School of Behavioral and Brain Sciences, The University of Texas At Dallas, Richardson, TX, USA.
Department of Psychiatry, University of Texas Southwestern Medical School, Dallas, TX, USA.
Psychol Med. 2020 Nov;50(15):2557-2565. doi: 10.1017/S0033291719002708. Epub 2019 Oct 2.
Autism spectrum disorder (ASD) and schizophrenia (SCZ) are separate neurodevelopmental disorders that are both characterized by difficulties in social cognition and social functioning. Due to methodological confounds, the degree of similarity in social cognitive impairments across these two disorders is currently unknown. This study therefore conducted a comprehensive comparison of social cognitive ability in ASD and SCZ to aid efforts to develop optimized treatment programs.
In total, 101 individuals with ASD, 92 individuals with SCZ or schizoaffective disorder, and 101 typically developing (TD) controls, all with measured intelligence in the normal range and a mean age of 25.47 years, completed a large battery of psychometrically validated social cognitive assessments spanning the domains of emotion recognition, social perception, mental state attribution, and attributional style.
Both ASD and SCZ performed worse than TD controls, and very few differences were evident between the two clinical groups, with effect sizes (Cohen's d) ranging from 0.01 to 0.34. For those effects that did reach statistical significance, such as greater hostility in the SCZ group, controlling for symptom severity rendered them non-significant, suggesting that clinical distinctions may underlie these social cognitive differences. Additionally, the strength of the relationship between neurocognitive and social cognitive performance was of similar, moderate size for ASD and SCZ.
Findings largely suggest comparable levels of social cognitive impairment in ASD and SCZ, which may support the use of existing social cognitive interventions across disorders. However, future work is needed to determine whether the mechanisms underlying these shared impairments are also similar or if these common behavioral profiles may emerge via different pathways.
自闭症谱系障碍（ASD）和精神分裂症（SCZ）是两种独立的神经发育障碍，其特征均为社会认知和社会功能障碍。由于方法学上的混淆，目前尚不清楚这两种疾病的社会认知障碍程度有多大的相似性。因此，本研究对 ASD 和 SCZ 的社会认知能力进行了全面比较，以帮助努力开发优化的治疗方案。
共有 101 名 ASD 患者、92 名 SCZ 或分裂情感障碍患者和 101 名典型发育（TD）对照者完成了一套心理测量学验证的社会认知评估大电池，涵盖情绪识别、社会知觉、心理状态归因和归因风格等领域。所有患者均具有正常范围内的智力和平均 25.47 岁的年龄。
ASD 和 SCZ 患者的表现均差于 TD 对照组，且两个临床组之间很少有明显差异，效应量（Cohen's d）范围为 0.01 至 0.34。对于那些达到统计学意义的影响，如 SCZ 组的敌意更大，控制症状严重程度后，这些影响就不再显著，表明临床差异可能是这些社会认知差异的基础。此外，ASD 和 SCZ 的神经认知和社会认知表现之间的关系强度相似，均为中等大小。
研究结果表明，ASD 和 SCZ 患者的社会认知障碍程度大致相当，这可能支持在两种疾病中使用现有的社会认知干预措施。然而，需要进一步的工作来确定这些共同的损害机制是否也相似，或者这些共同的行为特征是否可能通过不同的途径出现。
