Loneliness is associated with mentalizing and emotion recognition abilities in schizophrenia, but only in a cluster of patients with social cognitive deficits

Abstract

Objective: Loneliness is a concern for patients with schizophrenia. However, the correlates of loneliness in patients with schizophrenia are unclear; thus, the aim of the study is to investigate neuro- and social cognitive mechanisms associated with loneliness in individuals with schizophrenia. Method: Data from clinical, neurocognitive, and social cognitive assessments were pooled from two cross-national samples (Poland/USA) to examine potential predictors of loneliness in 147 patients with schizophrenia and 103 healthy controls overall. Furthermore, the relationship between social cognition and loneliness was explored in clusters of patients with schizophrenia differing in social cognitive capacity. Results: Patients reported higher levels of loneliness than healthy controls. Loneliness was linked to increased negative and affective symptoms in patients. A negative association between loneliness and mentalizing and emotion recognition abilities was found in the patients with social-cognitive impairments, but not in those who performed at normative levels. Conclusions: We have elucidated a novel mechanism which may explain previous inconsistent findings regarding the correlates of loneliness in individuals with schizophrenia.

Validation of the english version of the Multidimensional Mentalizing Questionnaire (MMQ)

“…Individuals experiencing higher scores on loneliness were more likely to have poor mentalizing compared to people feeling satisfied with their social relationships. Previous studies have found negative correlation between loneliness and mentalizing only in patients suffering from schizophrenia [ 47 ]. The present study, conducted on non-clinical population, suggests that this relationship exists also among individuals from the general population.…”

Threatened by others or by everything? The effects of momentary and trait loneliness on daily appraisals of social company and being alone in young adults

“…predominant 'focus on social cues indicating social isolation') on various levels of social information processing. Indeed, loneliness has been associated with more pronounced social cognitive bias (Okruszek et al, 2021(Okruszek et al, , 2023Qualter et al, 2013), attentional threat bias (Wei et al, 2020), and distrust (Lieberz et al, 2021) in reaction to social stimuli. Thus, investigating the effects of loneliness on negative appraisals of one's social company might be crucial for understanding its potential pathways towards psychopathology.…”

“…Notably, many studies examining the sensitivity to social threat in lonely individuals (LI) were conducted in laboratory settings and with the use of questionnaire measures (Lieberz et al, 2021;Okruszek et al, 2021Okruszek et al, , 2023Qualter et al, 2013;Wei et al, 2020). At the same time, it has been increasingly recognised that research in the field of mental health requires investigation of experience in naturalistic settings (Myin-Germeys et al, 2018), especially in social contexts (Redcay & Schilbach, 2019).…”

“…As previous studies have presented evidence consistent with this assumption (e.g. Okruszek et al, 2023;Qualter et al, 2013), we decided to treat trait loneliness as a dichotomous rather than a continuous variable. Second, we wanted to explore the extent to which the hypothesised effect was specific to the social context and the extent to which it could be attributed to a more general increased negativity of situational appraisals.…”