Autism, early psychosis, and social anxiety disorder: understanding the role of social cognition and its relationship to disability in young adults with disorders characterized by social impairments

Abstract

Impairments in social cognition are believed contribute to disability, particularly for disorders characterized by difficulties in social interaction. There has been little transdiagnostic investigation of this across social cognition domains in young adults. A total of 199 young adults diagnosed with autism spectrum disorder (ASD; N = 53), early psychosis (EP; N = 51), and social anxiety disorder (SAD; N = 64) were compared against neurotypical controls (NT; N = 31) on a battery of lower and higher-order and self-report social cognition measures. For both ASD and EP, participants showed impaired performance on all lower-order emotion recognition tasks and one higher-order social cognition test. Self-reports of empathy were reduced in all clinical groups and particularly in ASD. For SAD, despite showing no objective social cognition impairment, self-reported empathy was reduced to the same level as EP. Discriminant analysis revealed that self-reported empathy and lower-order emotion recognition tests provide best capacity to differentiate groups. Regressions predicting disability revealed depression as the strongest predictor across all disability measures. Empathy provided additional predictive value for social disability and social interaction anxiety. Overall, results support a similar social-cognitive development profile across ASD and EP. While self-reported empathy differentiated between groups, discrepancy between objective social cognition test performance and self-reported empathy in the SAD group suggests probable threat-related self-monitoring report biases that likely further influence all group outcomes. As depression and empathy were the most important predictors of disability, regardless of diagnostic group, research is required to explore targeted interventions for difficulties in these domains to reduce disability.

Autistic traits in psychotic disorders: prevalence, familial risk, and impact on social functioning

“…Likewise, the correlation between social cognition and social functioning was surprisingly small. We used a classic mentalizing (false belief) paradigm, which is typically performed less accurately by individuals with PD (Langdon et al, 2006), though not always (Pepper et al, 2018). Group differences in mentalizing were obscured by relatively strong effects of IQ and age in our study.…”

Modified CBT for Social Anxiety and Social Functioning in Young Adults with Autism Spectrum Disorder

“…Measures of social anxiety and social functioning were included as primary outcome measures, and measures of mood were included as secondary outcome measures. These measures were selected on the basis of their reliability in tracking outcomes relevant to the aims of the study, and from their previous use in assessing symptoms and treatment responsiveness in adults with ASD [7,17,41].…”

A Review of Default Mode Network Connectivity and Its Association With Social Cognition in Adolescents With Autism Spectrum Disorder and Early-Onset Psychosis

“…While early detection and clinical diagnosis of both disorders has improved over the past decade, frequent challenges still arise in differential diagnosis (e.g., in the event of later diagnosis of ASD) especially if predominant symptoms for both involve social difficulties and unusual social thinking (2,6). Recent behavioral studies of adults with ASD and schizophrenia highlighted not only the similarities but also some divergent patterns of social impairments in the two disorders-with ASD characterized by lower social motivation, poorer social reciprocity, and undermentalizing, and schizophrenia characterized by greater reciprocity but poor expressiveness (7,8). Moreover, these social impairments are associated with difficulties in the work setting (9,10), social relationships (11,12), and overall reduced quality of life (13,14) across both groups.…”