We observed group differences in social cognition, such that the FHR group reported lower levels of personal distress than all other groups, while the HC group.
Characterizing Differences in Social Cognitive Deficits in Individuals at Clinical-High Risk for Psychosis, Familial Risk for Psychosis, and with Psychotic Disorders: A cross-group comparisons Elyssa M. Barrick1, Sarah Hope Lincoln1, Laura M. Tully2, David Dodell-Feder1, Christine I. Hooker3 1. McLean Hospital/Harvard Medical School 2. Department of Psychiatry and Behavioral Sciences, UC Davis 3. Rush University Medical Center
INTRODUCTION
SOCIAL ADJUSTMENT SCALE
• Although positive symptoms are often thought of as the main factor driving functional impairment in individuals with psychotic disorders, negative symptoms and cognitive impairments contribute substantially to deficits in overall functioning, and are pervasive throughout the duration of the illness1.
INTERPERSONAL REACTIVITY INDEX IRI9: A self-report measure of social cognitive ability; assesses four aspects of social cognition. Higher scores indicate better ability to display the tendency.
SAS8: A self-report measure of social functioning in the past two weeks. Higher scores indicate more impairment.
Personal Distress F (3,104) = 8.372, p < 0.001
35
Group Difference
CHR > FHR
0.0057
CHR > HC
0.0055
• Despite the presence of these deficits in both high-risk and clinical populations, there have been relatively few studies examining the impairment across the psychosis spectrum.
CHR : SZ
0.9931
FHR : HC
0.9682
• We predicted that:
SZ > FHR
0.0018
SZ > HC
0.0014
• In addition, studies have identified these deficits as potential riskfactors for development of psychotic disorders in high-risk populations 3.
• Schizophrenia (SZ), clinical high-risk (CHR), and familial high-risk (FHR) groups would have poorer social functioning than the control group
25 20 15 10 5
Group
SAS X IRI HC
N
Age
IQ
HC
38(22 M)
30 ± 12
112
FHR
19(5 M)
27 ± 4
117
CHR
27(18 M)
22 ± 4
107
***
***
SZ
26(16 M)
39 ± 10
108
***
***
FHR
***
***
*
CLINICAL MEASURES
CHR
***
***
**
***
***
* ***
***
**
*
lifetime psychiatric disorders in individuals 18 years and older. Social Impairment as a function of Fantasy
Kiddie Schedule for Affective Disorders and Schizophrenia5 (KSADS): Assesses current and lifetime psychiatric disorders for individuals
Social Impairment as a function of Personal Distress
* < 0.05 ** < 0.01 *** < 0.001
Social Impairment as a function of Empathic Concern
Positive and Negative Syndrome Scale7 (PANSSS): Assesses the presence and overall severity of psychiatric symptoms in individuals with psychotic disorders . Group
SIPS Positive
Negative
HC
1 ± 2.5
FHR
PANSS Disorganized
Positive
Negative
0.9 ± 1.9
0.5 ± 0.8
5 ± 0.2
7.3 ± 1
0.6 ± 0.5
0.3 ±0.3
0.5 ± 0.4
--
--
CHR
12.2 ± 4.5
7 ± 5.3
2.6 ± 1.6
12 ± 3.6
9.4 ± 3.4
SZ
--
--
--
16.3 ± 5.4
13.8 ± 5.7
Social Impairment
Assesses the presence of prodromal psychotic symptoms.
0.042
HC > FHR
0.04
SZ > FHR
0.0013
Fantasy F (3,104) = 4.094, p < 0.01
Contrast
p value
CHR > FHR
0.017
SZ > FHR
0.012
Contrast
p value
HC > FHR
0.09
Perspective Taking: all ps > 0.05
• We observed group differences in social cognition, such that the FHR group reported lower levels of personal distress than all other groups, while the HC group reported lower scores than the CHR group but not the schizophrenia group. The FHR group also reported lower levels of imaginative engagement (fantasy) than the CHR and SZ groups, and had a trend towards lower empathic concern than the HC group. • Contrary to our hypothesis, we do not see significant correlations between social cognition (IRI) and social functioning (SAS). This could potentially be due to small sample sizes across groups. • In visualizing individual variability in social functioning and self-reported social cognition, while not a significant relationship between the two, we see that FHR and HC groups tend to show a similar pattern of higher social functioning related to higher social cognition. We do not see a consistent pattern within the CHR and SZ groups.
younger than 18.
The Structured Interview for Prodromal Syndromes6 (SIPS):
CHR > HC
• Our results revealed that overall, the SZ and CHR groups showed greater social impairment than the FHR and HC groups.
SZ
Social Impairment x Fantasy: HC and FHR, ps < 0.05 No social impairment scores correlated with IRI subscales within CHR or SZ
Structured Interview for the DSM-IV4 (SCID): Assesses current and
< 0.0001
DISCUSSION
***
*
CHR > FHR
Empathic Concern
• Social cognition would predict social functioning across all groups
Group
p value
F (3,104) = 2.306, p = 0.08
0
PARTICIPANTS
Perspective Taking
p value
Empathic Concern
Contrast
Personal Distress
30
F (3,93) = 8.675, p < 0.001
Fantasy
• Among these impairments, social cognitive deficits have been identified as correlating strongly with long-term outcomes for patients with schizophrenia2.
Contrast
• Overall, our findings suggest similar levels of impairment in CHR and SZ groups in social functioning and social cognition, relative to both the FHR and HC groups.
References and Funding Measures the tendency to imaginatively transpose oneself into fictional situations. R2 = 0.1811, p < 0.001
Assesses the tendency to experience distress and discomfort in response to extreme distress in others. R2 = 0.1992, p < 0.001
Assess the tendency to experience feelings of sympathy and compassion for others. R2 = 0.1811, p < 0.001
1. Rabinowitz, J., et al. (2012). Schizo. Research, 137, 147-150. 2. Couture, S.M., et al. (2006). Schizo. Bull., 32, S44-S63. 3. Cornblatt, B.A., et al. (2011). Schizo. Bull., 38(6), 1247-1257. 4. First, M.B., et al. (2007). NY: Biometrics Research, NY State Psych. Institute. 5. Kaufman, J.,et al. (1997). Jour. American Academy of Child & Adolesc. Psych., 36, 980-988. 6. McGlashan, T.H. (2001). Yale Univ., New Haven. 7. Kay, S.R., et al. (1987). Schizo. Bull., 13(2), 261-276. 8. Weissman, M.M., et al. (1978). Jour. Nervous & Mental Diseases, 166, 317-326. 9. Davis, M.H. (1983). Jour. Personality & Soc. Psych., 44, 113-126.This work was supported by funding from Sackler Programme in Psychobiology.
