Search

Background: 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.Methods: 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.Results: 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.Implications: 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. [ABSTRACT FROM AUTHOR]

Rationale: Variables influencing real-life functioning have repeatedly been modeled in schizophrenia subjects but not systematically investigated in their unaffected first-degree relatives (SRs), in whom milder forms of deficits reported in schizophrenia have been observed, but confounders of clinical cohorts are not in play. Demonstrating that pathways to functional outcome are similar between patients and SRs would validate structural models developed in schizophrenia subjects. The present multicenter study aimed to explore whether variables associated with real-life functioning are similar in schizophrenia patients and their unaffected relatives.Methods: The study sample included 921 schizophrenia patients, 379 SRs and 780 healthy controls. Structural Equation Models (SEMs) were used in patients and SRs to test associations of psychopathological dimensions, neurocognition, social cognition, resilience, perceived stigma and functional capacity with real-life functioning domains, impaired in both patients and SRs.Results: Interpersonal Relationships and Work Skills were the only functional domains impaired in both patients and SRs. For both domains, functional impairment in patients was found to predict impairment in unaffected relatives, suggesting the involvement of similar illness-related vulnerability factors. In both groups variables significantly associated with Interpersonal Relationships included Social Cognition, Neurocognition, Avolition, Resilience, Disorganization, Perceived Stigma and Gender, and those significantly associated with Work Skills included Social Cognition, Neurocognition and Disorganization.Conclusions: Pathways to functional outcome for Interpersonal relationships and Work skills are similar between schizophrenia patients and their unaffected first-degree relatives. These findings validate, in the absence of confounders of clinical cohorts, structural models of determinants of functional outcome in people with schizophrenia. [ABSTRACT FROM AUTHOR]

Semantic priming tasks are classically used to influence and implicitly promote target behaviors. Recently, several studies have demonstrated that prosocial semantic priming modulated feelings of social affiliation. The main aim of this study was to determine whether inducing feelings of social affiliation using priming tasks could modulate nonverbal social behaviors in schizophrenia. We used the Scrambled Sentence Task to prime schizophrenia patients according to three priming group conditions: pro-social, non-social or anti-social. Forty-five schizophrenia patients, diagnosed according to DSM-IV-TR, were randomly assigned to one of the three priming groups of 15 participants. We evaluated nonverbal social behaviors using the Motor-Affective subscale of the Motor-Affective-Social-Scale. Results showed that schizophrenia patients with pro-social priming had significantly more nonverbal behaviors than schizophrenia patients with anti-social and non-social priming conditions. Schizophrenia patient behaviors are affected by social priming. Our results have several clinical implications for the rehabilitation of social skills impairments frequently encountered among individuals with schizophrenia. [ABSTRACT FROM AUTHOR]

Aim Research in the phenomenological tradition suggests that the schizophrenia spectrum is characterized by disturbance of the 'basic' self, whereas borderline personality disorder involves disturbance of the 'narrative' self. The current study investigated this proposal in an ultra-high risk for psychosis sample. Methods The sample consisted of 42 ultra-high-risk participants with a mean age of 19.22 years. Basic self-disturbance was measured using the Examination of Anomalous Self- Experience. Borderline personality pathology was measured using the borderline personality disorder items from the Structured Clinical Interview for DSM-IV (Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition) Axis II Personality Questionnaire. Results No correlation was found between the measures of basic self-disturbance and borderline personality pathology. Conclusions The finding is consistent with the proposal that different (although not mutually exclusive) types of self-disturbance characterize the schizophrenia spectrum and borderline personality disorder. Further research should further examine the question of basic self-disturbance in patients with established borderline personality disorder. [ABSTRACT FROM AUTHOR]

Schizophrenia and high functioning autism-spectrum disorders (ASD) are neurodevelopmental conditions that mainly impair social competence, while general intelligence (IQ) is spared. Both disorders have a strong ancillary role in theoretical research on social cognition. Recently the debate has started to be inflected by embodied and phenomenological approaches, which claim that the standard portrayal of all social understanding as so-called ‘mindreading’, i.e. the attribution of mental states to others in the service of explaining and predicting their behavior, is misguided. Instead it is emphasized that we normally perceive others directly as conscious and goal-directed persons, without requiring any theorizing and/or simulation. This paper evaluates some of the implications of abnormal experiences reported by people with schizophrenia and ASD for the current debate in cognitive science. For these people the practice of explicit mindreading seems to be a compensatory strategy that ultimately fails to compensate for – and may even exacerbate – their impairment of intuitive and interactive social understanding. Phenomenological psychopathology thereby supports the emerging view that ‘mindreading’ is not the principal form of normal social understanding. [Copyright &y& Elsevier]

Waters F, Rock D, Dragovic M, Jablensky A. 'Social dysmetria' in first-episode psychosis patients. The 'embodied cognition' hypothesis suggests a close relationship between internal self-representations and the outward expression of social behaviours and emotions. Given self-awareness disturbances in patients with first-rank symptoms (FRS), we hypothesized that these patients would show abnormal social behaviours. In this study, we examined the social interactive skills of patients with first-episode psychosis during an interview, together with changes in performance over time. We analysed previously unreported data from 227 patients with first-episode psychosis (90 with, and 137 without, FRS) who took part in the WHO multicentre study on the Determinants of Outcome of Severe Mental Disorders. They were assessed on the Psychological Impairment Rating Schedule (PIRS) and examined again after 2 years. A principal component analysis on the Psychosocial Impairment Rating Schedule produced two factors (interactive skills; withdrawal from interactions). Patients with FRS showed greater impairments in the domain linked to 'interactive skills', which remained 2 years after the first experience of a psychotic illness. These findings were not explained by clinical characteristics, or presence of non-FRS delusions. Self-awareness deficits, as indexed by the FRS symptom cluster, are linked to deficits in social interactive behaviours. These abnormalities are indicative of 'social dysmetria' in this group, which involves difficulties conveying motor aspects of behaviours, volition and affect to facilitate mutual communication. These findings point to the utility of behavioural assessment scales in clinical and research settings. [ABSTRACT FROM AUTHOR]

Objective: The aim of the present study was to investigate whether the boundaries between the happy and angry emotions of schizophrenia would be influenced by social context and the difference in emotion categorization boundaries between schizophrenia patients and healthy controls. Method: Eighteen patients with schizophrenia and 16 healthy controls were given a forced-choice emotion identification task in which they were required to listen to a series of conversations with different social contexts. The stimuli were linear morphed facial expressions between 'happy' and 'angry' emotions. For each type of social context, the shift point was used as the parameter to estimate when the subjects began to perceive the morphed facial expression as angry. The response slope was used to estimate how abruptly this change in perception occurred. Results: There was no significant difference in the schizophrenia group in the shift point of emotion categorization perception for four categories of conversations occurring in different social contexts. Compared with the healthy controls, the schizophrenia group demonstrated a steeper response slope at the shift point regardless of the conversation type. Conclusion: The patients with schizophrenia were less discriminative in their categorization of emotion perception in conversations with different social contexts. The schizophrenia patients, however, were more alert to angry facial expressions in the process of facial expressions morphing from happy to angry, independent of the social context. [ABSTRACT FROM AUTHOR]

This study begins with the premise that individuals living with schizophrenia can and do develop social relationships and derive pleasure from these relationships. This premise prompted us to explore how individuals living with schizophrenia form and maintain social relationships. We begin by considering two important constructs with respect to the role of social relationships, the constructs of intersubjective self and occupational self. This study was directed by a grounded theory methodology. Grounded theory focuses on firsthand knowledge of empirical worlds while recognizing the role the researcher plays in the interpretation of findings (Charmaz, 2006a). Eight individuals participated in in-depth interviews with the first author. Interviews were transcribed verbatim, analyzed, and emergent themes were organized into five core themes. The findings suggest that environmental proximity, a routine environment, reciprocity, constancy/hope, and understanding are important dimensions in the formation and maintenance of social relationships. We discuss these findings in terms of two reciprocal processes: (1) structural form, and (2) relational qualities. The findings of this study suggest that structural forms such as environmental proximity and routine environments, dimensions frequently facilitated by engagement in occupation, contribute to opportunities for persons living with schizophrenia to form and maintain relationships. Furthermore, relational qualities such as reciprocity, constancy and understanding, were found to be highly valued, and to be implicated in participants' engagement in social relationships. This theoretical account of how individuals form and maintain relationships attempts to privilege the voices of persons living with Schizophrenia, and can act as a catalyst for future research and a lens through which to view rehabilitation practice. [ABSTRACT FROM AUTHOR]

Objective: The relationship between suicide and social class has been equivocal. While some authors have reported that higher social class is related to higher rates of suicide, most other studies report that lower social class is associated with higher rates of suicide. Our study attempted to resolve these inconsistencies by using a High Risk for schizophrenia method. Method: Children of women with severe schizophrenia were assessed in 1962. In 2005, when subjects were a mean age of 58 years, we identified those who had committed suicide. Results: A higher rate of suicide was associated with risk for schizophrenia in the High-Risk sample. Higher social class origin was associated with suicide in persons at risk for mental illness. Conclusion: Higher social class origin was associated with suicide in subjects at genetic risk for schizophrenia (but not those without risk). [ABSTRACT FROM AUTHOR]

Objective: To compare the social functioning of individuals experiencing their first episodes of schizophrenia with those who have experienced multiple episodes and with nonpsychiatrically ill control subjects.Method: Subjects included 40 patients with first-episode (FE) schizophrenia, 40 patients with multiepisode (ME) schizophrenia, and a control group of 40 nonpsychiatrically ill individuals. Three social-functioning measures were used: the Social Functioning Scale (SFS), the Quality of Life Scale (QOL), and the Assessment of Interpersonal Problem-Solving Skills (AIPSS).Results: Control subjects significantly outperformed FE and ME participants on all social-functioning measures. FE and ME samples did not differ in their performance on the SFS and the AIPSS. On the QLS, ME participants outperformed FE participants.Conclusions: This study demonstrated that deficits in social functioning are present near the onset of schizophrenia. [ABSTRACT FROM AUTHOR]

Proposes a family intervention model designed to meet the sociocultural needs of Asian-American schizophrenic patients and their families. Stages of the model; Guidelines and suggestions for implementing the stages; Issues concerning the implementation of the model.

Background: Many studies have demonstrated that in schizophrenia there are decreased rates of marriage, fertility and marital fertility. However, it is not clear whether this finding occurs as a social consequence of having the illness or is an inherent part of the illness. One would expect it to vary across cultures if it were being mediated by social and cultural factors.Method: We investigated this by reviewing the marital and fertility data from a multi-ethnic first-contact group of patients in London with CATEGO broadly defined schizophrenia, and comparing this with similar data from a group of controls who were matched for age, gender and ethnicity.Results: Our sample comprised 38 White British, 38 Caribbean and 24 Asian subjects. The Asian group were significantly older (mean age 38, P < 0.003) and had a greater percentage of females (50%). When compared to controls, the White and Caribbean patients, but not the Asians, had decreased marital and stable relationship rates. There was also decreased fertility and marital fertility as evidenced by number of children among the Whites and Caribbeans, but again significantly not among the Asians. Marital status did not predict fertility rates, particularly among the Caribbeans. Regression analysis demonstrated an effect for age on the number of children but not on marital status.Conclusions: These findings suggest that marital and reproductive behaviour are reduced in schizophrenia, but this effect may be mediated by social and cultural factors and therefore not apply consistently across ethnicity. Further research is needed to prospectively investigate populations to determine whether impairments of this nature are inherent or consequential to the illness. [ABSTRACT FROM AUTHOR]