Mehta Urvakhsh Meherwan, Thirthalli Jagadisha, Bhagyavathi H D, Keshav Kumar J, Subbakrishna D K, Gangadhar Bangalore N, Eack Shaun M, Keshavan Matcheri S
Department of Psychiatry, National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore 560029, India.
Clinical Psychology, National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore 560029, India.
Schizophr Res. 2014 Aug;157(1-3):70-7. doi: 10.1016/j.schres.2014.05.018. Epub 2014 Jun 6.
Schizophrenia patients experience substantial impairments in social cognition (SC) and these deficits are associated with their poor functional outcome. Though SC is consistently shown to emerge as a cognitive dimension distinct from neurocognition, the dimensionality of SC is poorly understood. Moreover, comparing the components of SC between schizophrenia patients and healthy comparison subjects would provide specific insights on the construct validity of SC. We conducted principal component analyses of eight SC test scores (representing four domains of SC, namely, theory of mind, emotion processing, social perception and attributional bias) independently in 170 remitted schizophrenia patients and 111 matched healthy comparison subjects. We also conducted regression analyses to evaluate the relative contribution of individual SC components to other symptom dimensions, which are important clinical determinants of functional outcome (i.e., neurocognition, negative symptoms, motivational deficits and insight) in schizophrenia. A three-factor solution representing socio-emotional processing, social-inferential ability and external attribution components emerged in the patient group that accounted for 64.43% of the variance. In contrast, a two-factor solution representing socio-emotional processing and social-inferential ability was derived in the healthy comparison group that explained 56.5% of the variance. In the patient group, the social-inferential component predicted negative symptoms and motivational deficits. Our results suggest the presence of a multidimensional SC construct. The dimensionality of SC observed across the two groups, though not identical, displayed important parallels. Individual components also demonstrated distinct patterns of association with other symptom dimensions, thus supporting their external validity.
精神分裂症患者在社会认知（SC）方面存在严重损害，这些缺陷与他们较差的功能结局相关。尽管一直表明SC作为一个与神经认知不同的认知维度出现，但对SC的维度了解甚少。此外，比较精神分裂症患者和健康对照受试者之间的SC成分，将为SC的结构效度提供具体见解。我们对170名缓解期精神分裂症患者和111名匹配的健康对照受试者分别进行了八项SC测试分数（代表SC的四个领域，即心理理论、情绪加工、社会感知和归因偏差）的主成分分析。我们还进行了回归分析，以评估个体SC成分对其他症状维度的相对贡献，这些维度是精神分裂症功能结局的重要临床决定因素（即神经认知、阴性症状、动机缺陷和洞察力）。在患者组中出现了一个代表社会情感加工、社会推理能力和外部归因成分的三因素解决方案，该方案解释了64.43%的方差。相比之下，在健康对照组中得出了一个代表社会情感加工和社会推理能力的两因素解决方案，该方案解释了56.5%的方差。在患者组中，社会推理成分预测了阴性症状和动机缺陷。我们的结果表明存在多维SC结构。两组中观察到的SC维度虽然不完全相同，但显示出重要的相似之处。各个成分也表现出与其他症状维度不同的关联模式，从而支持了它们的外部效度。
