Social cognition mediates illness-related and cognitive influences on social function in patients with schizophrenia-spectrum disorders

Social cognition mediates illness-related and cognitive influences on social function in patients with schizophrenia-spectrum disorders


J Psychiatry Neurosci 2010;35(1):49-54

Jean Addington, PhD; Todd A. Girard, PhD; Bruce K. Christensen, PhD; Donald Addington, MD

J. Addington, Christensen — Department of Psychiatry, University of Toronto; J. Addington, Girard, Christensen — Centre forAddiction and Mental Health, Toronto; J. Addington, D. Addington — Department of Psychiatry, University of Calgary, Calgary, Alta.; Girard — Department of Psychology, Ryerson University, Toronto, Ont.; Christensen — Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton, Ont.


Background: Although cognition has been studied extensively among patients with schizophrenia, social cognition has only recently emerged as an area of interest. The objective of the current study was to use structural equation modelling to test the hypothesis that the relation between cognitive performance and social function is mediated by patients’ social cognitive abilities.

Methods: We assessed participants who met criteria for a schizophrenia-spectrum disorder, with equal distribution among first- and multi-episode participants, and nonpsychiatric controls on a range of measures within each of the domains of cognition, social cognition and social function.

Results: Using structural equation modelling, we derived a model that explained 79.7% of the variance in social function and demonstrated that the link between cognition and social function was fully mediated by social cognition.

Limitations: A limitation of this study is that the measures contributing to the structural equation modelling analysis were obtained at the same point in time. Thus, the temporal order of causation suggested by Model 2 remains theoretically specified.

Conclusion: This study provides some first steps in understanding the complex relation between cognition and social function. Such a relation has potential implications for the design of remediation strategies.

Competing interests: None declared for Drs. Girard and Christensen. Dr. J. Addington has received investigator-initiated funding support from not-for-profit entities, including the National Institute of Mental Health and the Schizophrenia Society of Ontario. She has also received consultant fees from AstraZeneca and speaker fees from AstraZeneca and Pfizer. Dr. D. Addington has served as a consultant to Pfizer and Eli Lilly.

Contributors: Drs. J. and D. Addington designed the study and acquired the data, which Drs. J. Addington, Girard and Christensen analyzed. Drs. J. Addington and Girard wrote the article. All authors reviewed the article and approved the final version for publication.

This study was conducted at the University of Calgary, Alberta, Canada, and was supported by a grant to Jean Addington from The Canadian Institutes of Health Research. J Psychiatry Neurosci 2010;35(1):49-54.

Submitted Feb. 28, 2008; Revised May 29, Aug. 5, 2009; Accepted Aug. 6, 2009.

Correspondence to: Dr. J. Addington, Centre for Addiction and Mental Health, 250 College St., Toronto ON M5T 1R8; jean_addington