Mechanisms of Social Cognition in Early Episode Psychosis

Abstract

The mental abilities required to identify, understand, and respond to social information are broadly referred to as social cognition, and individuals with schizophrenia spectrum disorders display significant impairments in these abilities. Social cognition has been identified as a primary contributor to functional outcomes in psychosis, and represents a critical target for treatment and recovery. Although previous research has extensively examined the magnitude of social cognitive impairments across phases of psychosis using a variety of measures, the factors that contribute to social cognition are still relatively unknown, but may hold the key to improve our understanding of why these impairments arise and persist over time. Because traditional measures of social cognition place demands on neurocognitive and motivational resources, it was hypothesized these illness-related factors would be implicated in the social cognitive performance of individuals in the early stages of a psychotic disorder. In two studies, tasks of social cognition were experimentally manipulated to assess for the influence of cognitive biases and amotivation on performance in a sample of early psychosis patients (n = 35) and demographically-matched community controls (n = 35). Results from these studies demonstrated that jumping to conclusions, a cognitive bias common to psychosis, and extrinsic motivators during testing were directly associated with outcomes on tasks of social cognition, and that these factors were particularly relevant to the performance of the early psychosis group. These studies add to the existing literature on social cognition in psychosis by emphasizing the role of jumping to conclusions and amotivation, which may be informative for refining the theoretical model of social cognition and enhancing interventions designed to remediate these impairments. Moreover, the functional relevance of social cognition highlights the importance of ongoing research efforts using experimental designs to better understand the illness-related factors most strongly associated with social cognition in psychosis.