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Social cognition

What is social cognition? 

Social cognition describes the ability to understand the actions and intentions of other people. Aspects of social cognition may be altered in people with schizophrenia, including processes such as Theory of Mind, social perception, and emotion processing. Theory of Mind refers to the ability to infer the mental states of other people. Social perception is an awareness of social cues and norms that dictate social interactions. Emotion processing is the ability to perceive emotional cues. Social cognition is crucial for effective communication, and may relate to social competence and predict work functioning.

What is the evidence for social cognition?

Moderate quality evidence suggests a large effect of impaired social perception, emotion perception and emotion processing, and a medium-sized effect of impaired social knowledge in people with schizophrenia. In general, those with predominately negative symptoms may show poorer social cognition than those with predominately positive symptoms. Facial emotion perception may be adversely affected by more severe negative symptoms, and non-emotional recognition may be adversely affected by more severe positive symptoms. High quality evidence shows a large Theory of Mind impairment in people with schizophrenia across multiple tasks, regardless of sex or age. Moderate quality evidence suggests patients in an acute phase of the illness perform worse than outpatients or patients soon to be discharged from hospital. Lower general IQ contributed to lower Theory of Mind performance only in outpatients or patients soon to be discharged from hospital. Patients with disorganised symptoms are particularly impaired on Theory of Mind tasks. High quality evidence shows a very small improvement in facial affect processing with antipsychotic medication, particularly second generation antipsychotics.

High quality evidence suggests a small to medium-sized Theory of Mind impairment in relatives of people with schizophrenia, with lower education levels contributing to lower Theory of Mind scores. Moderate to high quality evidence also suggests a medium-sized Theory of Mind impairment in people at ultra-high risk of psychosis.

Good social and community functioning is associated with better Theory of Mind, emotion processing, information processing, verbal learning, working memory, attention and reasoning ability. Moderate quality evidence suggests associations between poor performance on facial recognition, emotion processing, emotion perception, social perception and Theory of Mind tasks and poor performance on cognitive measures, and more severe symptoms.


April 2016

Page last updated: 4:54  6 September 2017

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