Symptom Domains and Neurocognitive Functioning Can Help Differentiate Social Cognitive Processes in Schizophrenia: A Meta-Analysis

Abstract

The existence of deficits in several social cognitive domains has been established in schizophrenia, and those impairments are known to be a significant determinant of functional outcome. Both symptoms and neurocognition have been linked to social cognitive deficits, but the nature and the relative strength of these relationships have not been established. A meta-analysis of 154 studies (combined N = 7175) was conducted to determine the magnitude of the relationships between 3 symptom domains (reality distortion, disorganization, and negative symptoms) and 6 Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS) domains of neurocognition with 4 domains of social cognition. Analyses were conducted to determine whether the strength of these relationships differed depending on the symptom type or neurocognitive domain under investigation. The correlations between reality distortion and the domains of social cognition ranged from near zero to moderate (r's range from -.07 to -.22), as compared with the moderate association for disorganization (r's range from -.22 to -.32) and negative symptoms (r's range from -.20 to -.26). For each of the neurocognitive domains, the relationships to social cognitive domains were mostly moderate (r's range from .17 to .37), with no one neurocognitive domain being prominent. The effect sizes of the correlations between disorganization and negative symptoms with social cognition were relatively larger and more consistent than reality distortion. The relationship between social cognition and 6 MATRICS domains of neurocognition were mostly moderate and relatively consistent. When considering disorganization and negative symptoms, the relationship to social cognitive processes was relatively as strong as for neurocognition.