Social Cognitive Impairment Research Articles

Cerebral and cerebellar correlates of social cognitive impairment in schizophrenia

Social cognition is a broad construct encompassing the ways in which individuals perceive, process, and use information about other people. Social cognition involves both lower- and higher-level processes such as emotion recognition and theory of mind, respectively. Social cognitive impairments have been repeatedly demonstrated in schizophrenia spectrum illnesses and, crucially, are related to functional outcomes. In this review, we summarize the literature investigating the brain networks implicated in social cognitive impairments in schizophrenia spectrum illnesses. In addition to cortical and limbic loci and networks, we also discuss evidence for cerebellar contributions to social cognitive impairment in this population. We conclude by synthesizing these two literatures, with an emphasis on current knowledge gaps, particularly in regard to cerebellar influences, and future directions.

Effects of Transcranial Direct Current Stimulation on Social Attention Patterns and Emotion Recognition Ability in Male Adolescents with Autism Spectrum Disorder.

Autism Spectrum Disorder (ASD) is characterized by impairments in social cognition including emotion recognition (ER) abilities. Common symptoms include unusual patterns of visual social attention, which are investigated as early developmental biomarkers for ASD. Transcranial Direct Current Stimulation (tDCS) has shown promising results in influencing social functioning in individuals with ASD. However, the effects of tDCS on social attention patterns and ER ability in adolescents with ASD remain unclear. This double-blind, sham-controlled, randomized clinical trial examined the effects of repeated sessions of tDCS on gaze behavior and ER ability in 22 male adolescents diagnosed with ASD. Participants received either 20 min of 2 mA active tDCS or sham stimulation for 10 days and an intra-stimulation training. Social allocation patterns were assessed using eye-tracking paradigms, including ER tasks. Our results indicated no tDCS-specific effects. Both groups showed improvements in ER and more frequent, faster, and longer fixations on the eyes than the mouth, and on social than nonsocial areas. In tasks with low social content, fixating the mouth seemed to increase ER accuracy. Understanding the effects of tDCS on social functioning in adolescents with ASD holds promise for the development of targeted interventions to improve their social cognition abilities.

Association of Alexithymia With Positive Symptoms in Chinese Chronic Schizophrenia Patients With and Without Obesity.

A growing body of research suggests the presence of alexithymia (a form of social cognitive impairment) in patients with schizophrenia (SCZ), which may be related to their psychopathological symptoms. Patients with SCZ exhibit high rates of obesity. Interestingly, studies of the general population have found that alexithymia acts a pivotal role in the development and maintenance of obesity. However, little is known regarding the relationship between obesity, alexithymia, and clinical symptoms in SCZ patients. The study was aim to explore the relationship between obesity, alexithymia, and clinical symptoms in SCZ patients. Demographic and clinical data were collected from 507 patients with chronic SCZ. Their symptoms were assessed with the Positive and Negative Syndrome Scale (PANSS), and alexithymia was assessed with the Toronto Alexithymia Scale (TAS). Compare with nonobese SCZ patients, obese SCZ patients scored higher on PANSS positive symptoms, TAS total score, difficulty identifying feelings, and difficulty describing feelings (all p<0.05). Correlation analysis revealed a significant association between difficulty identifying feelings and positive symptoms in SCZ patients. Further correlation analysis showed that this association was only present in obese SCZ patients (p<0.05). Obesity may moderate the association between alexithymia and positive symptoms in chronic SCZ patients.

Social Cognition in Idiopathic Generalized Epilepsies and Nonlesional Temporal Lobe Epilepsy

Objectives. Social cognition (SC) is a multifaceted concept involving mental processes to understand, store, and apply information regarding social relationships. Brain lesions in key areas can impair critical components of SC, but seizures and epileptiform discharges could also be associated with deficits in SC. To verify this hypothesis, this study evaluated SC in persons with generalized or focal epilepsy without detectable brain lesion. Materials and Methods. Forty-eight adult persons with idiopathic generalized epilepsy (IGE) or temporal lobe epilepsy without brain lesion (cryptoTLE) and 24 healthy controls were evaluated by means of the Faux Pas Test (FPT), Social Situation Test (SST), Moral/Conventional Distinction Test (MCDT), and Empathy Questionnaire (EQ) which assess theory of mind (ToM), recognition of social behaviors and moral and conventional rules, and empathy. Clinical work-up included information on age at seizure onset, epilepsy duration, seizure symptoms and frequency, demographic characteristics, and the presence of comorbidities. Results. Compared to controls, persons with IGE or cryptoTLE were impaired in the understanding of existent faux pas on the FPT. On the SST, persons with cryptoTLE also showed significant deficits, whereas the IGE persons only were less accurate in recognizing normative behaviors. In cryptoTLE persons, the capacity to recognize cognitive and affective mental states correlated with seizure frequency and age, whereas, in IGE persons, the SST and MCDT scores correlated with schooling and age, respectively. Conclusions. CryptoTLE can cause extensive deficits in ToM and recognition of social situations, whereas IGE is only associated with deficits in fewer domains. Dysfunction of temporolimbic areas could be related to seizure frequency and associated with more severe SC impairment in cryptoTLE. Older age and poor education may be associated with SC deficits in focal or generalized epilepsy.

Altered brain metabolism in frontotemporal dementia and psychiatric disorders: involvement of the anterior cingulate cortex

BackgroundBehavioural symptoms and frontotemporal hypometabolism overlap between behavioural variant of frontotemporal dementia (bvFTD) and primary psychiatric disorders (PPD), hampering diagnostic distinction. Voxel-wise comparisons of brain metabolism might identify specific frontotemporal-(hypo)metabolic regions between bvFTD and PPD. We investigated brain metabolism in bvFTD and PPD and its relationship with behavioural symptoms, social cognition, severity of depressive symptoms and cognitive functioning.ResultsCompared to controls, bvFTD showed decreased metabolism in the dorsal anterior cingulate cortex (dACC) (p < 0.001), orbitofrontal cortex (OFC), temporal pole, dorsolateral prefrontal cortex (dlPFC) and caudate, whereas PPD showed no hypometabolism. Compared to PPD, bvFTD showed decreased metabolism in the dACC (p < 0.001, p < 0.05FWE), insula, Broca’s area, caudate, thalamus, OFC and temporal cortex (p < 0.001), whereas PPD showed decreased metabolism in the motor cortex (p < 0.001). Across bvFTD and PPD, decreased metabolism in the temporal cortex (p < 0.001, p < 0.05FWE), dACC and frontal cortex was associated with worse social cognition. Decreased metabolism in the dlPFC was associated with compulsiveness (p < 0.001). Across bvFTD, PPD and controls, decreased metabolism in the PFC and motor cortex was associated with executive dysfunctioning (p < 0.001).ConclusionsOur findings indicate subtle but distinct metabolic patterns in bvFTD and PPD, most strongly in the dACC. The degree of frontotemporal and cingulate hypometabolism was related to impaired social cognition, compulsiveness and executive dysfunctioning. Our findings suggest that the dACC might be an important region to differentiate between bvFTD and PPD but needs further validation.

Examining associations, moderators and mediators between childhood maltreatment, social functioning, and social cognition in psychotic disorders: a systematic review and meta-analysis.

Childhood maltreatment (CM) has been related to social functioning and social cognition impairment in people with psychotic disorders (PD); however, evidence across different CM subtypes and social domains remains less clear. We conducted a systematic review and meta-analysis to quantify associations between CM, overall and its different subtypes (physical/emotional/sexual abuse, physical/emotional neglect), and domains of social functioning and social cognition in adults with PD. We also examined moderators and mediators of these associations. A PRISMA-compliant systematic search was performed on 24 November 2022 (PROSPERO CRD42020175244). Fifty-three studies (N = 13 635 individuals with PD) were included in qualitative synthesis, of which 51 studies (N = 13 260) with 125 effects sizes were pooled in meta-analyses. We found that CM was negatively associated with global social functioning and interpersonal relations, and positively associated with aggressive behaviour, but unrelated to independent living or occupational functioning. There was no meta-analytic evidence of associations between CM and social cognition. Meta-regression analyses did not identify any consistent moderation pattern. Narrative synthesis identified sex and timing of CM as potential moderators, and depressive symptoms and maladaptive personality traits as possible mediators between CM and social outcomes. Associations were of small magnitude and limited number of studies assessing CM subtypes and social cognition are available. Nevertheless, adults with PD are at risk of social functioning problems after CM exposure, an effect observed across multiple CM subtypes, social domains, diagnoses and illness stages. Maltreated adults with PD may thus benefit from trauma-related and psychosocial interventions targeting social relationships and functioning.

The Enigmatic CA2: Exploring the Understudied Region of the Hippocampus and Its Involvement in Parkinson's Disease.

Parkinson's disease (PD) is a neurodegenerative disease that affects both motor and non-motor functions. Although motor impairment is a prominent clinical sign of PD, additional neurological symptoms may also occur, particularly in the preclinical and prodromal stages. Among these symptoms, social cognitive impairment is common and detrimental. This article aims to review non-motor symptoms in PD patients, focusing on social cognitive deficits. It also examines the specific characteristics of the CA2 region and its involvement in social behavior, highlighting recent advances and perspectives. Additionally, this review provides critical insights into and analysis of research conducted in rodents and humans, which may help improve the understanding of the current status of putative therapeutic strategies for social cognitive dysfunction in PD and potential avenues related to the function of the hippocampal CA2 region.

Investigation of social cognition and cognitive impairment among patients with bipolar disorder, their healthy first-degree relatives, and the control group

Evidence regarding cognitive function in relatives of patients with bipolar disorder (BP) is controversial. This study aims to investigate social cognition and cognitive impairment among patients with BP, their healthy relatives (BP-Rel), and the healthy control group (HCs). A total of 180 participants in this study participated in three groups of 60 people, BP, BP-Rel, and HCs. All subjects were examined by the Bar-On emotional quotient inventory (Bar-On EQ-i), Gross Emotion Regulation Questionnaire (Gross -ERQ), and Screen for Cognitive Impairment in Psychiatry (SCIP) scale. In addition, the clinical and demographic data of the participants were also collected and analyzed by appropriate statistical methods (one-way analysis of variance, chi-square test, and correlation coefficient). Compared to BP-Rel and HCs, BP patients had lower overall emotional intelligence (EI) and emotion regulation (ER) scores. The overall scores of these sales were lower in BP-Rel compared to the control group. In addition, we also studied the correlation of the mentioned scales with SCIP subscales. Except for the working memory test and verbal fluency test, other SCIP subscales had a positive and significant correlation with the EI scale (p<.05). Regarding ER scale, all subscales of SCIP had a positive and significant correlation with the emotion regulation scale (p<.05). Healthy relatives of BP patients may also have maladaptive emotion regulation strategies. More studies are needed to confirm the above evidence on this issue.

Social Cognition in Behavioral Variant Frontotemporal Dementia and Pathological Subtypes: A Narrative Review.

Behavioral variant frontotemporal dementia (bvFTD) belongs to the spectrum of frontotemporal lobar degeneration (FTLD) and is characterized by frontal dysfunction with executive deficits and prominent socioemotional impairments. Social cognition, such as emotion processing, theory of mind, and empathy may significantly impact daily behavior in bvFTD. Abnormal protein accumulation of tau or TDP-43 are the main causes of neurodegeneration and cognitive decline. Differential diagnosis is difficult due to the heterogeneous pathology in bvFTD and the high clinicopathological overlap with other FTLD syndromes, especially in late disease stages. Despite recent advances, social cognition in bvFTD has not yet received sufficient attention, nor has its association with underlying pathology. This narrative review evaluates social behavior and social cognition in bvFTD, by relating these symptoms to neural correlates and underlying molecular pathology or genetic subtypes. Negative and positive behavioral symptoms, such as apathy and disinhibition, share similar brain atrophy and reflect social cognition. More complex social cognitive impairments are probably caused by the interference of executive impairments due to increasing neurodegeneration. Evidence suggests that underlying TDP-43 is associated with neuropsychiatric and early social cognitive dysfunction, while patients with underlying tau pathology are marked by strong cognitive dysfunction with increasing social impairments in later stages. Despite many current research gaps and controversies, finding distinct social cognitive markers in association to underlying pathology in bvFTD is essential for validating biomarkers, for clinical trials of novel therapies, and for clinical practice.

The effect of the interaction between autistic traits and psychotic proneness on empathy: a cross-sectional study with a non-clinical sample

PurposeRecent evidence indicates an improving effect of the co-occurrence of autistic traits and psychotic symptoms on social cognition, but there is no agreement on the effect of the interaction between autistic traits and psychotic proneness on empathy. The aim of this study is to examine the effect of the interaction between autistic traits and positive psychotic experiences on cognitive and affective empathy.Design/methodology/approachThe sample consisted of 420 adults aged between 18 and 60. Assessments were administered anonymously online. Empathic abilities were evaluated by the Interpersonal Reactivity Index (IRI). While Autism Spectrum Quotient (AQ) was applied to measure autistic traits, The Community Assessment of Psychic Experience (CAPE) was used as a measurement of positive psychotic experiences.FindingsA series of regression analyses showed that although AQ and CAPE scores were not correlated with cognitive-IRI, the interaction between these scores predicted cognitive-IRI scores. It was found that the personal distress subscale of IRI was significantly associated with AQ, but this relationship was moderated by CAPE scores.Originality/valueThese findings provide a different perspective on understanding social cognitive impairments in autism, which may have potential clinical implications. Findings also contribute to explaining the individual differences in empathic abilities.

Social cognition and adjustment in adult survivors of pediatric central nervous system tumors.

Survivors of pediatric central nervous system (CNS) tumors are at risk for neurocognitive and social difficulties throughout childhood. This study characterized social cognition (perception and reasoning from social cues) and adjustment in adulthood. A total of 81 adult survivors of pediatric CNS tumors (51% female; mean [SD] age,28.0 [5.8] years), were recruited across four groups: (1) no radiation therapy (RT) [n=21], (2) infratentorial (IT) tumors+focal RT [n=20], (3) IT tumors+craniospinal irradiation [n=20], and (4) supratentorial tumors+focal RT [n=20]. Prevalence of social cognitive and adjustment impairments was compared to test norms. Multivariable models examined clinical and neurocognitive predictors of social cognition and its impact on functional outcomes. Survivors demonstrated elevated risk of severe social cognitive impairments (social perception Morbidity Ratio [95% CI] 5.70 [3.46-9.20]), but self-reported few social adjustment problems. Survivors of IT tumors treated with craniospinal irradiation performed nearly 1 SD worse than survivors treated without RT on multiple measures of social cognition (e.g., social perception: β=-0.89, p=.004). Impaired executive functioning and nonverbal reasoning were associated with worse social cognitive performance (e.g., social perception: β=-0.75, p<.001; β=-0.84, p<.001, respectively). Better social perception was associated with higher odds of attaining full-time employment (odds ratio, 1.52 [1.17-1.97]) and at least some college education (odds ratio, 1.39 [1.11-1.74]). Adult survivors of CNS tumors are at elevated risk of severely impaired social cognition, but do not perceive social adjustment difficulties. Better understanding of potential mechanisms underlying social cognitive deficits may inform intervention targets to promote better functional outcomes for at-risk survivors.

Inter-relationships among psychopathology, cognition, and real-life functioning in early and late phase schizophrenia: A network analysis approach.

Many illness-related factors contribute to the reduction of the real-life functioning observed in people with schizophrenia (SZ). These include the psychopathological dimensions of the disorder such as positive, negative, disorganization, and depressive symptoms as well as impairment in neurocognition, social cognition, and metacognition. The associations between some of these variables change with the duration of illness (DOI), but this aspect was not explored with a network approach. This study aimed at describing and comparing the inter-relationships between psychopathological, cognitive, and functioning variables in early (DOI≤5years) and late (DOI>5years) phase SZ with network analyses and at assessing which variables were more strictly and directly associated with the real-life functioning. A network representation of the relationships between variables and the calculation of centrality indices were performed within each group. The two groups were compared with a network comparison test. Seventy-five patients with early and ninety-two with late phase SZ were included. No differences in the global network structure and strength were found between the two groups. In both groups, visual learning and disorganization exhibited high centrality indices and disorganization, negative symptoms, and metacognition were directly and strongly associated with real-life functioning. In conclusion, regardless of the DOI, a rehabilitation aimed at improving visual learning and disorganization (i.e., the most central variables) might reduce the strength of the associations that compose the network and therefore indirectly facilitate functional recovery. Simultaneously, therapeutic interventions targeting disorganization and metacognition might directly improve real-life functioning.

Investigating the symptomatic and morphological changes in the brain based on pre and post-treatment: A critical review from clinical to neuroimaging studies on schizophrenia.

Pharmacological treatment for schizophrenia has been a long-standing concern. As a severe neuropsychological illness, schizophrenia is always a challenging disorder to unravel its pathophysiology. Since it exhibits both positive and negative symptoms, such as hallucination and delusion, as well as social isolation and cognitive impairment, following the symptomatic changes is a crucial task for clinicians. Although various pharmacological treatments are available in the form of antipsychotics, however, their actual consequences need to be examined with the observable changes in symptoms as well as the unobservable changes in brain functioning. This study is a first of its kind to critically investigate both clinical and neuroimaging studies to find out the changes being observed in schizophrenia patients after clinical intervention with various antipsychotics. We observed several symptomatic changes being reported in clinical studies incorporating clinical trials of various first-generation and second-generation antipsychotic drugs. Alongside, we encapsulated several neuroimaging studies showing functional and structural changes in the brain of schizophrenia patients triggered by a variety of drugs. The basal ganglia, frontal lobe, temporal lobe, cuneus, and middle occipital gyrus are some of the notable brain regions that were observed to show subtle functional and structural changes. This critical review paper may pave the way for future research into the study of the pathological and morphological changes in the brains of schizophrenia patients as they progress through the course of medicinal therapy.

Methodological precautions in the assessment and health care management of social cognition impairments

Methodological precautions in the assessment and health care management of social cognition impairments

Emotional arousal and valence in patients with fibromyalgia: a pilot study.

The pathogenesis of pain in fibromyalgia is still not completely understood. A disrupted emotional modulation could affect the physiology of nociception and contributes to an altered perception of pain. The aim of this study was to test the role of emotional arousal and valence in pain susceptibility in fibromyalgia using the International Affective Picture System (IAPS) paradigm and the Fibromyalgia Severity Scale (FSS). The study focused on comparing emotional arousal and valence between patients with fibromyalgia and the control group. The secondary objective was to examine the correlation between emotional indices and scores on the FSS and the duration of the disease. The 20 patients with fibromyalgia enrolled showed a higher mean arousal score for all the stimuli, including a higher score for unpleasant and socially unpleasant stimuli. The valence scores for social-relevant stimuli were also higher. Increased arousal to unpleasant and socially unpleasant images and increased valence of them correlated with the duration of the disease and the severity of symptoms and could reflect impairment in social cognition and marked sensitivity to pain in interaction with central nociceptive dysregulation.

0692 Relationships Between Sleep and Social Cognitive Biases in Schizophrenia-Spectrum and Bipolar Disorders

Abstract Introduction People with schizophrenia-spectrum disorders (SSDs) and bipolar disorders (BDs) experience difficulty with social cognition, or the mental processes that underlie social interactions, but determinants of social cognitive impairment are still under investigation. Research suggests that poor sleep quality is related to reduced social cognitive ability in BDs, but it is unclear if sleep quality is related to social cognition in SSDs and if sleep may be related to different types of social cognition (e.g., emotion recognition, biases) in different ways. This study aimed to examine relationships between sleep and different types of social cognition in SSDs and BDs. Given known relationships between blaming and untrustworthiness biases and paranoia in these populations, paranoia was also examined as potential mediator of these relationships. Methods Participants (SSDs n=91; BDs with psychotic features n=87) completed tasks of social cognitive ability (e.g., facial and multi-modal emotion recognition, attributional bias, untrustworthiness bias). Participants self-reported their sleep quality. Paranoia was assessed via clinical interview. Results In the BD group, poor sleep quality (r=-.23, p=.04) and shorter sleep duration (r=-.25, p=.02) were associated with a bias towards untrustworthiness. For those with SSDs, increased use of sleep medication was associated with poorer multi-modal emotion recognition (r=-.22, p=.04). Additionally, poor sleep quality and overall poor sleep were associated with increased blaming (r=.22, p=.03; r=.21, p=.04) and untrustworthiness biases (r=-.24, p=.03; r=-.24, p=.03) in this group. Higher daytime tiredness was also associated with untrustworthiness bias (r=-.23, p=.03) in SSDs. Regarding mediation results, paranoia did serve as a mediator in the relationships between sleep and blaming and untrustworthiness biases across the sample. Conclusion Results suggest that poor sleep quality is linked to increased attributional and untrustworthiness biases, and that these relationships may be at least partially explained by paranoia symptoms. Of note, however, is that indirect effect sizes in mediation models were small. Contrary to expectations, poor sleep quality was not consistently associated with reduced social cognitive ability in the current sample. Findings from the current study require further exploration and replication. Support (if any) This work was supported by the National Institute of Mental Health (grant number R01 MH116902-04 awarded to C.A.D).

Age-Related Social Cognitive Performance in Individuals With Psychotic Disorders and Their First-Degree Relatives.

Social cognitive impairment is a recognized feature of psychotic disorders. However, potential age-related differences in social cognitive impairment have rarely been studied. Data came from 905 individuals with a psychotic disorder, 966 unaffected siblings, and 544 never-psychotic controls aged 18-55 who participated in the Genetic Risk and Outcome of Psychosis (GROUP) study. Multilevel linear models were fitted to study group main effects and the interaction between group and age on emotion perception and processing (EPP; degraded facial affect recognition) and theory of mind (ToM; hinting task) performance. Age-related differences in the association between socio-demographic and clinical factors, and EPP and ToM were also explored. Across groups, EPP performance was associated with age (β = -0.02, z = -7.60, 95% CI: -0.02, -0.01, P < .001), with older participants performing worse than younger ones. A significant group-by-age interaction on ToM (X2(2) = 13.15, P = .001) indicated that older patients performed better than younger ones, while no age-related difference in performance was apparent among siblings and controls. In patients, the association between negative symptoms and ToM was stronger for younger than older patients (z = 2.16, P = .03). The findings point to different age-related performance patterns on tests of 2 key social cognitive domains. ToM performance was better in older individuals, although this effect was only observed for patients. EPP was less accurate in older compared with younger individuals. These findings have implications with respect to when social cognitive training should be offered to patients.

Performance in emotion recognition and theory of mind tasks in social anxiety and generalized anxiety disorders: a systematic review and meta-analysis.

Social cognition impairments may be associated with poor functional outcomes, symptoms, and disability in social anxiety disorder (SAD) and generalized anxiety disorder (GAD). This meta-analysis aims to determine if emotion recognition and theory of mind (ToM) are impaired in SAD or GAD compared to healthy controls. A systematic review was conducted in electronic databases (PubMed, PsycNet, and Web of Science) to retrieve studies assessing emotion recognition and/or ToM in patients with SAD or GAD, compared to healthy controls, up to March 2022. Meta-analyses using random-effects models were conducted. We identified 21 eligible studies: 13 reported emotion recognition and 10 ToM outcomes, with 585 SAD patients, 178 GAD patients, and 753 controls. Compared to controls, patients with SAD exhibited impairments in emotion recognition (SMD = -0.32, CI = -0.47 - -0.16, z = -3.97, p < 0.0001) and ToM (SMD = -0.44, CI = -0.83 -0.04, z = -2.18, p < 0.01). Results for GAD were inconclusive due to the limited number of studies meeting the inclusion criteria (two for each domain). Relevant demographic and clinical variables (age, sex, education level, and anxiety scores) were not significantly correlated with emotion recognition or ToM impairments in SAD and GAD. Further studies employing ecological measures with larger and homogenous samples are needed to better delineate the factors influencing social cognition outcomes in both SAD and GAD.

Understanding the link between immunosuppressant and natural killer cell in the progression of autism: The role of natural killer cell and mammalian target of rapamycin in autistic brain

Natural killer cell plays a major role in the pathogenesis of neurodevelopmental disorder including autism spectrum disorder (ASD). ASD is a neurodevelopmental disorder that is associated with symptoms that reduce the quality of life of affected individuals such as social interaction deficit, cognitive impairment, intellectual disabilities, restricted, and repetitive behavioral patterns. This disorder begins in early childhood and continues throughout adulthood. ASD pathogenesis is associated with alteration in natural killer (NK) cells as well as mammalian target of rapamycin signaling functioning that leads to altered physiological processes during development. Here, we review literature highlighting the role of immunosuppressants especially rapamycin and azathioprine and their impact on treating the neurodevelopmental disorder and mechanism by which these drugs may act to ameliorate the autistic symptoms. Furthermore, this review discusses reports highlighting the role of NK cells and familial adenomatous polyposis gene in the etiology of ASD. This review suggests that further investigative work on these drugs could be vital in the management of ASD.

Loneliness is associated with mentalizing and emotion recognition abilities in schizophrenia, but only in a cluster of patients with social cognitive deficits.

Loneliness is a concern for patients with schizophrenia. However, the correlates of loneliness in patients with schizophrenia are unclear; thus, the aim of the study is to investigate neuro- and social cognitive mechanisms associated with loneliness in individuals with schizophrenia. Data from clinical, neurocognitive, and social cognitive assessments were pooled from two cross-national samples (Poland/USA) to examine potential predictors of loneliness in 147 patients with schizophrenia and 103 healthy controls overall. Furthermore, the relationship between social cognition and loneliness was explored in clusters of patients with schizophrenia differing in social cognitive capacity. Patients reported higher levels of loneliness than healthy controls. Loneliness was linked to increased negative and affective symptoms in patients. A negative association between loneliness and mentalizing and emotion recognition abilities was found in the patients with social-cognitive impairments, but not in those who performed at normative levels. We have elucidated a novel mechanism which may explain previous inconsistent findings regarding the correlates of loneliness in individuals with schizophrenia.