Altered mechanisms of social rank recognition in schizophrenia spectrum disorders

The Social Rank Recognition Test (SRRT) assesses social rank recognition based on social context (SC) and physical characteristics (PC), processed by distinct neural systems via bottom-up and top-down processes. Schizophrenia spectrum disorders (SSD) encompass biases in predictive processing, leading to overestimation of prior precision. We hypothesized that patients with SSD would show augmented reliance on both social context and physical characteristics when judging social rank.

Forty-one healthy subjects (HCs) and 41 remitted patients with SSD completed the SRRT, based on SC, PC, and conflicted signs (CF). Visual perception was assessed with Optical Illusion Test (OIT), subjective appraisal of social rank with the Social Comparison Test, and theory of mind with Hinting Task. We investigated oxytocin and oxytocin receptor levels as biological correlates of social cognition.

Patients with SSD showed augmented social rank recognition based on PC, whereas no such augmentation was observed for SC. In SSD, moderate and weak correlations between OIT and both SRRT-PC and SRRT-SC suggested that visual perception may be associated with social rank judgments. Exploratory logistic regression identified PC-based recognition and theory of mind as factors associated with SSD. Weak relationships were found between social rank recognition, psychopathology, and global functioning. Both oxytocin and oxytocin receptor levels were decreased in patients with SSD.

Social rank judgments in SSD may rely on atypical weighting of physical-characteristic and social-context cues, indicating altered mechanisms of processing rank-related social information. These alterations may reflect an imbalance toward weak top-down and consequent stronger bottom-up processes, as well as differences in the relationship between visual perception and social rank judgments, suggesting a broader deficit across sensory and social domains.