Validation of behavioral measures of social cognition in individuals diagnosed with schizophrenia

Abstract

Schizophrenia, a complex neuropsychiatric disorder, manifests severe impairments in social cognition, notably in Theory of Mind (ToM), empathy, and emotion recognition, which significantly influence social competence and overall functioning. These aspects are crucial for prognosis in individuals diagnosed with schizophrenia (SZ). This study validates a comics strip paradigm for ToM and empathy assessment, the Montreal Affective Voices (MAV) for measuring emotion recognition, and a Go-NoGo task for inhibition control estimation in individuals diagnosed with SZ, comparing their performance with healthy controls. SZ participants exhibited diminished abilities in the comics strip task, especially in ToM and empathy conditions, alongside challenges in identifying emotions from vocal cues in MAV. They responded slower and tended to be less accurate in the Go-NoGo task. The validated behavioral battery addresses the limitations of previous measures and emerges as a promising tool for future investigations into the neural systems underlying social cognition in schizophrenia. Such insights can lead to the development of long-needed treatment for negative symptoms and social dysfunctions in schizophrenia.

Keywords: Go-NoGo; Montreal Affective Voices (MAV); comic strip; emotion recognition; schizophrenia; social cognition; theory of mind (ToM).

Figure 1

Comics strip scheme. (A) One trial scheme. (B) Example of a comic from the ToM condition. (C) Example of a comic from the Physica1 condition. (D) An example of a comic from the Empathy condition. (E) An example of a comic from the Physical2 condition.

Figure 2

Emotional voice scheme. (A) One trial scheme. (B) Rating form.

Figure 3

Auditory Go-NoGo task scheme. Schematic presentation of two trails. Orange lines mark the trail onset.

Figure 4

SZ shows decreased abilities in choosing the correct ending to the story particularly in the social cognition conditions. (A) Accuracy. (B) Response time. Error bars indicate the standard error of the mean (SEM). Asterisks indicate the level of statistical significance: *p < 0.001.

Figure 5

SZ exhibited impairments in identifying vocal emotions. (A) Accuracy by group and emotion. (B) Accuracy over groups demonstrates all possible pairwise comparisons, given the main effect of emotions. (C) Intensity ratings. (D) Valence ratings. Error bars indicate the standard error of the mean (SEM). Asterisks indicate level of statistical significance: *p < 0.05, **p < 0.005, and ***p < 0.001.

Figure 6

SZ were slower and tend to be less accurate compared to HC in the Go-NoGo paradigm. (A) Accuracy. (B) Response time in Go (hit) and NoGo (commission error). Error bars indicate the standard error of the mean (SEM).