Factor structure of social cognition in schizophrenia: Investigation of four core domains

Experts have categorized social cognition in schizophrenia into four domains: theory of mind, emotion processing, social perception, and attributional bias. However, previous factor analyses based on this categorization have yielded inconsistent results, likely because some domains were inadequately represented due to a lack of available measures. To address this issue, we conducted a factor analysis using a set of validated measures encompassing all four domains.

The individual domains of social cognition were assessed in clinically stable outpatients with schizophrenia (n = 136) using the Hinting task, Metaphor and Sarcasm Scenario Test, the Bell Lysaker Emotion Recognition Task, Facial Emotion Selection Test, the Social Attribution Task-Multiple Choice, and the Ambiguous Intentions and Hostility Questionnaire. Exploratory and confirmatory factor analyses were conducted to determine the factor structure. Additionally, correlation analysis (n = 123) was performed to examine the relationships between the identified factors and clinical variables, such as psychiatric symptoms.

Exploratory factor analysis identified a two-factor structure for social cognition: "social cognitive skills", which includes theory of mind, emotion processing, and social perception; and "social cognitive bias", which includes attributional bias. Confirmatory factor analysis showed good fit indices. Correlation analysis revealed that social cognitive skills were associated with positive, negative, and disorganized symptoms, neurocognition, and social functioning, while social cognitive bias was related to excitement, depression, and defeatist beliefs.

The results of this study suggest that social cognition can be divided into two distinct factors and provide guidance for developing treatment strategies aimed at improving social cognition.