Effort Allocation Influences Upon Cognition in Schizophrenia

Structural differences in key brain region linked to hallucinations in people diagnosed with schizop
Structural differences in key brain region linked to hallucinations in people diagnosed with schizop
Researchers studied social cognition and social problem solving in patients with schizophrenia by employing a validated test designed to assess emotion recognition abilities.

It’s well documented that in addition to a combination of positive and negative symptoms, many individuals suffering with chronic schizophrenia also present with a dysfunction across several cognitive domains including attention, memory, and cognitive flexibility. It has been reported that higher order cognitive abilities, such as social cognition and social problem solving, are significantly impaired in patients diagnosed with schizophrenia. Previously published data also indicate that patients with schizophrenia exhibit poor self-recognition performance on tests designed to assess subjective well-being.

In a new study published in Schizophrenia Research, investigators examined social cognitive performance by administering the Bell-Lysaker Emotion Recognition Test (BLERT) to 57 patients with schizophrenia or schizoaffective disorder. This test is designed to evaluate participants’ ability to correctly identify emotional states. Researchers then compared these data to data collected from typical, healthy control participants matched by gender, ethnicity, race, and age.

Investigators modified the BLERT by instructing the participants to respond as quickly as possible without sacrificing accuracy, and also to rate how certain they were [(ie, their level of confidence (0 to 100)] that they correctly identified the emotion presented in the video clip. Researchers noted that negative symptoms were not significantly associated with performance, confidence levels, or response times.

Patients with schizophrenia performed significantly worse on the BLERT [63.49% correct (SD=20.88)] compared with the results collected from control participants [72.95% correct (SD=14.63), t(102)=2.62, P=.01)].  Control participants were also more confident in their responses to items that were correct compared with patients with schizophrenia.

Data also indicate that levels of depression among the individuals with schizophrenia significantly influenced their level of certainty. These data are in line with previous findings, as it has been shown that depression is associated with “self-assessment of social cognition for both healthy and non-healthy individuals.”

With regard to the response time measure, control participants took longer to respond to items that were incorrect [6.52 seconds (SD=4,80)] vs items that were correct [2.99 seconds (SD=3.36)]. Among patients with schizophrenia, the magnitude of difference in response times to incorrect [5.30 seconds (SD=4.68)] vs correct [4.25 seconds (SD=4.08)] items was much lower.

“Assuming that longer response times indicate greater effort… patients [with schizophrenia] did not adjust their effort accordingly to social cognitive stimuli that were more challenging for them to solve,” the authors wrote in their publication.

Taken together, these findings provide additional support for the pattern of diminished social cognitive function, possibly driven by impaired effort allocation, in patients with schizophrenia.

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Cornacchio D, Pinkham AE, Penn DL, Harvey PD. Self-assessment of social cognitive ability in individuals with schizophrenia: appraising task difficulty and allocation of effort. Schizophr Res. 2016. doi:10.1016/j.schres.2016.09.033. [Epub ahead of print]