A novel task-based method for tracking social cognition and its association with social functioning in schizophrenia...

Schizophrenia spectrum disorders (SCZ) are a group of psychiatric disorders that can severely impact social and occupational functioning. Social cognition plays a key role in social functioning, with deficits in social cognition potentially revealing social deficits. However, existing tests of social cognition are lengthy to administer and only measure one or two aspects of social cognition. The Edinburgh Social Cognition Test (ESCoT) is a newly developed brief assessment that evaluates multiple domains of social cognition, including cognitive Theory of Mind (ToM), affective ToM, and interpersonal and intrapersonal understandings of social norms. However, the ESCoT has not been utilized before to examine social cognition in SCZ. This observational study analyzed 18 individuals with SCZ and 19 healthy controls (HC), all of whom completed the ESCoT and several social functioning scales, including the Lubben Social Network Scale (LSNS), the Pinkham Social Skill Rating (PSSR), the Role Function Scale (RFS), and the Social Disconnectedness Scale (SDS). Between-group comparisons revealed significantly reduced scores in the participants with SCZ on cognitive and affective ToM but comparable scores on interpersonal and intrapersonal understandings of social norms, compared to HC. Additionally, the participants with SCZ showed reduced scores on the LSNS, PSSR, RFS, and SDS. Furthermore, ESCoT-derived cognitive ToM scores were positively correlated with scores on the LSNS, PSSR, and SDS, whereas affective ToM scores were positively correlated with the LSNS and PSSR. Interpersonal understanding of social norms was positively correlated with the LSNS and RFS score. The current study showed deficits in cognitive and affective ToM alongside other aspects of social functioning in SCZ compared to HC participants. The ESCoT sub-scores were correlated with scores from validated questionnaires of social functioning, thus validating the utility of the ESCoT to study social cognition in SCZ. Further investigation is recommended to replicate these findings in larger and more heterogeneous samples of SCZ individuals for a better generalization of these findings.