Social cognitive impairments are core features of schizophrenia and are closely associated with poor functional outcome. This study sought to identify specific aspects of social cognition and their relationships to measures of social function, quality of life, and neurocognition. Principal component analysis was performed using social cognitive measures in patients with schizophrenia and healthy matched controls and revealed three factors: Interpersonal Discomfort, Basic Social Cognition, and Empathy. Patients had higher scores on Interpersonal Discomfort and lower scores on Basic Social Cognition than controls, but the two groups were the same on Empathy. Lower social performance was significantly correlated with poor Basic Social Cognition in patients and with high Interpersonal Discomfort in controls. While neurocognition was significantly associated with Basic Social Cognition in both groups, it was not associated with Empathy. Social cognitive interventions should emphasize improving basic social cognitive processing deficits, managing Interpersonal Discomfort, and utilizing preserved capacity for empathy as a potential strength in social interactions. 1. Introduction Patients with schizophrenia have poor social cognitive skills, and these deficits greatly impact their daily functioning [1]. Additionally, social cognition has been found to mediate the relationship between neurocognition and social functioning [2, 3]. Treatment interventions have proliferated to address deficits in social cognition as ways to improve social functioning and several meta-analyses strongly support the efficacy of the interventions [4–6]. However, social cognition and social function are two broad multidimensional constructs and relatively little is known about the relationships among more specific aspects of each, either within or across the two broader spheres, or what aspects of each are most responsive to current treatments. One recent meta-analysis by Kurtz and Richardson [6] compared treatment effects on various measures of social cognition and found the greatest effects on facial affect recognition and lesser effects on measures of other aspects of social cognition. More work is needed to clarify which social cognitive constructs most directly influence social functioning [3] and which are more or less amenable to existing treatments. Understanding the social cognitive constructs that most relate to social functioning would help identify targets to treat in social cognitive interventions. Some studies have attempted to study the relationships between selected
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