Deficits in a wide array of functional outcome areas (eg, social functioning, social skills, independent living skills, etc) are marked in schizophrenia. Consequently, much recent research has attempted to identify factors that may contribute to functional outcome; social cognition is one such domain. The purpose of this article is to review research examining the relationship between social cognition and functional outcome. Comprehensive searches of PsycINFO and MEDLINE/PUBMED were conducted to identify relevant published manuscripts to include in the current review. It is concluded that the relationship between social cognition and functional outcome depends on the specific domains of each construct examined; however, it can generally be concluded that there are clear and consistent relationships between aspects of functional outcome and social cognition. These findings are discussed in light of treatment implications for schizophrenia.

https://cdr.lib.unc.edu/downloads/kk91fn727

The Functional Significance of Social Cognition in Schizophrenia: A Review

Emotion recognition via facial expression and affective prosody in schizophrenia: A methodological review

Stress-reactivity in psychosis: evidence for an affective pathway to psychosis

Background The vulnerability-stress model of psychotic disorders describes, in essence, an interaction between personal vulnerability and environmental stressors The present study investigated this interaction and studied emotional reactivity to daily life stress as a vulnerability marker for psychotic illness Methods Patients with psychotic illness (n = 42), their first-degree relatives (n = 47), and control subjects (n = 49) were studied with the Experience Sampling Method (a structured diary technique assessing thoughts, current context, and mood in daily life) to assess (1) appraised subjective stress of daily events and smaller disturbances in daily life and (2) emotional reactivity conceptualized as changes in both negative affect and positive affect Results Multilevel regression analyses showed that an increase in subjective stress was associated with an increase in negative affect and a decrease in positive affect in all groups However, the groups differed quantitatively in their pattern of reactions to stress Patients with psychotic illness reacted with more intense emotions to subjective appraisals of stress in daily life than control subjects The decrease in positive affect in the relatives was similar to that of the patients, while the increase in negative affect in this group was intermediary to that of patients and control subjects Conclusions Higher levels of familial risk for psychosis were associated with higher levels of emotional reactivity to daily life stress in a dose-response fashion Subtle alterations in the way persons interact with their environment may constitute part of the vulnerability for psychotic illness

https://jamanetwork.com/journals/jamapsychiatry/articlepdf/481870/yoa20443.pdf

Emotional reactivity to daily life stress in psychosis.

Synopsis of Psychiatry

Integrated Psychological Therapy (IPT) is a structured intervention program that prescribes steps to remediate cognitive and behavioral dysfunctions that are characteristic of the psychopathology of schizophrenia. Evaluative studies of IPT indicated that the program improved schizophrenic patients' elementary cognitive processes such as attention, abstraction, and concept formation but that patients' performance was still below the normal range. The clinical utility of IPT will depend on studies that document the hierarchical generalization of improvements from the cognitive to the social and symptomatic levels of functioning.

/pdf/treatment-of-cognitive-dysfunctions-and-behavioral-deficits-1zfjcv3e5a.pdf

Treatment of Cognitive Dysfunctions and Behavioral Deficits in Schizophrenia

Cognitive disorders have long assumed a central position in describing the pathognomonic characteristics of schizophrenia. Kraepelin's (1902) and Bleuler's (1911) uniquely innovative descriptions of attentional dysfunctions and associational loosening in thought processes laid the groundwork for the concept of basic disorder devised by authors who embraced a phenomenological approach to psychopathology in German-speaking countries (Huber, 1983; Janzarik, 1983), and for experimental research endeavours in English-speaking countries to identify a ‘core psychological deficit’ in schizophrenia (Lang & Buss, 1965). Recent research has identified specific information-processing deficits in affected individuals. These include (a) problems with elementary functions such as selective attention towards relevant stimuli and sustained attention over prolonged periods of time (Oltmanns & Neale, 1975; Nuechterlein, 1977); (b) problems with more complex functions such as encoding and recognition of familiar cues, storing information for future retrieval, or drawing deductive or analogous conclusions from available information (Broga & Neufeld, 1981; Brenner, 1983; Nuechterlein & Dawson, 1984b); and (c) problems with executive functions and response selection (Broen & Storms, 1967; Weinberger et al, 1986, 1988).

Biological and cognitive vulnerability factors in schizophrenia: implications for treatment.

Kognitive Therapie bei Schizophrenen: Problemanalyse und empirische Ergebnisse

Background Emotional management therapy (EMT) aims to improve handling of emotional stress in schizophrenia. It consists of two sub-programmes: the first includes relaxation techniques, the second stress coping skills. Method A pilot study of EMT in 19 patients with early psychosis produced positive results and a post-hoc study of 16 patients was commenced. Results EMT showed positive results, with chronic patients improving more than patients with early psychosis. Conclusion EMT can be effective in early psychosis, especially for cognitive functioning.

Emotional management therapy in early psychosis.

Schizophrenia may nowadays be most readily understood as a systemic disorder in which changes in the brain structure underlie individual cognitive abnormalities which for their part interact with environmental factors at the onset of the illness and during its course. From this, one may deduce the rationale for cognitive therapy for schizophrenic patients. Existing approaches may be systemised as direct, indirect and combined procedures. The latter are based on the assumption of the pervasive effects of elementary and complex cognitive dysfunctions at the levels of open behaviour. However, in a mirror-design study with 21 schizophrenic patients according to DSM-III-R in which the effects of various intervention sequences were examined, it was not possible to find confirmation for this. This and other open questions have led to doubts expressed in current literature concerning the utility of cognitive therapy, especially with respect to the locus, nature and malleability of cognitive disorders, as well as the possibility of generalizing cognitive improvements. The latter are discussed in detail and possible future directions in cognitive therapy for schizophrenic patients are shown.

Bettina Hodel

Papers

Treatment of Cognitive Dysfunctions and Behavioral Deficits in Schizophrenia

Biological and cognitive vulnerability factors in schizophrenia: implications for treatment.

Kognitive Therapie bei Schizophrenen: Problemanalyse und empirische Ergebnisse

Emotional management therapy in early psychosis.

Cognitive therapy with schizophrenic patients: conceptual basis, present state, future directions.