Kubota Ryotaro, Uchino Takashi, Okubo Ryo, Akiyama Hisashi, Okano Hiroki, Yamada Yuji, Suzuki Takefumi, Nemoto Takahiro, Hashimoto Naoki, Ikezawa Satoru
Department of Forensic Psychiatry, National Center of Neurology and Psychiatry, Tokyo 187-8551, Japan; Department of Neuropsychiatry, University of Yamanashi Faculty of Medicine, Yamanashi 409-3898, Japan.
Department of Neuropsychiatry, Toho University Faculty of Medicine, Tokyo 143-8541, Japan; Department of Psychiatry and Implementation Science, Toho University Faculty of Medicine, Tokyo 143-8541, Japan.
Schizophr Res. 2025 Apr;278:26-34. doi: 10.1016/j.schres.2025.02.006. Epub 2025 Mar 14.
Experts have categorized social cognition in schizophrenia into four domains: theory of mind, emotion processing, social perception, and attributional bias. However, previous factor analyses based on this categorization have yielded inconsistent results, likely because some domains were inadequately represented due to a lack of available measures. To address this issue, we conducted a factor analysis using a set of validated measures encompassing all four domains.
The individual domains of social cognition were assessed in clinically stable outpatients with schizophrenia (n = 136) using the Hinting task, Metaphor and Sarcasm Scenario Test, the Bell Lysaker Emotion Recognition Task, Facial Emotion Selection Test, the Social Attribution Task-Multiple Choice, and the Ambiguous Intentions and Hostility Questionnaire. Exploratory and confirmatory factor analyses were conducted to determine the factor structure. Additionally, correlation analysis (n = 123) was performed to examine the relationships between the identified factors and clinical variables, such as psychiatric symptoms.
Exploratory factor analysis identified a two-factor structure for social cognition: "social cognitive skills", which includes theory of mind, emotion processing, and social perception; and "social cognitive bias", which includes attributional bias. Confirmatory factor analysis showed good fit indices. Correlation analysis revealed that social cognitive skills were associated with positive, negative, and disorganized symptoms, neurocognition, and social functioning, while social cognitive bias was related to excitement, depression, and defeatist beliefs.
The results of this study suggest that social cognition can be divided into two distinct factors and provide guidance for developing treatment strategies aimed at improving social cognition.
专家已将精神分裂症的社会认知分为四个领域：心理理论、情绪加工、社会感知和归因偏差。然而，此前基于这种分类的因素分析结果并不一致，这可能是因为由于缺乏可用的测量方法，一些领域的代表性不足。为解决这一问题，我们使用一组涵盖所有四个领域的经过验证的测量方法进行了因素分析。
使用暗示任务、隐喻和讽刺情景测试、贝尔·莱萨克情绪识别任务、面部情绪选择测试、社会归因任务 - 多项选择以及模糊意图和敌意问卷，对136名临床稳定的精神分裂症门诊患者的社会认知各个领域进行评估。进行探索性和验证性因素分析以确定因素结构。此外，进行了相关性分析（n = 123），以检查所确定的因素与临床变量（如精神症状）之间的关系。
探索性因素分析确定了社会认知的双因素结构：“社会认知技能”，包括心理理论、情绪加工和社会感知；以及“社会认知偏差”，包括归因偏差。验证性因素分析显示出良好的拟合指数。相关性分析表明，社会认知技能与阳性、阴性和紊乱症状、神经认知以及社会功能相关，而社会认知偏差与兴奋、抑郁和失败主义信念有关。
本研究结果表明，社会认知可分为两个不同的因素，并为制定旨在改善社会认知的治疗策略提供指导。
