Query: social  cognitive schizophrenia

title: Comprehensive comparison of social cognitive performance in autism spectrum disorder and schizophrenia
abstract: Autism spectrum disorder (ASD) and schizophrenia (SCZ) are separate neurodevelopmental disorders that are both characterized by difficulties in social cognition and social functioning. Due to methodological confounds, the degree of similarity in social cognitive impairments across these two disorders is currently unknown. This study therefore conducted a comprehensive comparison of social cognitive ability in ASD and SCZ to aid efforts to develop optimized treatment programs.  In total, 101 individuals with ASD, 92 individuals with SCZ or schizoaffective disorder, and 101 typically developing (TD) controls, all with measured intelligence in the normal range and a mean age of 25.47 years, completed a large battery of psychometrically validated social cognitive assessments spanning the domains of emotion recognition, social perception, mental state attribution, and attributional style.  Both ASD and SCZ performed worse than TD controls, and very few differences were evident between the two clinical groups, with effect sizes (Cohen's d) ranging from 0.01 to 0.34. For those effects that did reach statistical significance, such as greater hostility in the SCZ group, controlling for symptom severity rendered them non significant, suggesting that clinical distinctions may underlie these social cognitive differences. Additionally, the strength of the relationship between neurocognitive and social cognitive performance was of similar, moderate size for ASD and SCZ.  Findings largely suggest comparable levels of social cognitive impairment in ASD and SCZ, which may support the use of existing social cognitive interventions across disorders. However, future work is needed to determine whether the mechanisms underlying these shared impairments are also similar or if these common behavioral profiles may emerge via different pathways.

title: Social cognitive interventions for people with schizophrenia: A systematic review.
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.

title: Self assessment of social cognitive ability in schizophrenia: Association with social cognitive test performance, informant assessments of social cognitive ability, and everyday outcomes
abstract: Impairments in self assessment are common in people with schizophrenia and impairments in self assessment of cognitive ability have been found to predict impaired functional outcome. In this study, we examined self assessment of social cognitive ability and related them to assessments of social cognition provided by informants, to performance on tests of social cognition, and to everyday outcomes. The difference between self reported social cognition and informant ratings was used to predict everyday functioning.  People with schizophrenia (n=135) performed 8 different tests of social cognition. They were asked to rate their social cognitive abilities on the Observable Social Cognition Rating Scale (OSCARs) High contact informants also rated social cognitive ability and everyday outcomes, while unaware of the patients' social cognitive performance and self assessments. Social competence was measured with a performance based assessment and clinical ratings of negative symptoms were also performed.  Patient reports of their social cognitive abilities were uncorrelated with performance on social cognitive tests and with three of the four domains of functional outcomes. Differences between self reported and informant rated social cognitive ability predicted impaired everyday functioning across all four functional domains. This difference score predicted disability even when the influences of social cognitive performance, social competence, and negative symptoms were considered.  Mis estimation of social cognitive ability was an important predictor of social and nonsocial outcomes in schizophrenia compared to performance on social cognitive tests. These results suggest that consideration of self assessment is critical when attempting to evaluate the causes of disability and when trying to implement interventions targeting disability reduction.

title: Neural correlates of social cognitive introspective accuracy in schizophrenia
abstract: Introspective accuracy (IA) refers to the ability to accurately assess one's own skills and capabilities. Recent work provides evidence of IA deficits in schizophrenia that are predictive of everyday functioning. Thus, IA deficits are an important target to understand mechanistically. The current study used fMRI to assess neural activation in 32 healthy controls and 31 individuals with schizophrenia as they completed IA and control versions of a social cognitive task (i.e. emotion recognition) Analyses revealed different areas of IA specific neural activity between groups including activations of rostrolateral prefrontal cortex (rlPFC) and dorsal anterior cingulate cortex in healthy individuals that were absent in patients. Direct group comparisons revealed greater IA specific activation for healthy individuals in right rlPFC, a region thought to be critical for successful IA. For healthy individuals only, activation in rlPFC was positively correlated with IA ability, but no association was observed for patients. Further, among individuals with schizophrenia, increased activation of rlPFC during judgments of IA was positively correlated with better informant reported interpersonal functioning. These results suggest that reduced specialization of IA related neural activation may contribute to impaired IA in schizophrenia and also highlight IA as a potential target for remediation programs aimed at improving real world functioning.

title: Associations of oxytocin and vasopressin plasma levels with neurocognitive, social cognitive and meta cognitive function in schizophrenia
abstract: Many with schizophrenia experiences deficits in social cognition, neurocognition and metacognition. Yet the biological mechanisms which may underpin these cognitive deficits are poorly understood. Two candidate causes of these deficits are disturbances in oxytocin (OT) and vasopressin (VP) To explore this we assessed plasma OT and VP in 34 schizophrenia patients and 31 healthy controls. We also concurrently assessed social cognition using the Reading the Mind from the Eyes test, neurocognition using the Wisconsin Card Sorting Test and metacognition using the Metacognitive Assessment Scale Abbreviated. Group comparisons revealed lower plasma OT levels in the schizophrenia group. Plasma VP levels did not differ between groups. Correlations revealed that lower levels of OT were associated with poorer levels of metacognitive functioning in the schizophrenia group but not poorer social cognition or neurocognition. In a stepwise multiple regression, plasma OT level, neurocognition and social cognition contributed uniquely to the prediction of metacognition in the schizophrenia group. Results may suggest that disturbance in OT is linked with deficits in metacognition and may interact with other forms of cognitive deficits, interfering with the person's abilities to form a complex and integrated sense of self and others.

title: Comprehensive treatments for social cognitive deficits in schizophrenia: A critical review and effect size analysis of controlled studies.
abstract: Recent advances in psychosocial treatments for schizophrenia have targeted social cognitive deficits. A critical literature review and effect size (ES) analysis was conducted to investigate the efficacy of comprehensive programs of social cognitive training in schizophrenia. Results revealed 16 controlled studies consisting of seven models of comprehensive treatment with only three of these treatment models investigated in more than one study. The effects of social cognitive training were reported in 11/15 studies that included facial affect recognition skills (ES=.84) and 10/13 studies that included theory of mind (ES=.70) as outcomes. Less than half (4/9) of studies that measured attributional style as an outcome reported effects of treatment, but effect sizes across studies were significant (ESs=.30 .52) The effect sizes for symptoms were modest, but, with the exception of positive symptoms, significant (ESs=.32 .40) The majority of trials were randomized (13/16) selected active control conditions (11/16) and included at least 30 participants (12/16) Concerns for this area of research include the absence of blinded outcome raters in more than 50% of trials and low rates of utilization of procedures for maintaining treatment fidelity. These findings provide preliminary support for the broader use of comprehensive social cognitive training procedures as a psychosocial intervention for schizophrenia.

title: Social cognitive brain function and connectivity during visual perspective taking in autism and schizophrenia
abstract: Autism spectrum disorder (ASD) and schizophrenia are neurodevelopmental conditions that are characterized by significant social impairment. Emerging genomic and neurobiological evidence has increasingly pointed to shared pathophysiologic mechanisms in the two disorders. Overlap in social impairment may reflect similar underlying neural dysfunction in social cognitive brain networks, yet few studies have directly compared brain function and communication between those with ASD and schizophrenia.  Outpatients with schizophrenia (n=36) ASD (n=33) and healthy volunteers (n=37) completed a visual perspective taking task during functional neuroimaging at 3T to assess similarities and differences in fronto temporal brain function and connectivity during social cognitive processing. Analyses employed general linear models to examine differences in amplitude of BOLD signal response between disorder groups, and computed functional connectivity coefficients to investigate differences in the connectivity profiles of networks implicated in social cognition.  Despite similar behavioral impairments, participants with ASD and schizophrenia evidenced distinct neural abnormalities during perspective taking. Functional activation results indicated reduced temporo parietal junction and medial prefrontal activity in ASD compared to schizophrenia (all Puncor<0.002) Functional connectivity analyses further revealed significantly greater local orbitofrontal connectivity in ASD than schizophrenia (all PFDR<0.028) during perspective taking. Differences in brain activation and connectivity were unrelated to antipsychotic medication dose.  Autism and schizophrenia are characterized by similar social cognitive impairments that may stem from different underlying abnormalities in the functional organization and communication of the social brain.

title: Impact of cognitive and social cognitive impairment on functional outcomes in patients with schizophrenia.
abstract: Schizophrenia is a severely disabling disease that affects millions of people worldwide. The notion of recovery from schizophrenia has recently become a topic of both research and clinical focus. With the advent of antipsychotic medications in the 1950s, many more patients achieved symptom remission than ever before. However, less than half of all patients have been able to achieve recovery. With so many drugs available to improve the symptoms of schizophrenia, why is the disorder still associated with such severe disability? In the last couple of decades, researchers and clinicians have begun to realize that a hindrance to widespread recovery is that available antipsychotic medications have been effective in treating the positive symptoms (hallucinations and delusions) of schizophrenia but not other features of illness such as cognitive impairment. Dysfunction in cognition and social cognition has a significant impact on patients' functional status, meaning that impaired cognition and social cognition should be treatment targets to improve the likelihood of recovery.

title: A 12 week randomized controlled trial of twice daily intranasal oxytocin for social cognitive deficits in people with schizophrenia
abstract: Social cognition is impaired in people with schizophrenia and these deficits are strongly correlated with social functioning. Oxytocin is a hypothalamic peptide that contributes to maternal infant bonding and has diverse pro social effects in adults. This study tested the hypothesis that 12weeks of intranasal oxytocin will improve social cognitive function in outpatients with schizophrenia and schizoaffective disorder. Sixty eight eligible participants were randomized to oxytocin (24IU twice daily) or placebo. Social cognitive function was assessed using the Emotion Recognition 40, Brune Theory of Mind, Reading the Mind in the Eyes test, Trustworthiness task and Ambiguous Intentions Hostility Questionnaire at baseline, 6weeks and 12weeks. In addition, social function was assessed using the Specific Levels of Functioning Scale and a role play test, and psychopathology was assessed using the Positive and Negative Syndrome Scale (PANSS) Fifty five participants completed the 12 week trial. The study found no evidence for a differential advantage of oxytocin over placebo on social cognition. Among secondary outcomes, there was a modest advantage for oxytocin over placebo on a component of social functioning, although there was also evidence that the placebo group outperformed the oxytocin group on the role play task. No between group differences emerged on measures of psychopathology in pre specified comparisons, but oxytocin showed significant within group reduction in PANSS negative symptoms and significant between group improvement in negative symptoms in the schizophrenia subgroup. Further testing is needed to clarify whether oxytocin has therapeutic potential for social cognitive deficits and/or negative symptoms in people with schizophrenia.

title: Social Cognitive Deficits in Schizophrenia.
abstract: Patients with schizophrenia not only suffer from prototypical psychotic symptoms such as delusions and hallucinations and from cognitive deficits, but also from tremendous deficits in social functioning. However, little is known about the interplay between the cognitive and the social cognitive deficits in schizophrenia. Our chapter gives an overview on behavioral, as well as functional imaging studies on social cognition in schizophrenia. Main findings on cognitive and motivational deficits in schizophrenia are reviewed and introduced within the context of the dopamine hypothesis of schizophrenia. The reviewed findings suggest that disturbed "social brain" functioning in schizophrenia, depending on the specific context, can either lead to a neglect of the emotions and intentions of others or to the false attribution of these emotions and intentions in an emotionally neutral social content. We integrate these findings with the current knowledge about aberrant dopaminergic firing in schizophrenia by presenting a comprehensive model explaining core symptoms of the disorder. The main implication of the presented model is that neither cognitive motivational, nor social cognitive deficits alone cause schizophrenia symptoms, but that symptoms only emerge by the interplay of disturbed social brain functioning with aberrant dopaminergic firing.