Social cognition, schizophrenia and brain imaging

Abstract

118 Social cognition refers to the whole “mental operation underlying social interactions, which includes the human ability to perceive the intentions and disposition of others” (Brothers, 1990). Although social cognition has differently been defined, most of the researchers suggest that it is composed by the following domains: (a) emotional processing, (b) theory of mind (the ability to infer the intentions and beliefs of others), (c) social perception (which expresses the person’s ability to ascertain social cues from behaviour provided in a social context, including emotional cues), (d) social context, (e) social knowledge (the awareness of the roles, rules and goals that characterize social situations and guides social interactions), and (e) attributional bias (how one explains the causes for positive and negative outcome of events) (Green et al., 2005; Salovey et al., 1997; Toomey et al., 1997). All these dimensions would together support the complex behaviours necessary for social interactions and a neural network involving prefrontal cortex (PFC) areas (i.e. orbitofrontal cortex, ventrolateral, dorsolateral and dorsomedial PFC), cingulate, fusiform gyrus, amygdala, and superior temporal sulcus participate in supporting social cognition in humans (Burns, 2006; Grady et al., 2002). In this regard, individuals with PFC damage have impaired social behaviour and functioning, despite the retention of intact cognitive skills. This would lead to misinterpretation of social situations, especially when the damage is located in the orbitofrontal/ventromedial PFC region (Shamay-Tsoory et al., 2007). Impairment in social functioning is also a core feature of schizophrenia (Spauwen et al., 2006; Pinkham et al., 2003). Burns (2006) argued that the patient’s sense of detachment and disembodiment from “social self” and “social world” is the essential disturbance of schizophrenia. Altered social cognition is in fact present throughout the course of the illness, worsens with chronicity, is often resistant to antipsychotic treatment, and may represent a risk factor for the disease (Killackey et al., 2007; Pinkham et al., 2003; Addington et al., 2000). Moreover, since social cognition partially sustains functioning, it is considered an intervention target (Green et al., 2008) and some studies have shown that cognitive training may improve social outcome measures in schizophrenia (Combs et al., 2007; Jabben et al., 2007; Wolwer et al., 2005). Indeed, there is growing evidence that social cogAddress for correspondence: Dr. M. Bellani, Department of Medicine and Public Health, Section of Psychiatry and Clinical Psychology, University of Verona, Piazzale L.A. Scuro 10, 37134 Verona (Italy). Fax: +39-045-585.871 E-mail: marcella.bellani@univr.it Social cognition, schizophrenia and brain imaging