Abstract
Background: Deficits in information processing, sustained attention and social cognition have important implications for the daily functioning of people with schizophrenia. The present study analyzed the relationship between processing speed, sustained attention, social cognition, and functioning in clinically stable people with schizophrenia. Method: Ninety people with schizophrenia and 100 healthy controls completed a battery of measures to assess clinical symptoms, processing speed, sustained attention, social cognition, and functioning. GLMMs and SEM were used to assess the relationships between these variables. Results: People with schizophrenia had impaired performance in all cognitive outcomes compared to healthy controls. Processing speed and sustained attention, together in a latent variable, had a strong effect on functioning (Beta = 0.32; p < .05). However, social cognition had also a strong effect on functioning (Beta = 0.29; p <.001) in the mediation model, which exhibited better indices of fit than the model including neurocognition alone (e.g. RMSEAbasic = 0.131 and RMSEAmediator = 0.054). Conclusions: The mediating effect of social cognition on the relationship between processing speed, sustained attention, and functioning in people with schizophrenia suggests the importance of including both domains of neurocognition along with social cognition as treatment targets in rehabilitation interventions to optimize improvements in functioning in schizophrenia
References
Addington, J., Girard, T. A., Christensen, B. K., & Addington, D. (2010). Social Cognition mediates illness-related and cognitive influences on social function in patients with schizophrenia- spectrum disorders. Journal of Psychiatry Neuroscience, 35(1), 49–54. https://doi.org/10.1503/jpn.080039
Addington, J., Liu, L., Perkins, D. O., Carrion, R. E., Keefe, R. S., & Woods, S. W. (2017). The Role of Cognition and Social Functioning as Predictors in the Transition to Psychosis for Youth With Attenuated Psychotic Symptoms. Schizophrenia Bulletin, 43, 57-63. https://doi.org/10.1093/schbul/sbw152
Addington, J., Saeedi, H., & Addington, D. (2006). Facial affect recognition: a mediator between cognitive and social functioning in psychosis?. Schizophrenia Research, 85(1-3), 142-150.
https://doi.org/10.1016/j.schres.2006.03.028
Agnew-Blais, J., & Seidman, L. J. (2013). Neurocognition in youth and young adults under age 30 at familial risk for schizophrenia: a quantitative and
qualitative review. Cognitive Neuropsychiatry, 18(1-2), 44-82. https://doi.org/10.1080/13546805.2012.676309
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Author. https://www.doi.org/10.1176/appi.books.9780890425596
Andrade-González, N., Sarasa, M., García-López, A., Leonés, I., Halverson, T. F., & Lahera, G. (2021). Mentalizing Errors in Patients with Schizophrenia Who Received Psychosocial Rehabilitation: a Case-Control Study. Psychiatric Quaterly, 92(3), 947-959. https://doi.org/10.1007/s11126-020-09863-x
Ayesa-Arriola, R., Setién-Suero, E., Neergaard, K. D., Ferro, A., Fatjó-Vilas, M., Ríos-Lago, M., Otero, S., Rodríguez-Sánchez, J. M., & Crespo-Facorro, B. (2016). Evidence for trait related theory of mind impairment in first episode psychosis patients and its relationship with processing speed: a 3 year follow-up study. Frontiers in Psychology, 7, Article 592. https://doi.org/10.3389/fpsyg.2016.00592
Barnett, J. H., Robbins, T. W., Leeson, V. C., Sahakian, B. J., Joyce, E. M., & Blackwell, A. D. (2010). Assessing cognitive function in clinical trials of schizophrenia. Neuroscience & Biobehavioral Reviews, 34(8), 1161-1177. https://doi.org/10.1016/j.neubiorev.2010.01.012
Bell, M., Tsang, H. W., Greig, T. C., & Bryson, G. J. (2009). Neurocognition, social cognition, perceived social discomfort, and vocational outcomes in schizophrenia. Schizophrenia Bulletin, 35(4), 738-747. https://doi.org/10.1093/schbul/sbm169
Benton, A. L., & Hamsher, K. (1978). Multilingual aphasia examination manual (revised). AJA Associates. Bezdicek, O., Michalec, J., Kališová, L., Kufa, T., Děchtěrenko, F., Chlebovcová, M., Havlík, F., Green, M. F., & Nuechterlein, K. H. (2020). Profile of cognitive deficits in schizophrenia and factor structure of the Czech MATRICS Consensus Cognitive Battery. Schizophrenia Research, 218, 85-92. https://doi.org/10.1016/j.schres.2020.02.004
Brekke, J., Kay, D. D., Lee, K. S., & Green, M. F. (2005). Biosocial pathways to functional outcome in schizophrenia. Schizophrenia Research, 80(2-3), 213–225. https://doi.org/10.1016/j.schres.2005.07.008
Brenner, H. D., Roder, V., Hodel, B., Kienzle, N., Reed, D., & Liberman, R. P. (1994). Integrated psychological therapy for schizophrenic patients (IPT). Hogrefe & Huber Publishers.
Brissos, S., Palhava, F., Marques, J. G., Mexia, S., Carmo, A. L., Carvalho, M., Dias, C., Franco, J. D., Mendes, R., Zuzarte, P., Carita, A. I., Molodynski, A., & Figueira, M. L. (2012). The Portuguese version of the Personal and Social Performance Scale (PSP): reliability, validity, and relationship with cognitive measures in hospitalized and community schizophrenia patients. Social Psychiatry and Psychiatric Epidemiology, 47(7), 1077-1086. https://doi.org/10.1007/s00127-011-0412-6
Brittain, P., Ffytche, D. H., McKendrick, A., & Surguladze, S. (2010). Visual processing, social cognition and functional outcome in schizophrenia. Psychiatry Research, 178(2), 270–275. https://doi.org/10.1016/j.psychres.2009.09.013
Byrne, B. M. (1994). Structural equation modeling with EQS and EQS/Windows. Sage Publications.
Calvo-Gómez, J. M., Sánchez-Pedraza, R., Jaramillo-González, L. E., & Tarcisio-Mantilla, C. (2006). Validating the Simpson-Angus Extrapyramidal Collateral Symptom Evaluation Scale. Revista de Salud Pública, 8(1), 74-87. https://doi.org/10.1590/s0124-00642006000100007
Cassetta B. D., Tomfohr-Madsen, L. M., & Goghari, V. M. (2018). A randomized controlled trial of working memory and processing speed training in schizophrenia. Psychological Medicine, 49(12), 2009-2019. https://doi.org/10.1017/S0033291718002775
Catalan, A., Angosto, V., Díaz, A., Martínez, N., Guede, D., Pereda, M., Madrazo, A., Bustamante, S., Bilbao, A., Osa, L., Inchausti, L., & Gonzalez-Torres, M. A. (2018). The relationship between theory of mind deficits and neurocognition in first episode-psychosis. Psychiatry Research, 268, 361-367. https://doi.org/10.1016/j.psychres.2018.06.066
Cornacchio, D., Pinkham, A. E., Penn, D. L., & Harvey, P. D. (2017). Selfassessment of social cognitive ability in individuals with schizophrenia: Appraising task difficulty and allocation of effort. Schizophrenia Research, 179, 85-90. https://doi.org/10.1016/j.schres.2016.09.033
Couture, S. M., Granholm, E. L., & Fish, S. C. (2011). A path model investigation of neurocognition, theory of mind, social competence, negative symptoms and real-world functioning in schizophrenia. Schizophrenia Research, 125(2-3), 152-160. https://doi.org/10.1016/j.schres.2010.09.020
Couture, S. M., Penn, D. L., & Roberts, D. L. (2006). The functional significance of social cognition in schizophrenia: a review. Schizophrenia Bulletin, 32, S44-S63. https://doi.org/10.1093/schbul/sbl029
Deckler, E., Hodgins, G., Pinkham, A., Penn, D., & Harvey, P. D. (2018). Social Cognition and Neurocognition in Schizophrenia and Healthy Controls: Intercorrelations of Performance and Effects of Manipulations Aimed at Increasing Task Difficulty. Frontiers in Psychiatry, 9, 356. https://doi.org/10.3389/fpsyt.2018.00356
Dickinson, D., Ramsey, M. E., & Gold, J. M. (2007). Overlooking the obvious: a meta-analytic comparison of digit symbol coding tasks and other cognitive measures in schizophrenia. Archives of General Psychiatry, 64(5), 532–542. https://doi.org/10.1001/archpsyc.64.5.532
Dziobek, I., Fleck, S., Kalbe, E., Rogers, K., Hassenstab, J., Brand, M., Kessler, J., Woike, J. K., Wolf, O. T., & Convit, A. (2006). Introducing MASC: a movie for the assessment of social cognition. Journal of Autism and Developmental Disorders, 36(5), 623–36. https://doi.org/10.1007/s10803-006-0107-0
Fan, X., Thompson, B., & Wang, L. (1999). Effects of sample size, estimation methods, and model specification on structural equation modeling fit indexes. Structural Equation Modeling: a Multidisciplinary Journal, 6(1), 56-83. https://doi.org/10.1080/10705519909540119
Fett, A. K. J., Viechtbauer, W., Dominguez, M. G., Penn, D. L., van Os, J., & Krabbendam, L. (2011). The relationship between neurocognition and social cognition with functional outcomes in schizophrenia: a meta-analysis. Neuroscience & Biobehavioral Reviews, 35(3), 573-588. https://doi.org/10.1016/j.neubiorev.2010.07.001
Fonseca Pedrero, E. Pérez-Álvarez, M., Al-Halabí, S., Inchausti, F., Muñiz, J., López-Navarro, E., Pérez de Albéniz, A., Lucas Molina, B., Debbané, M., Bobes-Bascarán, M. T., Gimeno-Peón, A., Prado-Abril, J., FernándezÁlvarez, J., Rodríguez-Testal, J. F., González Pando, D., Díez-Gómez, A., García Montes, J. M., García Cerdán, L., Osma, J., … Marrero, R. J. (2021). Tratamientos Psicológicos Empíricamente Apoyados Para Adultos: Una Revisión Selectiva [Evidence-Based Psychological Treatments for Adults: A Selective Review]. Psicothema, 33(2), 188-197. https://doi.org/10.7334/psicothema2020.426
García-Portilla, M. P., Saiz, P. A., Bousoño, M., Bascaran, M. T., Guzmán-Quilo C., & Bobes, J. (2011). Validation of the Spanish Personal and Social Performance scale (PSP) in outpatients with stable and unstable schizophrenia. Revista de Psiquiatria y Salud Mental, 4(1), 9-18. https://doi.org/10.1016/S2173-5050(11)70003-6
Gard, D. E., Fisher, M., Garrett, C., Genevsky, A., & Vinogradov, S. (2009). Motivation and its relationship to neurocognition, social cognition, and functional outcome in schizophrenia. Schizophrenia Research, 115(1), 74–81. https://doi.org/10.1016/j.schres.2009.08.015
Gur, R. C., Sara, R., Hagendoorn, M., Marom, O., Hughett, P., Macy, L., Turner, T., Bajcsy, R., Posner, A., & Gur, R. E. (2002). A method for obtaining 3-dimensional facial expressions and its standardization for use in neurocognitive studies. Journal of Neuroscience Methods, 115(2), 137–143. https://doi.org/10.1016/S0165-0270(02)00006-7
Halverson, T. F., Orleans-Pobee, M., Merritt, C., Sheeran, P., Fett, A. K., & Penn, D. L. (2019). Pathways to functional outcomes in schizophrenia spectrum disorders: Meta-analysis of social cognitive and neurocognitive predictors. Neuroscience & Biobehavioral Reviews, 105, 212-219. https://doi.org/10.1016/j.neubiorev.2019.07.020
Harvey, P. D., Keefe, R. S. E., Patterson, T. L., Heaton, R. K., & Bowie, C. R. (2009). Abbreviated neuropsychological assessment in schizophrenia: Prediction of different aspects of outcome. Journal of Clinical and Experimental Neuropsychology, 31(4), 462–471. https://doi.org/10.1080/13803390802251386
Heinrichs, R. W., & Zakzanis, K. K. (1998). Neurocognitive deficit in schizophrenia: a quantitative review of the evidence. Neuropsychology, 12(3), 426–445. https://doi.org/10.1037/0894-4105.12.3.426
Hogarty, G. E., Greenwald, D. P., & Eack, S. M. (2006). A memorial tribute: Durability and mechanism of effects of cognitive enhancement therapy. Psychiatric Services, 57(12), 1751-1757.
https://doi.org/10.1176/ps.2006.57.12.175
Horton, H. K., & Silverstein, S. M. (2008). Social cognition as a mediator of cognition and outcome among deaf and hearing people with schizophrenia. Schizophrenia Research, 105(1-3), 125-137.
https://doi.org/10.1016/j.schres.2008.07.003
Hurlbert, S. H., Levine, R. A., & Utts, J. (2019). Coup de Grâce for a Tough Old Bull: “Statistically Significant” Expires. The American Statistician, 73, 352-357. https://doi.org/10.1080/00031305.2018.1543616
Irani, F., Seligman, S., Kamath, V., Kohler, C., & Gur, R. C. (2012). A Meta-Analysis of Emotion Perception and Functional Outcomes in Schizophrenia. Schizophrenia Research, 137(1-3), 203–211.
https://doi.org/10.1016/j.schres.2012.01.023
Kay, S. R., Opler, L. A., & Lindenmayer, J. P. (1989). The Positive and Negative Syndrome Scale (PANSS): rationale and standardisation. The British Journal of Psychiatry, 159(S7), 59-67. https://doi.org/10.1192/S0007125000291514
Keefe, R. S. E. (1999). Brief Assesment of cognition in Schizophrenia (BACS) Manual – A: Version 2.1. Duke University Medical Centre. Kohler, C. G., Walker, J. B., Martin, E. A., Healey, K. M., & Moberg, P. J. (2009). Facial emotion perception in schizophrenia: a meta-analytic review. Schizophrenia Bulletin, 36(5), 1009-1019. https://doi.org/10.1093/schbul/sbn192
Lahera, G., Boada, L., Pousa, E., Mirapeix, I., Morón-Nozaleda, G., Marinas, L., Gisbert, L., Pamiàs, M., & Parellada, M. (2014). Movie for the Assessment of Social Cognition (MASC): Spanish Validation. Journal of Autism and Developmental Disorders, 44(8), 1886-1896. https://doi.org/10.1007/s10803-014-2061-6
Leucht, S., Samara, M., Heres, S., Patel, M. X., Furukawa, T., Cipriani, A., Geddes, J., & Davis, J. M. (2015). Dose equivalents for second-generation antipsychotic drugs: The classical mean dose method. Schizophrenia Bulletin, 41(6), 1397–1402. https://doi.org/10.1093/schbul/sbv037
Lindenmayer, J. P., Fregenti, S., Kang, G., Ozog, V., Ljuri, I., Khan, A., Goldring, A., & McGurk, S. R. (2017). The relationship of cognitive improvement after cognitive remediation with social functioning in patients with schizophrenia and severe cognitive deficits. Schizophrenia Research, 185, 154-160. https://doi.org/10.1016/j.schres.2017.01.007
Meyer, M. B., & Kurtz, M. M. (2009). Elementary neurocognitive function, facial affect recognition and social-skills in schizophrenia. Schizophrenia Research, 110(1-3), 173–179. https://doi.org/10.1016/j.schres.2009.03.015
Mindrila, D. (2010). Maximum likelihood (ML) and diagonally weighted least squares (DWLS) estimation procedures: A comparison of estimation bias with ordinal and multivariate non-normal data. International Journal of Digital Society, 1(1), 60-66. https://doi.org/10.20533/ijds.2040.2570.2010.0010
Montag, C., Dziobek, I., Richter, I. S., Neuhaus, K., Lehmann, A., Sylla, R., Heekeren, H. R., Heinz, A, & Gallinat, J. (2011). Different aspects of theory of mind in paranoid schizophrenia: evidence from a video-based assessment. Psychiatry Research, 186(2-3), 203–209. https://doi.org/10.1016/j.psychres.2010.09.006
Morosini, P. L., Magliano, L., Brambilla, L., Ugolini, S., & Pioli, R. (2000). Development, reliability and acceptability of a new version of the DSM-IV Social and Occupational Functioning Assessment Scale (SOFAS) to assess routine social functioning. Acta Psychiatrica Scandinavica, 101(4), 323-329. https://doi.org/10.1034/j.1600-0447.2000.101004323.x
Nuechterlein, K. H., Green, M. F., Kern, R. S., Baade, L. E., Barch, D. M., Cohen, J. D., Essock, S., Fenton, W. S., Frese 3rd, F. J., Gold, J. M., Goldberg, T., Heaton, R. K., Keefe, R. S. E., Kraemer, H., Mesholam-Gately, R., Seidman, L. J., Stover, E., Weinberger, D. R., Young, A. S., … Marder, S. R. (2008). The MATRICS Consensus Cognitive Battery, Part 1: test selection, reliability, and validity. American Journal of Psychiatry, 165(2), 203–213. https://doi.org/10.1176/appi.ajp.2007.07010042
Partington, J. E., & Leiter, R. G. (1949). Partington’s Pathways Test. Psychological Service Center Journal, 1, 11-20.
Peña, J., Ibarretxe-Bilbao, N., Sánchez, P., Uriarte, J. J., Elizagárate, E., Gutiérrez, M., & Ojeda, N. (2018). Mechanisms of functional improvement through cognitive rehabilitation in schizophrenia. Journal of Psychiatric Research, 101, 21-27. https://doi.org/10.1016/j.jpsychires.2018.03.002
Peralta-Martín, V., & Cuesta-Zorita, M. J. (1994). Validation of positive and negative symptom scale (PANSS) in a sample of Spanish schizophrenic patients. Actas Luso-Españolas de Neurología, Psiquiatría y Ciencias Afines, 22(4), 171-177.
Pinkham, A. E., Harvey, P. D., & Penn, D. L. (2018). Social cognition psychometric evaluation: results of the final validation study. Schizophrenia Bulletin, 44(4), 737-748. https://doi.org/10.1093/schbul/sbx117
R Core Team (2020). R: A language and environment for statistical computing. R Foundation for Statistical Computing. https://www.r-project.org/
Rapisarda, A., Kraus, M., Tan, Y. W., Lam, M., Eng, G. K., Lee, J., Subramaniam, M., Collinson, S. L., Chong, S. A., & Keefe, R. S. E. (2014). The Continuous Performance Test, Identical Pairs: norms, reliability and performance in healthy controls and patients with schizophrenia in Singapore. Schizophrenia Research, 156(2-3), 233–240. https://doi.org/10.1016/j.schres.2014.04.016
Rassovsky, Y., Horan, W. P., Lee, J., Sergi, M. J., & Green, M. F. (2011).
Pathways between early visual processing and functional outcome in schizophrenia. Psychological Medicine, 41(3), 487–497. https://doi.org/10.1017/S0033291710001054
Revheim, N., Schechter, I., Kim, D., Silipo, G., Allingham, B., Butler, P., & Javitt, D. C. (2006). Neurocognitive and symptom correlates of daily problem-solving skills in schizophrenia. Schizophrenia Research, 83(2-3), 237-45. https://doi.org/10.1016/j.schres.2005.12.849
Rodriguez-Jimenez, R., Bagney, A., García-Navarro, C., Aparicio, A. I., López-Antón, R., Moreno-Ortega, M., Jimenez-Arriero, M. A., Santos, J. L., Lobo, A., Kern, R. S., Green, F., Nuechterlein, K. H., & Palomo, T. (2012). The MATRICS consensus cognitive battery (MCCB): co-norming and standardization in Spain. Schizophrenia Research, 134(2-3), 279-284. https://doi.org/10.1016/j.schres.2011.11.026
Rodríguez-Sánchez, J. M., Crespo-Facorro, B., González-Blanch, C., Pérez- Iglesias, R., & Vázquez-Barquero, J. L. (2007). Cognitive dysfunction in first-episode psychosis: the processing speed hypothesis. The British Journal of Psychiatry, 191(S51), s107-s110. https://doi.org/10.1192/bjp.191.51.s107
Sánchez, P., Ojeda, N., Peña, J., Elizagárate, E., Yoller, A. B., Gutiérrez, M., & Ezcurra, J. (2009). Predictors of longitudinal changes in schizophrenia: the role of processing speed. The Journal of Clinical Psychiatry, 70(6), 888-896. https://doi.org/10.4088/JCP.08m04294
Savla, G. N, Vella, L., Armstrong, C. C., Penn., D. L., & Twamley E. W. (2013). Deficits in Domains of Social Cognition in Schizophrenia: A Meta-Analysis of the Empirical Evidence. Schizophrenia Bulletin, 39(5), 979–992. https://doi.org/10.1093/schbul/sbs080
Schaefer, J., Giangrande, E., Weinberger, D. R., & Dickinson, D. (2013). The global cognitive impairment in schizophrenia: Consistent over decades and around the world. Schizophrenia Research, 150(1), 42–50. https://doi.org/10.1016/j.schres.2013.07.009
Schmidt, S. J., Mueller, D. R., & Roder, V. (2011). Social cognition as a mediator variable between neurocognition and functional outcome in schizophrenia: empirical review and new results by structural equation modeling. Schizophrenia Bulletin, 37(supl_2), S41-S54. https://doi.org/10.1093/schbul/sbr079
Segarra, N., Bernardo, M., Gutierrez, F., Justicia, A., Fernadez-Egea, E., Allas, M., Safont, G., Contreras, F., Gascon, J., Soler-Insa, P. A., Menchon J. M., Junque, C., & Keefe, R. S. E. (2011). Spanish validation of the Brief Assessment in Cognition in Schizophrenia (BACS) in patients with schizophrenia and healthy controls. European Psychiatry, 26(2), 69-73. https://doi.org/10.1016/j.eurpsy.2009.11.001
Sergi, M. J., Rassovsky, Y., Nuechterlein, K. H., & Green, M. F. (2006). Social perception as a mediator of the influence of early visual processing on functional status in schizophrenia. The American Journal of Psychiatry, 163(3), 448–454. https://doi.org/10.1176/appi.ajp.163.3.448
Shi, C., He, Y., Cheung, E. F., Yu, X., & Chan, R. C. (2013). An ecologically valid performance-based social functioning assessment battery for schizophrenia. Psychiatry Research, 210(3), 787-793.
https://doi.org/10.1016/j.psychres.2013.09.023
Shi, C., Kang, L., Yao, S., Ma, Y., Li, T., Liang, Y., Chenga, Z., Xue, Y., Shif, J., Xug, X., Zhangh, C., Franklini, D. R., Heatoni, R. K., Jin, H., & Yu, X. (2015). The MATRICS Consensus Cognitive Battery (MCCB): co-norming and standardization in China. Schizophrenia Research, 169(1-3), 109-115. https://dx.doi.org/10.1016%2Fj.schres.2015.09.003
Shipley, B. (2016). Cause and Correlation in Biology: A User’s Guide to Path Analysis, Structural Equations and Causal Inference with R. Cambridge University Press.
Simpson, G. M., & Angus, J. W. S. (1970). A rating scale for extrapyramidal side effects. Acta Psychiatrica Scandinavica, 212(S212), 11-19. https://doi.org/10.1111/j.1600-0447.1970.tb02066.x
Sjølie, C., Meyn, E. K., Raudeberg, R., Andreassen, O. A., & Vaskinn, A. (2020). Nonsocial cognitive underpinnings of theory of mind in schizophrenia. Psychiatry Research, 289, Article 113055.
https://doi.org/10.1016/j.psychres.2020.113055
Streiner, D. L. (2006). Building a Better Model: An Introduction to Structural Equation Modelling. Canadian Journal of Psychiatry, 51(5), 317-324. https://doi.org/10.1177/070674370605100507
Thibaudeau, É., Achim, A. M., Parent, C., Turcotte, M., & Cellard, C. (2019). A meta-analysis of the associations between theory of mind and neurocognition in schizophrenia. Schizophrenia Research, 216, 118–128. https://doi.org/10.1016/j.schres.2019.12.017
Tomotake, M. (2011). Quality of life and its predictors in people with schizophrenia. The Journal of Medical Investigation, 58(3-4), 167-174. https://doi.org/10.2152/jmi.58.167
Torio, I., Bagney, A., Dompablo, M., Campillo, M. J., García-Fernández, L., Rodríguez-Torresano, J., Jiménez-Arriero, M. A., Palomo, T., & Rodríguez-Jiménez, R. (2014). Neurocognition, social cognition and functional outcome in Schizophrenia. European Journal of Psychiatry, 28(4), 201-211. https://doi.org/10.4321/S0213-61632014000400001
Tsotsi, S., Bozikas, V. P., & Kosmidis, M. H. (2015). The role of attention processes in facial affect recognition in schizophrenia. Cognitive Neuropsychiatry, 20(6), 526-541. https://doi.org/10.1080/13546805.2015.1110517
Van Hooren, S., Versmissen, D., Janssen, I., Myin-Germeys, I., à Campo, J., Mengelers, R., van Os, J., & Krabbendam, L. (2008). Social cognition and neurocognition as independent domains in psychosis. Schizophrenia Research, 103(1-3), 257-265. https://doi.org/10.1016/j.schres.2008.02.022
Van Rooijen, G., van Rooijen, M., Maat, A., Vermeulen, J. M., Meijer, C. J., Ruhé, H. G., Haan, L. D., GROUP investigators; Genetic Risk and Outcome of Psychosis investigators:; Alizadeh, B. Z., Bartels-Velthuis, A. A., van Beveren, N. J., Bruggeman, R., Cahn, W., Delespaul, P., Myin-Germeys, I., Kahn, R. S., Schirmbeck, F., Simons, C. J. P., van Amelsvoort, T., van Haren, … van Winkel, R. (2019). Longitudinal evidence for a relation between depressive symptoms and quality of life in schizophrenia using structural equation modeling. Schizophrenia Research, 208, 82-89. https://doi.org/10.1016/j.schres.2019.04.011
Vaskinn, A., Sundet, K., Friis, S., Simonsen, C., Birkenaes, A. B., Jónsdóttir, H., Ringen, P.A., & Andreassen, O.A. (2008). Emotion perception and learning potential: mediators between neurocognition and social problem-solving in schizophrenia?. Journal of the International Neuropsychological Society, 14(2), 279–288. https://doi.org/10.1017/S1355617708080314
Vauth, R., Rüsch, N., Wirtz, M., & Corrigan, P. W. (2004). Does social cognition influence the relation between neurocognitive deficits and vocational functioning in schizophrenia?. Psychiatry Research, 128(2), 155–165. https://doi.org/10.1016/j.psychres.2004.05.018