情绪体验降低程度较高和较低的患者社会功能的预测因素：社会认知、社会能力和症状严重程度。
Predictors of social functioning in patients with higher and lower levels of reduced emotional experience: Social cognition, social competence, and symptom severity.
机构信息
Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, United States of America; Research Service, Miami VA Healthcare System, United States of America.
Department of Psychiatry and Behavioral Sciences, University of Miami Miller School of Medicine, Miami, FL, United States of America.
出版信息
Schizophr Res. 2019 Apr;206:271-276. doi: 10.1016/j.schres.2018.11.005. Epub 2018 Nov 13.
BACKGROUND
Deficits in social functioning in schizophrenia are primarily predicted by negative symptoms, social cognition deficits, and social skills deficits. Here we examine those predictive variables across variations in the severity of reduced emotional experience. We hypothesized that in patients with high symptom severity, factors such as social cognition would have reduced importance for predicting social outcomes.
METHODS
Participants with schizophrenia (n = 312) were tested using five different measures of social cognition. Performance-based assessments and clinical ratings of reduced emotion experience were used to assess social competence. High contact informants rated interpersonal functioning and social acceptability of behavior, while unaware of other patient data. Patients were divided into higher and lower reduced emotional experience using previously validated criteria.
RESULTS
33% of the patients had at least moderate symptoms of reduced emotional experience. Patients with greater severity had more social functioning impairment, but not poorer social competence and social cognition. In the patients with lower severity, social cognition accounted for 9% of the variance in interpersonal functioning, while in patients with higher severity, social cognition did not predict any variance. In the patients with lower severity, social cognition accounted for 4% of the variance in social acceptability of behavior, while in patients with higher severity, social cognition also did not predict any variance.
IMPLICATIONS
The influence of social cognition on social outcomes appears greater in patients with less severe symptoms of reduced emotional experience. As there are treatments for both these symptoms and social cognition with demonstrated efficacy, these data suggest differential application of these interventions based on symptom severity.
背景
精神分裂症患者的社交功能障碍主要由阴性症状、社会认知缺陷和社交技能缺陷预测。在这里，我们研究了在降低情绪体验严重程度的变化中这些预测变量。我们假设，在症状严重程度较高的患者中，社会认知等因素对预测社交结果的重要性降低。
方法
使用五种不同的社会认知测量方法对精神分裂症患者（n=312）进行测试。使用基于表现的评估和临床对降低情绪体验的评估来评估社交能力。高接触知情人对人际交往和行为的社会可接受性进行评分，而不了解其他患者数据。使用先前验证的标准将患者分为情绪体验降低程度较高和较低的两组。
结果
33%的患者至少有中度的情绪体验降低症状。严重程度较高的患者社交功能障碍更严重，但社交能力和社会认知较差。在严重程度较低的患者中，社会认知对人际交往功能的变化解释了 9%的方差，而在严重程度较高的患者中，社会认知则无法预测任何方差。在严重程度较低的患者中，社会认知对行为的社会可接受性的变化解释了 4%的方差，而在严重程度较高的患者中，社会认知也无法预测任何方差。
结论
在情绪体验降低症状较轻的患者中，社会认知对社交结果的影响更大。由于这些症状和社会认知都有经过验证的治疗方法，这些数据表明，根据症状严重程度，这些干预措施的应用存在差异。
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