BackgroundAutism spectrum disorder (ASD) and schizophrenia (SCZ) are separate neurodevelopmental disorders that are both characterized by difficulties in social cognition and social functioning. Due to methodological confounds, the degree of similarity in social cognitive impairments across these two disorders is currently unknown. This study therefore conducted a comprehensive comparison of social cognitive ability in ASD and SCZ to aid efforts to develop optimized treatment programs.MethodsIn total, 101 individuals with ASD, 92 individuals with SCZ or schizoaffective disorder, and 101 typically developing (TD) controls, all with measured intelligence in the normal range and a mean age of 25.47 years, completed a large battery of psychometrically validated social cognitive assessments spanning the domains of emotion recognition, social perception, mental state attribution, and attributional style.ResultsBoth ASD and SCZ performed worse than TD controls, and very few differences were evident between the two clinical groups, with effect sizes (Cohen's d) ranging from 0.01 to 0.34. For those effects that did reach statistical significance, such as greater hostility in the SCZ group, controlling for symptom severity rendered them non-significant, suggesting that clinical distinctions may underlie these social cognitive differences. Additionally, the strength of the relationship between neurocognitive and social cognitive performance was of similar, moderate size for ASD and SCZ.ConclusionsFindings largely suggest comparable levels of social cognitive impairment in ASD and SCZ, which may support the use of existing social cognitive interventions across disorders. However, future work is needed to determine whether the mechanisms underlying these shared impairments are also similar or if these common behavioral profiles may emerge via different pathways.

Although social cognition is frequently identified as a target in clinical trials and psychosocial interventions for adults with autism spectrum disorder (ASD), these efforts are hampered by a lack of consensus and validation of social cognitive measures. The current study provides psychometric evaluation of 11 frequently used measures encompassing different subdomains of social cognition. Adults with autism (N = 103) and typically developing controls (N = 95) completed 11 commonly used social cognitive tasks spanning the domains of emotion processing, social perception, and mentalizing/theory of mind. We examined each measure's internal reliability and sensitivity to group differences, how performance related to general intellectual ability, and alignment of measures with a proposed two‐factor structure of social cognition in ASD. Controls outperformed the ASD group on 8 of the 11 social cognitive tasks, with the largest group differences occurring on two mentalizing measures, The awareness of social inference task (TASIT) and hinting task. In ASD, all tasks demonstrated strong internal consistency and avoided ceiling and floor effects. Social cognitive performance was also related to, but not redundant with, intellectual functioning. We also found support for a two‐factor structure of social cognition, with basic social perception and emotional processing aligning into a lower‐order social perception factor, while mentalizing tasks aligned into a higher‐order social appraisal factor. In sum, eight tasks showed adequate to strong psychometric properties. The psychometric data, effect size estimates, and correlations between measures reported here can be used for study planning for social cognitive interventions in autism. Autism Research 2019, 12: 766–778. © 2019 The Authors. Autism Research published by International Society for Autism Research published by Wiley Periodicals, Inc. Lay Summary We examined 11 tasks that measure how adults with autism perceive and interpret social information. Eight of the tasks were reliable and showed lower performance in adults with autism compared to typically‐developing controls. Task performance was related to but distinguishable from IQ. These measures evaluated here may be useful in assessing the effectiveness of interventions and treatments to improve social abilities in adults with autism.

Social cognition is an important outcome in schizophrenia research. Unfortunately, there has been a lack of consensus regarding which measures of social cognition best capture this domain of functioning. The Social Cognition Psychometric Evaluation (SCOPE) study was developed to address the need for a battery of measures that have sound psychometric properties and can be implemented in clinical trials for individuals with chronic schizophrenia. The current study expands upon the SCOPE study by examining the psychometric properties of the eight candidate measures administered to individuals early in the course of psychosis. Thirty-eight stable outpatients with first episode psychosis and thirty-nine healthy controls completed the battery at baseline and one-month follow-up assessments. The SCOPE battery was evaluated on a collection of psychometric properties, including: (1) Reliability – including test-retest and internal consistency, (2) Between group differences, (3) Utility as a repeated measure, (4) Relationship to social and occupational functioning, (5) Incremental validity – variance in functioning beyond neurocognition, and (6) Feasibility – including practicality of administration and tolerability. Social cognition accounted for substantially more variance in functional outcome than neurocognition. Only one measure, the Hinting task, displayed adequate psychometric properties to be recommended for use in clinical research with first episode psychosis. The remaining candidate measures would require modifications before implementation or cannot be recommended for use in clinical research with first episode psychosis.

Scientific Abstract Overlapping social impairments in Autism Spectrum Disorder (ASD) and Schizophrenia (SCZ) contributed to decades of diagnostic confusion that continues to this day in some clinical settings. The current study provides the first direct and detailed comparison of social behavior in the two disorders by identifying profiles of social skill in adults with ASD (n=54), SCZ (n=54), and typically-developing (TD) controls (n=56) during a real-world social interaction. ASD and SCZ groups exhibited poorer social skill, both overall and on most discrete abilities, relative to the TD group. Direct comparison of ASD to SCZ revealed distinct behavioral profiles, with ASD uniquely characterized by fewer interactive behaviors, and SCZ characterized by greater impaired gaze and flat/inappropriate affective responses. Additionally, IQ was associated with both overall social skill and many discrete social skills in SCZ, but was largely unrelated to social skill in ASD. These results indicate that overlapping social deficits in ASD and SCZ are comprised of both shared and distinct social skill impairments. The largest distinctions — reduced social reciprocity but better expressivity in ASD relative to SCZ, and a greater role of IQ in social skill for SCZ than ASD — highlight disorder-specific features that can improve etiological understanding, diagnostic differentiation, and treatment strategies.

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