symptoms

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The role of social relatedness and self-beliefs in social functioning in first-episode psychosis: Are we overestimating the contribution of illness-related factors?

European Psychiatry ◽

10.1192/j.eurpsy.2020.90 ◽

2020 ◽

Vol 63 (1) ◽

Author(s):

César González-Blanch ◽

Leonardo A. Medrano ◽

Sarah Bendall ◽

Simon D’Alfonso ◽

Daniela Cagliarini ◽

...

Keyword(s):

Social Cognition ◽

Social Functioning ◽

Negative Symptoms ◽

First Episode Psychosis ◽

Equation Modeling ◽

First Episode ◽

Related Factors ◽

Social Relatedness ◽

Episode Psychosis ◽

Fit Index

Abstract Objective Numerous research studies have demonstrated an association between higher symptom severity and cognitive impairment with poorer social functioning in first-episode psychosis (FEP). By contrast, the influence of subjective experiences, such as social relatedness and self-beliefs, has received less attention. Consequently, a cohesive understanding of how these variables interact to influence social functioning is lacking. Method We used structural equation modeling to examine the direct and indirect relationships among neurocognition (processing speed) and social cognition, symptoms, and social relatedness (perceived social support and loneliness) and self-beliefs (self-efficacy and self-esteem) in 170 individuals with FEP. Results The final model yielded an acceptable model fit (χ2 = 45.48, comparative fit index = 0.96; goodness of fit index = 0.94; Tucker–Lewis index = 0.94; root mean square error of approximation = 0.06) and explained 45% of social functioning. Negative symptoms, social relatedness, and self-beliefs exerted a direct effect on social functioning. Social relatedness partially mediated the impact of social cognition and negative symptoms on social functioning. Self-beliefs also mediated the relationship between social relatedness and social functioning. Conclusions The observed associations highlight the potential value of targeting social relatedness and self-beliefs to improve functional outcomes in FEP. Explanatory models of social functioning in FEP not accounting for social relatedness and self-beliefs might be overestimating the effect of the illness-related factors.

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Negative symptoms of schizophrenia: Clinical features, relevance to real world functioning and specificity versus other CNS disorders

European Neuropsychopharmacology ◽

10.1016/j.euroneuro.2013.10.017 ◽

2014 ◽

Vol 24 (5) ◽

pp. 693-709 ◽

Cited By ~ 100

Author(s):

George Foussias ◽

Ofer Agid ◽

Gagan Fervaha ◽

Gary Remington

Keyword(s):

Clinical Features ◽

Real World ◽

Negative Symptoms ◽

Cns Disorders

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PM521. Relationship between Negative Symptoms and Social Cognition in Patient with Schizophrenia

The International Journal of Neuropsychopharmacology ◽

10.1093/ijnp/pyw041.521 ◽

2016 ◽

Vol 19 (Suppl_1) ◽

pp. 89-89

Keyword(s):

Social Cognition ◽

Negative Symptoms

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Psychotically driven aggression is associated with greater mentalizing challenges in psychotic spectrum disorders

BMC Psychiatry ◽

10.1186/s12888-020-02868-7 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Anette GM Johansson ◽

Malin Källman ◽

Lennart Högman ◽

Marianne Kristiansson ◽

Håkan Fischer ◽

...

Keyword(s):

Social Cognition ◽

Antipsychotic Medication ◽

Goal Attainment ◽

Negative Symptoms ◽

Past History ◽

Intellectual Ability ◽

Swedish Version ◽

History Of ◽

Spectrum Disorders ◽

Matrix Reasoning

Abstract Background Some aggressive acts committed by individuals with psychotic spectrum disorders (PSD) are understandable in the context of interpersonal conflict or goal attainment, yet others are unpredictable, arising from delusions or hallucinations (psychotically driven aggressive acts, PDA). It is unknown if there are underlying differences in cognitive or perceptive social cognition in relation to aggression motivation in PSD. Method We compared differences in social cognition performance between 49 individuals with PSD who had committed PDA with those exhibiting other types of aggression (n = 31) (non-PDA) and to community controls (n = 81) on the Swedish version of Double Movie for the Assessment of Social Cognition – Multiple Choice (DMASC-MC). Participants with PSD had more than 3 months of clinical stability and substance use abstention and stable antipsychotic medication doses. General intellectual ability was assessed with the information and matrix reasoning subtests of the Wechsler Intelligence Scales. Results The PSD group with a history of PDA exhibited lower total and perceptive social cognition scores on the DMASC-MC than the non-PDA group and controls. In addition, they also showed lower cognitive scores compared to typical controls. Lower total scores were associated with lower scores on Wechsler intelligence subtests information and matrix reasoning. Taking this into account, the PDA group still had lower social cognition scores. There were no associations of antipsychotic medication dosages, positive or negative symptoms with social cognition scores. Higher antipsychotic dosage at the time of DMASC-MC testing and social cognition scores predicted a past history of PDA. Conclusions We conclude that impaired social cognition, particularly perceptive social cognition, is associated with PDA in individuals with PSD.

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