Social cognition in schizophrenia.

Abstract

The topic of social cognition has attracted considerable interest in schizophrenia over the last several years. This construct generally refers to the detection, processing, and utilization of social information and, within the field of schizophrenia, includes several skills such as recognizing emotion, understanding the thoughts and intentions of others, and interpreting social cues. Individuals with schizophrenia show significant impairments in social cognition, and these impairments are strongly related to functional outcome. Treating social cognition yields significant improvements in real-world outcomes, including social functioning and social skill. Importantly, social cognitive abilities are linked to specific neural circuits that have been shown to be abnormal in individuals with schizophrenia. Investigations of these neural networks in patients have also demonstrated that brain activation is significantly correlated with social functioning, which suggests that abnormal activation in social cognitive networks may serve as a mechanism for social dysfunction in schizophrenia. Among the many challenges in this area is the issue of measurement. There is disagreement about which tasks best measure social cognition and many existing measures show poor psychometric properties. A recent project, called the Social Cognition Psychometric Evaluation (SCOPE) study, aims to address these problems by providing the field with a well-validated battery of social cognitive tasks that can be used in treatment outcome trials. Research is honing in on the potential mechanisms of social cognitive impairment in patients, and with improved measurement, there is promise for optimizing behavioral and pharmacologic interventions and remediation strategies.