Social functioning in schizophrenia: Comparing laboratory-based assessment with real-world measures

Abstract

Researchers have measured social functioning in schizophrenia using many different strategies. Recent technological advances have made it possible to passively measure behaviors in real-world social situations—allowing for more objective, ecologically valid assessments. Yet, research testing the convergent validity among real-world and laboratory-based social functioning assessment is sparse. The purpose of this study was to test the convergent validity among four social functioning measures: two interview-based rating scales, a self-reported ecological momentary assessment (EMA), and a passive, ambulatory ecological assessment. Data was collected from 36 people with schizophrenia and 33 control participants. Across the entire sample, relationships between interview-based ratings and real-world measures of social functioning only demonstrated small correlations (r's = 0.17–0.19), whereas real-world measures exhibited moderate correlations with one another (r = 0.36). Within groups, real-world measures showed moderate, significant relationships in the control group (r = 0.44) but not in the schizophrenia group (r = 0.27). For those with schizophrenia, the interview-based measures of social functioning were moderately associated with ambulatory ecological assessment (r's = 0.38 and 0.47), but only small associations were observed with self-reported EMA (r's = 0.15 and 0.17). Results suggest social functioning assessments are not highly convergent and likely target different aspects of social functioning. Laboratory-based measures offer global impressions of social functioning whereas real-world measures represent a more nuanced approach. Moreover, ambulatory ecological assessment may most accurately gauge frequency of daily social interactions for those with schizophrenia as it circumvents common pitfalls of self-report and offers a less-biased, in-depth evaluation of social behavior.