Elsevier

Journal of Psychiatric Research

Volume 68, September 2015, Pages 254-260
Journal of Psychiatric Research

Social cognition, social competence, negative symptoms and social outcomes: Inter-relationships in people with schizophrenia

https://doi.org/10.1016/j.jpsychires.2015.07.008Get rights and content

Highlights

  • We examined social functioning in people with schizophrenia.

  • Social cognition and negative symptoms predicted social competence.

  • Social competence, social cognition, and negative symptoms all predicted social outcomes.

  • The best predictor of social outcomes was negative symptoms.

  • Different negative symptoms predicted social competence and social outcomes.

Abstract

Social deficits are common in people with schizophrenia and the treatment of deficits in social competence has been a long-time treatment strategy. However, negative symptoms and social cognitive deficits also contribute to social dysfunction. In this study, we examined the correlations between everyday social outcomes, a performance based measure of social competence, and performance on 8 different social cognition tests in 179 patients with schizophrenia. Social cognition, social competence, and motivation-related negative symptoms accounted for 32% of the variance in real-world social outcomes. In addition, two different social cognition tests, along with expression-related negative symptoms accounted for 32% of the variance in performance-based assessments of social competence. These data suggest that negative symptoms exert an important influence on social outcomes and social competence, but not social cognition, and that social cognition and social competence exert separable influences on real-world social outcomes. Improving social outcomes seems to require a multi-faceted approach which considers social cognition, social competence, and negative symptoms.

Section snippets

Subjects

The data was collected in two different geographical locations. The study participants were patients (n = 179) with schizophrenia or schizoaffective disorder, receiving treatment at outpatient locations in Miami and Dallas. Miami patients were recruited from the outpatient services at the University of Miami Miller School of Medicine. Patients in Dallas were recruited using Metrocare Services, a large non-profit provider of mental health services in Dallas County, as well as other outpatient

Results

Table 2 presents demographic information on patient participants. Table 3 shows the means, standard deviations, and ranges for the real-world social functioning variables as well as the predictor variables, which include PANSS symptoms and social cognition measures. Table 4 shows the intercorrelations between these same variables. As seen in Table 4, many of the social cognition measures have significant correlations with one another. Additionally, overall scores on negative symptoms, as well

Discussion

Previous studies have examined the predictive relationships between negative symptoms, social competence, and social cognition and everyday social outcomes, but this is the first study to our knowledge that concurrently examined the interaction between social competence, a comprehensive assessment of social cognition, negative symptoms, and social functioning. Negative symptoms reflecting reduced motivation for social engagement appear to be the best predictors of everyday social outcomes in

Role of funding source

This research was funded by the National Institute of Mental Health, who provided no input into the analyses and presentation of these data.

Contributions of the authors

Drs. Harvey, Penn, and Pinkham designed the overall study and obtained funding. Dr. Kalin and Ms. Kaplan conceptualized and conducted the current analyses and wrote the first draft of the paper. Dr. Harvey provided scientific oversight throughout the project and edited the manuscript. All authors provided detailed comments on the manuscript.

Conflicts of interest and disclosure

Dr. Harvey has received consulting fees from Boehringer Ingelheim, Forum Pharma, Genentech, Otsuka America, Roche Pharma, Sanofi Pharma, Sunovion Pharma, and Takeda Pharma during the past year.

Dr. Pinkham has served as a consultant to Otsuka America.

None of the other authors have any commercial interests to report.

Acknowledgments

All individuals who contributed to this paper are listed as authors. No professional medical writer was involved in any portion of the preparation of the manuscripts. Data were collected by paid research assistants who did not contribute to the scientific work in this paper. This research was supported by NIMH grant number 93432 to Drs. Harvey, Penn, and Pinkham.

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