Facial affect recognition: a mediator between cognitive and social functioning in psychosis?

Facial affect recognition has been implicated in the relationship between cognition and social functioning. This 1-year longitudinal study tested the hypothesis that facial affect recognition mediates the relationship between cognitive and social functioning.

Three groups were included: 50 first-episode of psychosis (FE) subjects, 53 multi-episode schizophrenia subjects (ME) and 55 non-psychiatric controls (NPC). Subjects were assessed on two facial affect recognition tasks, a comprehensive cognitive battery and a measure of social functioning. FE subjects were assessed on admission to a comprehensive FE program and 1 year later. The ME and NPC groups had two assessments 1 year apart.

Both the FE and ME subjects were clearly impaired relative to NPCs in cognition, social functioning and facial affect recognition. There were significant associations among facial affect recognition, cognition and social functioning in all three groups. For ME and FE subjects, but not NPCs, there was evidence that facial affect recognition did partially mediate the relationship between cognitive and social functioning.

This study provides some first steps in understanding the complex relationship between cognition and outcome and has potential implications for the design of remediation strategies.