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Age, race, and sex are linked to social cognitive performance among healthy individuals, but whether similar effects are evident in schizophrenia is unknown. Data from 170 individuals with schizophrenia or schizoaffective disorder and 98 healthy controls were used to examine relations between these demographic factors and performance across multiple domains and measures of social cognition. Sex was not related to performance on any domain, but older age was related to poorer emotion recognition from dynamic stimuli in both patients and controls. In patients, older age was also associated with better abilities to decipher hints. Both Caucasian patients and controls performed better than African American individuals on emotion recognition and mental state attribution tasks that use only Caucasian individuals as visual stimuli. Findings suggest rather limited influences of demographic factors but do demonstrate normative age and race effects among patients. Findings also highlight important methodological considerations for measurement of social cognition.

The health benefits of exercise are well documented, yet annual health care costs related to physical inactivity are well within the billions. Furthermore, individuals with schizophrenia spectrum disorders (SSDs) are more likely to lead sedentary lives, exercise less than the general population, and die prematurely from preventable causes. Previous research examining the effects of exercise on individuals with SSDs has been encouraging yet limited in creating accessible and sustainable interventions. The current pilot study developed and evaluated the impact of Work out by Walking (WOW), a multicomponent group walking intervention on the health of 16 individuals with SSDs. Results indicated improvements in indicators of physical health, activity level, social support, and mental health and a high level of program satisfaction. Future research should examine multicomponent group walking programs for individuals with SSDs in larger samples and with the inclusion of a comparison condition.

Previous research has suggested that complexity of speech, speech rate, use of emotion words, and use of pronouns are all potential indicators of important clinical components of schizophrenia, but little research has examined the relationships of these disturbances to cognitive variables impaired in schizophrenia, including social cognition. The current study examined these lexical differences to better characterize the cognitive substrates of speech disturbances in schizophrenia. Brief narratives of individuals with schizophrenia (n = 42) and non-clinical controls (n = 48) were compared according to their lexical characteristics, and these were examined for relationships to social cognition and real-world functioning. Significant differences between the groups were found in words per sentence (related to functioning, but not negative symptoms) as well as pronoun use (related to attributional style and theory of mind). Additionally, lexical characteristics effectively distinguished individuals with schizophrenia from non-clinical controls. Language disturbances in schizophrenia seem related to social cognition impairments and real-world functioning, and are a robust indicator of clinical status.

Recent scholarship suggests that virtual environments can serve as effective proxies in battling implicit stereotypes. However, existing experimental research has rarely examined the effectiveness of virtual simulations of mental illnesses in inducing empathy to combat stereotypical responses. We report results from a 4-condition, between subjects experiment (N = 112), wherein participants were exposed to either a virtual simulation of schizophrenia, a written empathy-set induction of schizophrenia, a combination of both the simulation and written empathy conditions, or a control condition. The results indicated that the virtual simulation + empathy condition induced greater empathy and more positive perceptions toward people suffering from schizophrenia than the control or written empathy-set condition. Interestingly, the simulation-only condition resulted in the greatest desire for social distance whereas not significantly differing on empathy and attitude measures from either the written empathy or simulation + empathy conditions. We discuss the implications of the findings and recommend directions for future research.

A pilot randomized controlled trial was conducted to examine the effectiveness of adherence-coping-education (ACE) therapy. Twenty-four individuals with early psychosis were randomized to receive 14 sessions of either ACE therapy in addition to treatment as usual, or supportive therapy in addition to treatment as usual. Participants were assessed at baseline, midtreatment, and posttreatment on measures of medication attitudes, psychotic and depressive symptoms, and social functioning. ACE therapy was well tolerated and was associated with significant decrease in symptoms, as well as trend-level improvements in attitudes toward treatment. These results lend initial support for the feasibility of ACE Therapy, and suggest that it may have promise in facilitating recovery for individuals recovering from an initial psychotic episode.

This study examined clinical predictors of client and therapist alliance ratings early in therapy, the relationship between client and therapist alliance ratings, and the psychometric properties of the Working Alliance Inventory in individuals with schizophrenia receiving manual-based treatment. Assessment of clinical symptoms and social functioning were conducted at baseline, and alliance ratings were obtained at 5 weeks. The Working Alliance Inventory had high internal consistency, but there were low correlations between client and therapist ratings. Results also indicated that social functioning and the activation and autistic preoccupation factors on the Positive and Negative Syndrome Scale were significant predictors of therapists' alliance ratings. There were no significant relationships between clinical predictors and clients' therapeutic alliance ratings. The findings indicate that client interpersonal factors are significant predictors of the therapist-rated alliance in the treatment of schizophrenia. Low correlations between clients' and therapists' ratings of the alliance should be examined in future research.

The purpose of this study was to assess the utility of social cognition and insight in the prediction of violence in a psychiatric inpatient sample. Violence history, demographic information, symptomatology, neuropsychological functioning, social cognition (i.e., attributional style), and insight were assessed in 29 inpatients with severe mental illness. Greater posttest violence was associated with greater pretest violence, less education, greater psychiatric distress, neuropsychological impairment, and hostile attributional and personalizing biases. Hierarchical multiple regression analyses showed that history of violence contributed the most variance to posttest violence. Hostile attributional and personalizing biases were also uniquely associated with posttest violence. Overall, this study supported the modest utility of attributional style measures in the prediction of inpatient violence. The predictive value of insight in this context appears limited.

The relationship of insight with the social behaviors of outpatients with severe mental illness (SMI) was investigated. Participants' engaged in two social interactions (i.e., stigmatizing and nonstigmatizing), each with a different research confederate. The participant's behavior was later coded for the presence of various self-presentation and social skill variables. Results indicated that greater insight was associated with better overall social skill, less observed strangeness, and greater self-disclosure of one's mental illness. Furthermore, the three measures of insight, one based on self-report and two interview-based, were all highly intercorrelated, suggesting that they are measuring a similar construct. Finally, consistent with previous research in the area, greater insight was associated with less severe psychiatric symptoms. Implications of these findings for future research are discussed.

Lack of awareness of specific symptoms among persons with schizophrenia has not been adequately studied in the context of neuropsychological function. The purpose of this study is to investigate whether poor insight as measured by the Scale to Assess Unawareness of Mental Disorder is empirically related to performance measures having a known association with executive functions in a group of individuals with chronic schizophrenia. The results showed that unawareness and misattribution of negative symptoms are significantly associated with deficits in some aspects of executive functioning even after a test of general intelligence had been partialed from the analyses. We conclude that unawareness of negative symptoms is associated with executive functioning in individuals with chronic schizophrenia. Unawareness of other symptoms (i.e., positive symptoms) may reflect dysfunction in other types of neuropsychological processes, or it may reflect motivation to deceive oneself or others.

The relationship between basic information processing and social cognitive problem solving (SCPS) was studied in 31 schizophrenic, 16 depressive, and 31 control subjects. The clinical subjects were assessed twice, during symptom exacerbation and 3 months later, after partial remission. Control subjects were tested during the same time period. Subjects completed a means-ends problem-solving test, an alternative solution generation task, and an information-processing test battery. Results showed that schizophrenic subjects demonstrated significant improvement in a number of information-processing indices over time. No significant changes on the social cognitive problem-solving variables were found. Furthermore, all three groups demonstrated different patterns of relationships between information processing and social cognitive problem solving. Implications for treatment are discussed.