Social functioning in early psychosis: are all the domains predicted by the same variables?

Abstract

Results suggest that negative symptoms are predictive of all three areas of functioning but that specific variables add significant unique variance to individual areas of social functioning. Although a global social functioning score can be considered useful, greater precision can be gained by the use of domain-specific measures.

Psychotic symptoms, cognition and affect as predictors of psychosocial problems and functional change in first-episode psychosis

“…This is especially true for positive symptoms. In concordance with the literature, the present analyses show that negative symptoms are more consistently related to both current (Chang et al, 2011;Bourdeau et al, 2012;Evensen et al, 2012a,b) and future levels (Albert et al, 2011;Álvarez-Jiménez et al, 2012;Vesterager et al, 2012;González-Ortega et al, 2013) of psychosocial functioning than positive symptoms (Albert et al, 2011;Faber et al, 2011;Ventura et al, 2011;Chang et al, 2012). Also, severity levels of both positive and negative symptoms do not appear to be strong predictors of psychosocial functioning after 12 months (Albert et al, 2011;Faber et al, 2011;Chang et al, 2012).…”

Measuring psychosocial outcome is good

“…Terms such as social functioning are used interchangeably with terms such as social adjustment, adaptation, dysfunction, competence and quality of life, and scales of measurement are also used interchangeably [58]. Combining all indices of functioning under the umbrella term 'psychosocial outcome' may also be problematic, as predictors may be differentially associated with specific functional domains [20,34]. Moreover, quantifying good psychosocial outcome is difficult given the value judgments involved because it differs by culture and individual [57].…”

Social cognition and the course of social functioning in first‐episode psychosis

“…More recently, there has been increasing interest in the study of social cognition and social functioning in first‐episode psychosis (FEP) (Addington, Saeedi, & Addington, ; Thompson et al, ). Available research suggests that deficits in both of these variables are present early in the course of psychotic disorders (Achim, Ouellet, Roy, & Jackson, ; Bourdeau, Masse, & Lecomte, ; Lecomte et al, ; Thompson et al, ) and may also be present in first‐degree relatives of individuals with psychotic disorders (Glatt, Stone, Faraone, Seidman, & Tsuang, ; Lavoie, Bédard Lacroix, Godmaire‐Duhaime, Jackson, & Achim, ). Individuals early in the course of a psychotic illness may also be more responsive to psychosocial interventions than individuals with longstanding psychotic disorders (Goldstein, ; McFarlane, )—a finding that may be particularly relevant to recent efforts to develop psychosocial interventions to address social cognitive deficits in psychosis (Bartholomeusz et al, ; Penn, Roberts, Combs, & Sterne, ; Roberts & Penn, ).…”

“…Available research suggests that deficits in both of these variables are present early in the course of psychotic disorders (Achim, Ouellet, Roy, & Jackson, 2012;Bourdeau, Masse, & Lecomte, 2012;Lecomte et al, 2014;Thompson et al, 2012) and may also be present in firstdegree relatives of individuals with psychotic disorders (Glatt, Stone, Faraone, Seidman, & Tsuang, 2006;Lavoie, Bédard Lacroix, Godmaire-Duhaime, Jackson, & Achim, 2013). Individuals early in the course of a psychotic illness may also be more responsive to psychosocial interventions than individuals with longstanding psychotic disorders (Goldstein, 1996;McFarlane, 2002)-a finding that may be particularly relevant to recent efforts to develop psychosocial interventions to address social cognitive deficits in psychosis (Bartholomeusz et al, 2013;Penn, Roberts, Combs, & Sterne, 2007;Roberts & Penn, 2009 (Green et al, 2008) identified 5 domains of social cognition relevant to the study of psychotic disorders (ie, attributional style, emotion recognition, social knowledge, social perception and theory of mind), no study to date has examined all 5 domains of social cognition simultaneously in the same sample (Addington & Piskulic, 2011;Thompson et al, 2012).…”

“…Such designs obfuscate critical aspects of the nature of the relationship between these 2 variables including, for example, the direction of the relationship between social cognition and social functioning and whether a third unmeasured variable may account for the apparent association between these 2 variables (Breitborde, Lopez, & Nuechterlein, 2009a;Breitborde, Srihari, Pollard, Addington, & Woods, 2010;Kraemer, Stice, Kazdin, Offord, & Kupfer, 2001;Kraemer, Yesavage, Taylor, & Kupfer, 2000). Finally, there is an over-reliance in past psychosis research on "single score" measures of social functioning (eg, Global Assessment of Functioning scores) that may fail to accurately highlight variability in the different domains of social functioning (Burns & Patrick, 2007;Lecomte et al, 2014) or the differential effect of social cognition on different domains of social functioning (Bourdeau et al, 2012). Ultimately, addressing these limitations may help to clarify the nature of the relationship between specific aspects of these 2 variables among individuals with psychotic disorders.…”