Douglas Mental Health University Institute, Montreal, Canada; Department of Psychiatry, McGill University, Montreal, Canada; Cognition, Health, and Society Laboratory (EA 6291), University of Reims Champagne-Ardenne, Reims, France; Academic Department of Psychiatry, University Hospital of Reims, EPSM Marne, Reims, France.
Douglas Mental Health University Institute, Montreal, Canada; Department of Psychiatry, McGill University, Montreal, Canada; Department of Education and Pedagogy, Université du Québec À Montréal, Canada.
J Psychiatr Res. 2021 Nov;143:429-435. doi: 10.1016/j.jpsychires.2021.10.007. Epub 2021 Oct 11.
From the onset of schizophrenia, verbal memory (VM) deficits and negative symptoms are strongly associated, and both additively predict functional outcomes. Emotion recognition (ER) and theory of mind (ToM; the ability to infer others' mental states), two components of social cognition, are also particularly affected in schizophrenia. Explanatory models of negative symptoms have integrated these cognitive impairments as potential precursors and previous studies revealed relationships between ER and/or ToM and VM, as well as with negative symptoms, but the organization of these associations remains unclear. We aimed to determine whether impairments in VM and social cognition sequentially pave the way for negative symptoms in schizophrenia. To this end, we used mediation analyses. One hundred and forty participants with a diagnosis of schizophrenia or schizoaffective disorder were recruited. First, correlational analyses were conducted between our variables of interest. The mediating effect of social cognition between VM and negative symptoms was then examined using the PROCESS macro. Variables of interest were significantly correlated (r = |0.166| to |0.391|), except for ER and negative symptoms. Only the serial multiple mediation model with 2 mediators (ER followed by ToM) revealed a significant indirect effect of VM on negative symptoms (β = - 0.160, 95% CI = -.370 to -.004). This relationship was selective for expressive negative symptoms (e.g., blunted affect and alogia). This study illustrates the richness of the relationship between cognitive deficits and negative symptoms and provides additional information for the involvement of social cognition in negative symptoms' etiology.
从精神分裂症发病开始，言语记忆（VM）缺陷和阴性症状就强烈相关，两者都可累加预测功能结局。情绪识别（ER）和心理理论（ToM；推断他人心理状态的能力），是社会认知的两个组成部分，在精神分裂症中也受到特别影响。阴性症状的解释模型已经将这些认知缺陷整合为潜在的前兆，以前的研究揭示了 ER 和/或 ToM 与 VM 以及与阴性症状之间的关系，但这些关联的组织形式仍不清楚。我们旨在确定 VM 和社会认知障碍是否会依次为精神分裂症的阴性症状铺平道路。为此，我们使用了中介分析。我们招募了 140 名患有精神分裂症或分裂情感障碍的患者。首先，我们对感兴趣的变量进行了相关分析。然后，使用 PROCESS 宏检验了社会认知在 VM 和阴性症状之间的中介效应。除 ER 和阴性症状外，我们感兴趣的变量之间存在显著相关性（r=|0.166|至|0.391|）。只有 ER 紧随 ToM 之后的 2 个中介的串联多重中介模型显示 VM 对阴性症状的间接效应具有统计学意义（β=-0.160，95%置信区间=-0.370 至-0.004）。这种关系对表达性阴性症状（如情感迟钝和言语贫乏）具有选择性。这项研究说明了认知缺陷与阴性症状之间关系的丰富性，并为社会认知在阴性症状发病机制中的作用提供了更多信息。
