Social cognition psychometric evaluation (SCOPE) in people with early psychosis: A preliminary study

Abstract

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.

Social and non‐social measures of cognition for predicting self‐reported and informant‐reported functional outcomes in early psychosis

“…However, attributional style was the only cognitive measure that predicted variance in self‐reported occupational competence (OSA) and self‐reported executive dysfunction (BRIEF‐A). These results support previous findings in early psychosis and indicate that there may be a distinct difference between the predictive factors for self‐reported and informant‐reported measures of functional outcome in early psychosis (Ludwig et al ., ; Williams et al ., ).…”

“…However, although the two capacity‐based measures intercorrelated and correlated with verbal memory, ToM was not related to any of the functional outcome measures. These results contradict previous results in early psychosis (Lindgren, Torniainen‐Holm, Heiskanen et al ., ; Ludwig et al ., ; Sullivan, Herzig, Mohr et al ., ; Williams et al ., ), but the variability in methods used to assess ToM and functional outcomes in previous studies make comparisons between studies somewhat difficult. Unlike ToM, emotion recognition also correlated with visual reasoning (Matrix Reasoning) and processing speed (Digit Symbol Coding).…”

“…Although evidence suggests that peoples with schizophrenia have substantial problems in self‐reporting everyday functioning (Bowie, Twamley, Anderson et al ., ), about one‐third of chronic schizophrenia patients may be able to accurately report their functional abilities (Sabbag et al ., ). Further, it has been suggested that this rate might even be higher in first‐episode samples than in older patients (Ludwig et al ., ; Williams, Whitford, Flynn et al ., ).…”

“…However, there is some debate as to whether early psychosis and chronic schizophrenia patients exhibit the same types and degree of social‐cognitive impairment. Whereas, some studies have found similar deficits between early psychosis samples and those with chronic schizophrenia (Addington, Saeedi & Addington, 2006a,2006b; Bertrand, ; Bora & Pantelis, ; Clayson, Kern, Nuechterlein et al ., ; Green, Bearden, Cannon et al ., ), others have found that social‐cognitive deficits are of lesser magnitude in early psychosis samples than in chronic schizophrenia samples, in particular for emotion recognition (Healey, Bartholomeusz & Penn, ; Kucharska‐Pietura, David, Masiak & Phillips, ; Ludwig, ; Savla, Vella, Armstrong, Penn & Twamley, ). Similar to results in chronic schizophrenia, evidence suggests that social cognition accounts for more variance in functional outcome than neurocognition, and is a mediator of the relationship between neurocognition and poor functional outcome (Addington, ; Ludwig, ; Ventura et al ., ).…”

“…Early psychosis samples may be more heterogeneous and have a greater fluctuation in clinical presentation than chronic schizophrenia samples (Nuechterlein, Dawson, Gitlin et al ., ), which may affect the stability and severity of social‐cognitive deficits and their relationships to functional outcome (Green et al ., ; Horan et al ., ). Furthermore, little is known about the role of attributional style in predicting functional outcomes in early psychosis, although there is some support for its relevance to self‐reported functioning (Ludwig et al ., ).…”