Low Versus High Levels of Social Cognition Impairment and Their Associations With Specific Schizophrenia Symptom Domains

Social cognition is defined as the ability to construct mental representations about oneself, others, and one’s relationships with others to guide social behaviors, including referring to mental states (cognitive factor) and understanding emotional states (affective factor). Difficulties in social cognition may be symptoms of schizophrenia. The authors examined associations between two factors of social cognition and specific schizophrenia symptoms, as well as a potential path from low-level affective perceptual social cognition to high-level social cognition, which may be associated with schizophrenia symptoms.

The authors compared IQ, executive function, and social cognition scores of 41 patients with schizophrenia with those of a community-based group of 30 healthy individuals by using the Diagnostic Analysis of Nonverbal Accuracy 2–Taiwan version, the Movie for the Assessment of Social Cognition–Taiwan version, and the Chinese version of the theory of mind task.

In analyses controlled for IQ and executive function scores, patients with schizophrenia were found to perform more poorly than individuals in the healthy comparison group on all social cognition tasks. Disorganized symptoms were associated with lower accuracy of recognizing happy and angry faces, a lower verbal theory of mind score, and altered low- and high-level social cognition scores. A potential causal link was identified between low-level affective perceptual social cognition and high-level social cognition, resulting in disorganized symptoms.

These results indicate distinct roles of two factors of social cognition in schizophrenia symptomatology and provide a new direction for alleviating symptoms of this disorder by enhancing social cognition.