Validation of the Social Effort and Conscientious Scale (SEACS) in Schizophrenia

People with schizophrenia often experience impaired social functioning and low satisfaction with relationships. Existing measures of social impairment in schizophrenia primarily assess pleasure derived from social interactions, rather than examining impairments in social motivation, including effortful behavior. We conducted a validation study of a recently developed self-report measure of social effort in 31 participants with schizophrenia spectrum disorders, including tests of association with standard assessments of social functioning and behavior in daily life using ecological momentary assessment (EMA). We also assessed predictive validity of the scale, measuring the extent to which social effort at baseline predicted changes in social functioning over a 60-day smartphone-based social intervention. Higher social effort was associated with greater social functioning and lower negative symptom severity at baseline. Baseline social effort did not predict changes in social functioning over the intervention period, nor was it related to EMA-reported social experiences. Thus, tendencies toward social effort exertion may capture meaningful variance in gold-standard assessments of social functioning and negative symptoms, but may not track with social experiences in daily life. Further research should examine whether social effort is sensitive to change, and evaluate the utility of targeting social effort in evidence-based interventions for improving the social functioning in schizophrenia.