Social Cognitive Deficits In Schizophrenia Research Articles

Trajectories and predictors of response to social cognition training in people with schizophrenia: A proof-of-concept machine learning study

BackgroundSocial cognition training (SCT) can improve social cognition deficits in schizophrenia. However, little is known about patterns of response to SCT or individual characteristics that predict response. Methods76 adults with schizophrenia randomized to receive 8–12 weeks of remotely-delivered SCT were included in this analysis. Social cognition was measured with a composite of six assessments. Latent class growth analyses identified trajectories of social cognitive response to SCT. Random forest and logistic regression models were trained to predict membership in the trajectory group that showed improvement from baseline measures including symptoms, functioning, motivation, and cognition. ResultsFive trajectory groups were identified: Group 1 (29 %) began with slightly above average social cognition, and this ability significantly improved with SCT. Group 2 (9 %) had baseline social cognition approximately one standard deviation above the sample mean and did not improve with training. Groups 3 (18 %) and 4 (36 %) began with average to slightly below-average social cognition and showed non-significant trends toward improvement. Group 5 (8 %) began with social cognition approximately one standard deviation below the sample mean, and experienced significant deterioration in social cognition. The random forest model had the best performance, predicting Group 1 membership with an area under the curve of 0.73 (SD 0.24; 95 % CI [0.51–0.87]). ConclusionsFindings suggest that there are distinct patterns of response to SCT in schizophrenia and that those with slightly above average social cognition at baseline may be most likely to experience gains. Results may inform future research seeking to individualize SCT treatment for schizophrenia.

Social cognition and social motivation in schizophrenia and bipolar disorder: are impairments linked to the disorder or to being socially isolated?

People with schizophrenia on average are more socially isolated, lonelier, have more social cognitive impairment, and are less socially motivated than healthy individuals. People with bipolar disorder also have social isolation, though typically less than that seen in schizophrenia. We aimed to disentangle whether the social cognitive and social motivation impairments observed in schizophrenia are a specific feature of the clinical condition v. social isolation generally. We compared four groups (clinically stable patients with schizophrenia or bipolar disorder, individuals drawn from the community with self-described social isolation, and a socially connected community control group) on loneliness, social cognition, and approach and avoidance social motivation. Individuals with schizophrenia (n = 72) showed intermediate levels of social isolation, loneliness, and social approach motivation between the isolated (n = 96) and connected control (n = 55) groups. However, they showed significant deficits in social cognition compared to both community groups. Individuals with bipolar disorder (n = 48) were intermediate between isolated and control groups for loneliness and social approach. They did not show deficits on social cognition tasks. Both clinical groups had higher social avoidance than both community groups. The results suggest that social cognitive deficits in schizophrenia, and high social avoidance motivation in both schizophrenia and bipolar disorder, are distinct features of the clinical conditions and not byproducts of social isolation. In contrast, differences between clinical and control groups on levels of loneliness and social approach motivation were congruent with the groups' degree of social isolation.

Social cognition and emotional rehabilitation in participants with schizofrenia.

People with schizophrenia have deficits in social cognition, emotion and social perception, as well as attributional style. The purpose of this study was to evaluate the efficacy of a multicomponent social cognition training program, e-Motional Training® (ET), in people with schizophrenia and to compare its efficacy with people who did not receive it. Therefore, a single-blind RCT was conducted in participants with a diagnosis of schizophrenia. A randomized, single-blind, clinical trial was conducted with 50 stable outparticipants with schizophrenia (registry number CHUC_2019_109). All participants (control and intervention) were treated with pharmacotherapy, case management and were on Individual Placement and Support methodology for competitive employment. The intervention group was treated with ET, an online program designed for social cognition rehabilitation. Pre and post assessment was performed using different battery of tests. General mixed models with subject identification and repeated measures over time were used. Different pre and post measurements were performed in the two groups. No significant differences were found in sociodemographic characteristics between the control and intervention groups. Improvements were obtained in the intervention group in the Ekman test (p = 0.009), mainly enhanced by the improvement shown in three emotions: fear, sadness and disgust (p = 0.041, p = 0.021 and p = 0.038 respectively). ET is a promising online training tool for social cognition deficits in schizophrenia, in particular, for the improvement of emotions.Clinical Trial Registration: https://beta.clinicaltrials.gov, NCT05866328.

Social cognition and psychosocial functioning in schizophrenia and bipolar disorder: Theory of mind as a key to understand schizophrenia dysfunction

Functional impairment is a common symptom in schizophrenia (SZ) and bipolar disorder (BD). Pharmacological treatments have limited functional recovery in both disorders. Social cognition, a cognitive process, has been associated with functioning in mental disorders. Theory of mind (ToM) is considered a key factor in understanding the social cognitive deficits in SZ and BD. Our study aimed to investigate the relationship between ToM and functioning in SZ, BD, and healthy controls (HC) and compare ToM and functioning impairments between groups. A total of 208 participants (HC n = 69; BD n = 89; SZ n = 50) were evaluated with the Functioning Assessment Short Test (FAST), Reading the Mind in the Eyes Test (RMET), the Vocabulary subtest of the Wechsler Abbreviated Scale for Intelligence (WASI) and the Hopkins Verbal Learning Test - Revised (HVLT-R). Comparisons of RMET between low- and high-functioning individuals and multiple linear regression analyses were conducted for each group. Multiple regression analysis revealed that the association between ToM and psychosocial functioning was observed only in SZ (β = –1.352, p = 0.008). Low-functioning SZ participants showed a lower ToM performance compared to participants with high-functioning SZ (t = 1.80, p = 0.039, Cohen's d = 0.938). No significant associations were found in the other groups. ToM is essential to understand the functional impairment in SZ, more than in BD. Furthermore, ToM may be a primary target for intervention strategies in improving functioning in SZ.

Computational methods for integrative evaluation of confidence, accuracy, and reaction time in facial affect recognition in schizophrenia

People with schizophrenia (SZ) process emotions less accurately than do healthy comparators (HC), and emotion recognition have expanded beyond accuracy to performance variables like reaction time (RT) and confidence. These domains are typically evaluated independently, but complex inter-relationships can be evaluated through machine learning at an item-by-item level. Using a mix of ranking and machine learning tools, we investigated item-by-item discrimination of facial affect with two emotion recognition tests (BLERT and ER-40) between SZ and HC. The best performing multi-domain model for ER40 had a large effect size in differentiating SZ and HC (d = 1.24) compared to a standard comparison of accuracy alone (d = 0.48); smaller increments in effect sizes were evident for the BLERT (d = 0.87 vs. d = 0.58). Almost half of the selected items were confidence ratings. Within SZ, machine learning models with ER40 (generally accuracy and reaction time) items predicted severity of depression and overconfidence in social cognitive ability, but not psychotic symptoms. Pending independent replication, the results support machine learning, and the inclusion of confidence ratings, in characterizing the social cognitive deficits in SZ. This moderate-sized study (n = 372) included subjects with schizophrenia (SZ, n = 218) and healthy controls (HC, n = 154).

Social cognitive deficits in schizophrenia and their neurocognitive correlates across the different phases of illness.

This study aimed to assess the relationship between neurocognition (NC) and social cognition (SC) in patients with schizophrenia during the symptomatic phase and the phase of clinical remission. Thirty-two patients were assessed on Color trail test (CTT), Hopkins verbal learning test (HVLT), Controlled oral word association (COWA) test, Wisconsin card sorting test (WCST), Ravens standard progressive matrices (SPM) and Social cognition rating tool in Indian setting (SOCRATIS) during symptomatic and remission phases of illness at least 3 months apart. Compared to baseline assessment, even after controlling for PANSS scores except for social perception index all other domains of SC showed significant improvement at the time of remission. Although there was significant improvement in a few subtests of verbal learning, IQ and number of correct responses of COWA, colour trail test, no significant difference was seen in performance on WCST. Although second order theory of mind task had some association with IQ at the baseline assessment, no association was seen between SC and NC in the remission phase. To conclude, present study suggests that impairments in all the domains of SC (except for social perception index) and NC (except for WCST) improve in the remission phase.

Social Cognition and Neuro-cognition in Patients with Bipolar Disorder, Their First-Degree Relatives and Healthy Controls.

Background:Studies focusing on assessing social cognition deficits in schizophrenia have been expanded to bipolar disorder considering the similarities shared between the two conditions. Existing research has identified significant deficits in social cognitive skills independent of mood states and neurocognitive deficits, which could indicate the potentiality of this domain to be an endophenotype for bipolar disorder.Methods:The current study assesses the impairments in social cognition in patients with bipolar disorder and their first degree relatives, simultaneously testing for neurocognition as well, and comparing their performance to healthy controls. Fifty four participants were recruited, with 18 participants in each group. MATRICS Consensus Cognitive Battery was used to test neurocognition and Social Cognition Rating Tool in Indian Setting was administered for testing social cognition.Results:Significant deficits were found in social cognition and neurocognition (at p<.01) in the patient group when compared to both probands and healthy controls but no difference between probands and healthy controls. This finding established impairments in socio-cognitive functioning in remitted patients. Conclusion: The study has identified persistent deficits in social and neuro-cognition despite remission, having significant clinical implications in terms developing remediation programs for social cognition and planning early intervention as social cognition deficits have been identified as potential risk factors.

Social Cognition Training for Enhancing Affective and Cognitive Theory of Mind in Schizophrenia: A Systematic Review and a Meta-Analysis

People with schizophrenia disorder show the presence of a deficit in social cognition (SC). Several proposals of intervention for social cognitive deficits in schizophrenia have been raised. The present study aimed to provide an update to the state-of-the-art of SC training in schizophrenia, with specific analysis on their efficacy on ToM, which is deeply involved with social dysfunction in this disorder. Furthermore, we proposed to investigate the efficacy of SC training both on ToM cognitive and affective components. We conducted a systematic review, screening 5251 articles; 26 studies met our inclusion criteria. Interventions included were very heterogeneous. To test the efficacy of SC training on ToM domain, we conducted a meta-analysis. Our results showed that SC multidimensional training programs have a positive effect on ToM domain, with a moderate effect on both cognitive and affective ToM subcomponents. Future investigations about which could be the best option for the enhancement of SC in schizophrenia are needed, contributing to expanding the state-of-the-art of SC training in this disorder.

Online Social Cognition Training in Schizophrenia: A Double-Blind, Randomized, Controlled Multi-Site Clinical Trial.

Social cognition (SC), the mental operations underlying social functioning, are impaired in schizophrenia. Their direct link to functional outcome and illness status have made them an important therapeutic target. However, no effective treatment for these deficits is currently applied as a standard of care. To address this need, we have developed SocialVille-an online, plasticity-based training program that targets SC deficits in schizophrenia. Here we report the outcomes of a double-blind, controlled, randomized, multi-site clinical trial of SocialVille. Outpatients with schizophrenia were randomized to complete 40 sessions of either SocialVille (N = 55 completers) or active control (computer games; N = 53 completers) from home. The a priori co-primary outcome measures were a social cognitive composite and a functional capacity outcome (UCSD Performance-based Skills Assessment [UPSA-2]). Secondary outcomes included a virtual functional capacity measure (VRFCAT), social functioning, quality of life, and motivation. Linear mixed models revealed a group × time interaction favoring the treatment group for the social cognitive composite (b = 2.81; P < .001) but not for the UPSA-2 measure. Analysis of secondary outcome measures showed significant group × time effects favoring the treatment group on SC and social functioning, on the virtual functional capacity measure and a motivation subscale, although these latter findings were nonsignificant with FDR correction. These results provide support for the efficacy of a remote, plasticity-based social cognitive training program in improving SC and social functioning in schizophrenia. Such treatments may serve as a cost-effective adjunct to existing psychosocial treatments. Trial Registration: NCT02246426.

What you see is what you get: visual scanning failures of naturalistic social scenes in schizophrenia.

Impairments in social cognition contribute significantly to disability in schizophrenia patients (SzP). Perception of facial expressions is critical for social cognition. Intact perception requires an individual to visually scan a complex dynamic social scene for transiently moving facial expressions that may be relevant for understanding the scene. The relationship of visual scanning for these facial expressions and social cognition remains unknown. In 39 SzP and 27 healthy controls (HC), we used eye-tracking to examine the relationship between performance on The Awareness of Social Inference Test (TASIT), which tests social cognition using naturalistic video clips of social situations, and visual scanning, measuring each individual's relative to the mean of HC. We then examined the relationship of visual scanning to the specific visual features (motion, contrast, luminance, faces) within the video clips. TASIT performance was significantly impaired in SzP for trials involving sarcasm (p < 10-5). Visual scanning was significantly more variable in SzP than HC (p < 10-6), and predicted TASIT performance in HC (p = 0.02) but not SzP (p = 0.91), differing significantly between groups (p = 0.04). During the visual scanning, SzP were less likely to be viewing faces (p = 0.0001) and less likely to saccade to facial motion in peripheral vision (p = 0.008). SzP show highly significant deficits in the use of visual scanning of naturalistic social scenes to inform social cognition. Alterations in visual scanning patterns may originate from impaired processing of facial motion within peripheral vision. Overall, these results highlight the utility of naturalistic stimuli in the study of social cognition deficits in schizophrenia.

M67. UNDERSTANDING SOCIAL COGNITION IN SCHIZOPHRENIA THROUGH THE LENS OF SCHIZOTYPY

BackgroundSocial cognitive deficits are common, detectable across a wide range of tasks and appear to play a key role in influencing poor functioning in schizophrenia. Despite its importance as a treatment target, the factors that underlie social cognitive deficits in schizophrenia remains elusive. Schizotypy appears to be one such factor that can explain the variability in social cognitive deficits seen in schizophrenia. The study’s primary aim was to provide a more comprehensive understanding of social cognitive functioning and its relationship to schizotypy.Methods108 patients and 70 healthy controls completed nine tasks across 4 social cognitive domains based on the SCOPE study. In addition, all participants completed the Schizotypal Personality Questionnaire. Clinical symptoms were also rated using the Brief Psychiatric Rating Scale.ResultsTheory of Mind, social perception, emotion processing and attribution bias were measured in patients with schizophrenia (n = 108) and healthy controls (n = 70). A social cognition composite score was calculated using principal components analysis. Cluster analysis on the derived factor scores revealed 3 clusters. Multiple univariate ANOVAS with Bonferroni correction were used to examine differences between the 3 clusters on each of the 4 social cognition domain scores, which indicated that higher social cognitive performance was related to lower schizotypy. In addition, results indicated that despite differences in the social cognitive performance among patients in the 3 clusters, they did not differ in clinical outcome measures.DiscussionThe primary aim of the study was to address gaps in the current literature by examining the relationship between social cognition and schizotypy. This study built upon past studies which had the tendency to focus on single, discrete domains by comparing the social cognitive performance of patients and controls using an extensive battery of tests, indexing four social cognitive domains. The significant differences on total SPQ score and the SPQ domain scores between the various clusters, coupled with the significant correlations between schizotypy and social cognition, reinforces the utility of schizotypy in refining our understanding of the variation in the degree of social cognitive deficits in schizophrenia. In conclusion, this study substantiates the importance of understanding the relationship between social cognition and schizotypy. This could support and pave the way for the development and implementation of targeted social cognitive interventions catered to the patients’ level of deficit.

Cross-cultural comparison of theory of mind deficits in patients with schizophrenia from China and Denmark: different aspects of ToM show different results

Introduction: Theory of mind (ToM) has been established as one of the most investigated and pronounced social cognitive deficits in schizophrenia. Yet, knowledge on whether measures of ToM can be used and compared across cultures is sparse. In this study, we used two simple, non-verbal ToM tests in patients with schizophrenia and non-clinical controls from China and Denmark to investigate whether culture has an impact on ToM performance.Methods: Sixty-six patients with schizophrenia (35 Chinese) and 67 matched non-clinical controls (38 Chinese) from China and Denmark were tested with Brünés Picture Sequencing Task and Animated Triangles Task. We compared three models for each outcome variable in order to investigate which model best fitted the data: the first model included group (controls, patients) as a predictor variable, the second included group and nationality (Chinese, Danish), and the third included both predictors and their interaction.Results: On most ToM subtests, culture seemed to play a role. Only performance on Brüne’s 1st order ToM were best described as similar in both countries. The second model had the best fit for most of the subtests indicating that the difference between patients and controls in China and Denmark, respectively, is similar.Conclusions: Caution to cultural differences should be taken when comparing ToM in Asian and Western patients with schizophrenia as well as healthy individuals.

Are Negative Symptoms Merely the "Real World" Consequences of Deficits in Social Cognition?

Many investigations have demonstrated that negative symptoms and social cognitive deficits in schizophrenia play a large role in determining functional outcomes and ultimately long-term prognosis. Given this, there is increasing interest in understanding the relationship between these two symptom domains, particularly since studies have consistently found moderate to large associations between them. This shared variance raises a key question: to what degree do these two categories of symptoms arise from overlapping or identical changes in brain function? In other words, do some or all negative symptoms represent merely the downstream effects of social cognition deficits on daily functioning? In this commentary, the evidence for and against this possibility, limitations of currently validated empirical measurements of these symptoms, and directions for further investigation of this hypothesis are discussed. Understanding the shared and distinct mechanisms of these disabling deficits will have important implications for the design of novel, personalized treatments for psychotic illness.

Premorbid Adjustment in Predicting Symptom Severity and Social Cognitive Deficits in Schizophrenia

Schizophrenia patients have deficits in premorbid adjustment (PMA) and social cognition (SC); both deficits are associated with symptom severity, neuro-cognitive deficits, and prognosis. This study aimed to determine symptom severity and two domains of SC deficit by assessing specific areas of PMA in schizophrenia patients. This cross-sectional study included 60 male and 60 female patients with paranoid schizophrenia aged 20 to 35 years from two psychiatric inpatient departments of Chhattisgarh state of India. They were assessed using the Scale for Assessment of Positive Symptoms, Scale for Assessment of Negative Symptoms, Premorbid Adjustment Scale, Recognition of Facial Expression Task, and Picture Arrangement Test. Deficits in premorbid sociability and in scholastic performance were the best predictors of severity of positive symptoms, social knowledge, and negative emotion recognition deficit in schizophrenia patients. Given the important role of SC and PMA, assessing premorbid functioning can help in deciding early and appropriate intervention for schizophrenia.

Neural and behavioral effects of oxytocin administration during theory of mind in schizophrenia and controls: a randomized control trial.

Social cognitive impairments, including theory of mind (ToM), in schizophrenia more strongly predict functional outcomes than psychotic symptoms or nonsocial cognitive deficits. Despite their clinical importance, current medications do not improve these deficits. The current study investigated the hypothesis that oxytocin, a neuropeptide implicated in social behavior, would normalize neural abnormalities in schizophrenia during ToM, and that this normalization would correlate improvement in ToM behavior. In this cross-over, double-blind, and placebo-controlled functional magnetic resonance imaging study, a single dose of 40 IU of oxytocin was administered via nasal spray to maleindividuals with a schizophrenia spectrum disorder (schizophrenia and schizoaffective disorder, n = 23) and healthy controls (n = 25). Participants completed two ToM tasks in the scanner, the False Belief and Person Description tasks. During both tasks, on placebo day, schizophrenia was associated with reduced accuracy, hypo-activity in the right temporo-parietal junction (rTPJ; extended into the posterior superior temporal sulcus), and hypo-connectivity between the rTPJ and medial prefrontal cortex (mPFC) compared to healthy controls. Oxytocin, relative to placebo, significantly increased accuracy and rTPJ activation for ToM but not control stories in schizophrenia. Furthermore, a significant positive correlation was found between oxytocin induced increases in rTPJ activity and accuracy, indicating that oxytocin improved rTPJ activity in schizophrenia predicted behavioral improvement. Oxytocin also significantly improved connectivity between rTPJ and mPFC in schizophrenia. These findings suggest that rTPJ activity during ToM might be a potential neural target for the treatment of social cognitive deficits in schizophrenia.

Social Cognition in Schizophrenia: A Review Study

Social cognition includes all operations encountered in the process of perceiving, understanding & production of appropriate reactions while confronting with others. These include: social awareness, theory of mind, attributive style, and emotion processing. Social cognition skills have been recognized as a vital component in the rehabilitation process for schizophrenic persons, its strong contributors in social function among individual suffering from schizophrenia. The purpose of this review is to appraise various researches about social cognition and its correlates in addition to evaluating various cognitive interventions targeted toward improving social cognition function among patients group and to find the best techniques to ameliorate social cognitive deficits in schizophrenia. Databases were searched from the period from the year 2000 to October 2018. The search terms used were “Social cognition”, emotional management program, schizophrenia. A total of 85 articles were identified and those who meet inclusion criteria including 27 articles. Finding indicates the efficacy of social intervention that targets cognitive aspect in functional abilities of schizophrenic patients and also emotion processing which are significant mediators of social performance aptitudes in patients group.

Early motor resonance differentiates schizophrenia patients from healthy subjects and predicts social cognition performance.

Diminished motor resonance (facilitation of motor potentials during action observation) is possibly related to social cognition deficits in schizophrenia. Adequate social cognition requires the successful moment-to-moment appraisal of social stimuli over a temporal window. However, similar changes in motor resonance with successive action observation stimuli are unknown. We compared the time-course of motor resonance evoked during successive action observation stimuli between schizophrenia patients (antipsychotic-naïve and medicated) and healthy subjects and examined its association with social cognition performance. Fifty-four schizophrenia patients (33 antipsychotic-naive) and 45 healthy subjects underwent 10-recordings (T1 to T10) of cortical reactivity, using two single (sp)- and two paired-pulse (pp) transcranial magnetic stimulation (TMS) paradigms, while they observed goal-directed actions and a static image. They also underwent comprehensive social cognition assessments. Sp-motor resonance revealed a significant quadratic time effect (initial fall and then rise) in patients and healthy subjects [F=12.21, P=0.001]. Such a pattern was not observed for pp-motor resonance. We categorized motor resonance as early (T1-T3), middle (T4-T7) and late (T8-T10) based on pair-wise comparisons. Early, but not middle or late sp-motor resonance was reduced in antipsychotic naïve patients compared to the medicated patients and healthy subjects (F=3.41, P=0.037). Social cognition composite score had significant correlations with both early sp-motor resonance (r=0.34, P=0.01) and early pp-motor resonance (r=0.314, P=0.02) in the combined patient group. Motor resonance time-courses did not vary across groups. The magnitude of early motor resonance was reduced in the antipsychotic-naïve schizophrenia group, compared to healthy subjects. Early phase motor resonance was associated with social cognition deficits in patients.

SA108 - THE IMMUNE 8: IMPAIRED COGNITION IN SCHIZOPHRENIA RELATED TO GENETIC, ENVIRONMENTAL, AND IMMUNE INTERACTIONS IN IRISH AND UK COHORTS

Background The aim of this study is to characterise the effects of already identified genetic risk variants on social cognitive deficits in schizophrenia. Although the aetiology of schizophrenia is largely unknown, it is increasingly clear that genetic and environmental interactions contribute to cognitive deficits associated with this disorder. The ‘Immune Hypothesis’ suggests that schizophrenia is often predicted by early environmentally-driven immune challenges, and genetically driven sub-optimal immune responsiveness. In the largest genetic study of schizophrenia to date, recent Genome-Wide Association Studies (GWAS) have established the strongest association with schizophrenia was found at a region of the genome that is synonymous with immune function- the major histocompatibility complex, or MHC. Social cognitive deficits are core features of Schizophrenia, which relate to genetic risk. The current study analyses the effects of immune challenge (genetic and environmental) on social cognition, examining a set of genes related to immune function and schizophrenia risk, as well as environmental factors that may contribute to cognitive deficit. Methods To test if genetic variants related to immune function impair cognition, genes were selected by cross referencing “Immunology” Gene Ontology lists with the most recent list of genes implicated in GWAS for schizophrenia. 1013 participants were genotyped and cognitively assessed in an Irish population of schizophrenia sufferers and healthy controls, and this cohort was used for primary analysis of a gene-cognition relationship. A separate cohort of already collected data was also examined from the Avon Longitudinal Study of Parents and Children (ALSPAC) for replication of results and mediation analysis, consisting of ~5000 participants. Block regression analysis using SPSS statistical software was performed, testing a relationship between genetic risk levels and cognitive deficits. In a second element to the study, environmental factors were examined as possible mediators of the relationship between genetic risk variants and cognitive impairment (PROCESS mediation, SPSS) in the ALSPAC sample. Results Regression analysis suggests that 7 of genetic variants selected contribute to impairments in cognition across an Irish sample, and these findings were replicated in the ALSPAC sample. Cognitive deficits overlapped for the majority of genes examined, across domains of social cognition, IQ and episodic memory. In examining ALSPAC as a replication sample, many of the same genetic variants also showed negative effects on social cognition, as well as more generalized effects of these genes on various cognitive domains. In mediation analysis, environmental factors such as childhood abuse were also found to impact on this gene-cognition relationship. Discussion The Immune 8 may serve as significant risk markers for schizophrenia, and further elucidate aetiology of this disorder. Future studies on neurobiology of social cognition, and greater knowledge of genetic risk may establish targets for interventions. Childhood abuse was also found to be significantly related to cognitive deficit. The role of environmental stressors contributing to genetic risk and immune function is an interesting avenue for future research in schizophrenia.

Nucleus accumbens activation is linked to salience in social decision making.

Aberrant salience may explain hasty decision making and psychotic symptoms in schizophrenia. In healthy individuals, final decisions in probabilistic reasoning tasks are related to Nucleus accumbens (Nacc) activation. However, research investigating the Nacc in social decision making is missing. Our study aimed at investigating the role of the Nacc for social decision making and its link to (aberrant) salience attribution. 47 healthy individuals completed a novel social jumping-to-conclusion (JTC) fMRI-paradigm, showing morphed faces simultaneously expressing fear and happiness. Participants decided on the 'current' emotion after each picture, and on the 'general' emotion of series of faces. Nacc activation was stronger during final decisions than in previous trials without a decision, particularly in fear rather than happiness series. A JTC-bias was associated with higher Nacc activation for last fearful, but not last happy faces. Apparently, mechanisms underlying probabilistic reasoning are also relevant for social decision making. The pattern of Nacc activation suggests salience, not reward, drives the final decision. Based on these findings, we hypothesize that aberrant salience might also explain social-cognitive deficits in schizophrenia.

Diminished modulation of motor cortical reactivity during context-based action observation in schizophrenia

BackgroundDeficient mirror neuron system (MNS)-activity is associated with social cognition deficits in schizophrenia. However, it is not known how socio-emotional contexts modulate the MNS-response. In a Transcranial Magnetic Stimulation (TMS)-experiment, we aimed to compare putative MNS-responses to action observation stimuli with and without a context, in patients with schizophrenia and healthy subjects. MethodTMS-evoked motor cortical reactivity was measured by single and paired [short interval intracortical inhibition (SICI) and facilitation (ICF)] pulse-paradigms in schizophrenia patients (n = 39) and healthy subjects (n = 28) while they observed three experimental-blocks: a static image, a neutral hand action (NA) and a context-based hand action (CA). The degree of cortical reactivity facilitation with the two action observation blocks, relative to the static block provided indirect measures of premotor MNS-activity. A subset of patients (n = 31) also underwent comprehensive social cognition assessments. ResultsRMANOVA demonstrated significantly higher cortical reactivity during the CA-block in both groups (all TMS-paradigms); albeit significantly less pronounced in patients (SICI and ICF paradigms). MNS-activity during the CA-block was significantly higher compared to that during the NA-block in both groups (all TMS-paradigms), but significantly less pronounced in patients (SICI and single-pulse paradigms). MNS-activity during the CA-block measured by the ICF paradigm was positively correlated with social cognition performance. ConclusionProviding a context to the action modulates MNS-activity. This modulation is diminished in schizophrenia patients, suggestive of a diminished sensorimotor associative learning process. This novel, ecologically valid paradigm to tap into the MNS may serve as a neuro-marker of social cognition performance in schizophrenia.