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Social cognition refers to the mental operations underlying social interactions. Given the major role of social cognitive deficits in the disability associated with severe psychiatric disorders, they therefore constitute a crucial therapeutic target. However, no easily understandable and transnosographic self-assessment scale evaluating the perceived difficulties is available. This study aimed to analyze the psychometric qualities of a new self-administered questionnaire (ACSo) assessing subjective complaints in different domains of social cognition from 89 patients with schizophrenia, schizoaffective disorders, bipolar disorders or autism. The results revealed satisfactory internal validity and test-retest properties allowing the computation of a total score along with four sub scores (attributional biases, social perception and knowledge, emotional perception and theory of mind). Moreover, the ACSo total score was correlated with other subjective assessments traditionally used in cognitive remediation practice but not with objective neuropsychological assessments of social cognition. In summary, the ACSo is of interest to complete the objective evaluation of social cognition processes with a subjective assessment adapted to people with serious mental illness or autism spectrum disorder. [ABSTRACT FROM AUTHOR]

Aim: Social cognitive impairments are core features in 22q11.2 deletion syndrome (22q11.2DS) and schizophrenia (SCZ). Indeed, adults with 22q.11.2 DS often have poorer social competence as well as poorer performance on measures of social cognitive skills (emotion recognition and theory of mind, ToM) compared with typically developing people. However, studies comparing specific social cognitive components in 22q11.2DS and SCZ have not yet been widely conducted. Methods: In this study we compared performances of 22q11.2DS and SCZ on both facial emotion recognition and ToM. Patients with 22q11.2DS (n = 18) and matched SCZ patients were recruited. After neuropsychological testing, the facial emotion recognition test assessed the patients' ability to recognize six basic, universal emotions (joy, anger, sadness, fear, disgust, and contempt). The Versailles‐situational intentional reading evaluated ToM with six scenes from movies showing characters in complex interactions (involving hints, lies, and indirect speech). Results: We show that 22q11.2DS exhibited significantly lower performance in emotion recognition than SCZ patients did, especially for disgust, contempt, and fear. This impairment seems to be a core cognitive phenotype in 22q11.2DS, regardless of the presence of SCZ symptoms. Concerning ToM, our results may highlight the same impairment level in 22q11.2DS and SCZ but require to be replicated in a larger cohort. Conclusion: Our results document the existence of threshold social cognitive deficits distinguishing 22q11.2DS from SCZ. [ABSTRACT FROM AUTHOR]

Background Emotional and interpersonal impairments have been widely described in alcohol dependence, and their role in relapse has been clearly established. However, several components of social cognition have not been well explored in this context. Particularly, Theory of Mind (ToM) abilities, which are critical social skills enabling one to understand others' perspectives, and which have been largely investigated in other psychiatric populations, remain to be measured using ecological tasks in individuals with alcohol dependence. This study evaluated ToM abilities in close to real-life situations among alcohol-dependent individuals and differentiated its affective and cognitive subcomponents. Methods Thirty-two alcohol-dependent individuals (in their third week of abstinence) and 32 matched healthy controls performed the Movie for Assessment of Social Cognition ( MASC), a multiple-choice task requiring the identification of the emotions, thoughts, and intentions expressed in 45 short video sequences depicting real-life social interactions. Results Alcohol-dependent individuals showed a global ToM impairment, indexed by a reduced MASC global score. However, exploration of ToM's subcomponents showed that the overall deficit was driven by a massive reduction in affective ToM, with the cognitive subcomponent preserved. Conclusions Ecological ToM evaluation shows that alcohol dependence is not related to a generalized ToM deficit but rather to dissociation between a preserved cognitive subcomponent and an impaired affective one. These results underscore the importance of ecological measures to precisely investigate each subcomponent of social cognition in alcohol-dependent individuals. They further show that alcohol dependence is closely associated with emotional-affective impairments, pointing to the need to develop rehabilitation programs focusing on these components in clinical settings. [ABSTRACT FROM AUTHOR]

Cognitive impairments associated with schizophrenia are very frequent. They concern both neurocognition and social cognition, including facial emotion recognition. These impairments have a negative impact on the daily functioning, in particular the social and vocational rehabilitation of people with schizophrenia. Previous studies in this area clearly demonstrated the interest of cognitive remediation to improve neurocognitive and social cognitive functioning in schizophrenia. They also established clear links between facial emotion recognition skills and attentional processes. The present study compares the GAÏA s-face program (GAÏA arm), which focuses on facial emotion recognition processes, with the RECOS program (RECOS arm), a neurocognitive remediation therapy focusing on selective attention. Forty people with schizophrenia were randomly distributed between each study arm and assessed pre- (T1) and post- (T2) therapy. The single-blind assessment focused on facial emotion recognition (the main criteria), symptoms, social and subjective functioning, and neurocognitive and social cognitive performance. Both programs were conducted by nurses after a 3-day training session. The study showed a significant improvement in facial emotion recognition performance in both groups, with a significantly larger effect in the GAÏA arm. Symptoms and social functioning also improved in the GAÏA arm, and certain neurocognitive and social cognitive processes improved in both study arms. Further studies are recommended, with larger population samples and a follow-up assessing the long-term preservation of these improvements. [ABSTRACT FROM AUTHOR]

Difficulties in social interactions are a central characteristic of people with schizophrenia, and can be partly explained by impairments of social cognitive processes. New strategies of cognitive remediation have been recently developed to target these deficits. The RC2S therapy is an individualized and partly computerized program through which patients practice social interactions and develop social cognitive abilities with simulation techniques in a realistic environment. Here, we present the results of two case-studies involving two patients with schizophrenia presenting with specific profiles of impaired social cognition. Each patient completed three baseline sessions, 14 treatment sessions, and 3 follow-up sessions at the end of the therapy - and for 1 patient, another 3 sessions 9 months later. We used a multiple baseline design to assess specific components of social cognition according to the patients' profiles. Functioning and symptomatology were also assessed at the end of the treatment and 6 months later. Results highlight significant improvements in the targeted social cognitive processes and positive changes in functioning in the long term. The RC2S program seems, thus, to be a new useful program for social cognitive remediation in schizophrenia. [ABSTRACT FROM AUTHOR]

Attentional, visuospatial, and social cognition deficits have a negative impact on children's adaptative and social competences and, as a result, on their ability to achieve a normal functioning and behavior. Until now and despite the frequency of those deficits, there is a lack of children's specific cognitive remediation tools specifically dedicated to attentional and visuospatial areas. The «Cognitus & Moi» program involves a variety of exercises in a paper and/or pencil (n = 30) or a computerized format (n = 29) and a strategy coaching approach. Each module of «Cognitus & Moi» targets a single impaired cognitive area, within the limits of cognitive domains' overlapping. The little cartoon character named Cognitus, who illustrates the program, is supposed to be very friendly and kind toward children. Cognitus will accompany them throughout the program for an effective and positive reinforcement. The main goal of «Cognitus & Moi» is to adjust to children's difficulties in daily life. Moreover, since the cognitive remediation benefit is complex to apply in daily life, the program is based on a metacognitive strategy. After a complete neuropsychological assessment and a psychoeducational session (with the child and the parents), 16 1-h-sessions of cognitive remediation with the therapist are proposed. Each session is composed of three parts: (1) computerized tasks focusing on specific attentional or visuospatial components (20 min). The attentional module targets hearing, visual, and divided attention. A double attention task is also proposed. The visuospatial module targets eye tracking and gaze direction, spatial orientation, visuospatial memory and construction, and mental imagery; (2) pen and paper tasks focusing on the same processes (20 min) and a facial emotion recognition task; (3) a proposal of a home-based task (during 20 min). Weekly, specific attentional and visuospatial home tasks are proposed to the child and analyzed with the parents and the therapist. Indeed, home exercises are useful to promote the transfer of strategies to daily life and their subsequent automation. The heterogeneity of cognitive deficits in intellectual deficiency necessitates an individualized cognitive remediation therapy. In this regard, «Cognitus & Moi» seems to be a promising tool. [ABSTRACT FROM AUTHOR]

In people with psychiatric disorders, particularly those suffering from schizophrenia and related illnesses, pronounced difficulties in social interactions are a key manifestation. These difficulties can be partly explained by impairments in social cognition, defined as the ability to understand oneself and others in the social world, which includes abilities such as emotion recognition, theory of mind (ToM), attributional style, and social perception and knowledge. The impact of several kinds of interventions on social cognition has been studied recently. The best outcomes in the area of social cognition in schizophrenia are those obtained by way of cognitive remediation programs. New strategies and programs in this line are currently being developed, such as RC2S (cognitive remediation of social cognition) in Lyon, France. Considering that the social cognitive deficits experienced by patients with schizophrenia are very diverse, and that the main objective of social cognitive remediation programs is to improve patients' functioning in their daily social life, RC2S was developed as an individualized and flexible program that allows patients to practice social interaction in a realistic environment through the use of virtual reality techniques. In the RC2S program, the patient's goal is to assist a character named Tom in various social situations. The underlying idea for the patient is to acquire cognitive strategies for analyzing social context and emotional information in order to understand other characters' mental states and to help Tom manage his social interactions. In this paper, we begin by presenting some data regarding the social cognitive impairments found in schizophrenia and related disorders, and we describe how these deficits are targeted by social cognitive remediation. Then we present the RC2S program and discuss the advantages of computer-based simulation to improve social cognition and social functioning in people with psychiatric disorders. [ABSTRACT FROM AUTHOR]

Abstract: Lived experiences mentioned by patients with schizophrenia can be addressed with neurocognitive models. In particular, these models allow us to better understand self-consciousness and social cognition impairment that is a core feature of schizophrenia. Abnormal brain functioning related to this impairment has been shown. These data show that these symptoms are related to specific neurocognitive correlates. They shed a new light on the understanding of schizophrenic symptoms. [ABSTRACT FROM AUTHOR]

Abstract: Impairments in facial affect recognition have been well-established in schizophrenia. Programs of cognitive remediation specifically aiming at correcting these deficiencies are being developed. This paper reviews these programs’ results, and presents a critical perspective on the connections between cognitive remediation and social cognition. [Copyright &y& Elsevier]

Cognitive remediation is a type of treatment added recently to the range of tools available to therapists. It includes a number of miscellaneous methods that aim to correct some of the cognitive impairments observed in schizophrenia. These cover the fields of target attention, memory and executive deficits, as well as impaired social cognition. Cognitive remediation acts as a complement to medication and psychological therapies, which constitute the core methods of treatment for schizophrenia. The present paper reviews the state of the art in cognitive remediation. The principle underlying this innovative therapeutic approach is the enhancement of the cognitive resources of patients with schizophrenia in order to improve their cognitive functions, social skills and in some cases alleviate some of the symptoms of the disease. Several programs developed within the past two decades (e.g., IPT, CRT, NEAR, CET, NET, CRT and CAT) are becoming more widely used. Their efficacy on neurocognition and on functional outcome has been demonstrated, with inconstant continuation of benefit after completion of treatment. The sustainability of the cognitive and functional improvements following completion of these programs has to be further studied. Other programs aimed at acting upon altered social cognition (one of the critical facets of schizophrenia) are still in the experimental stages, but the results obtained so far are encouraging. A preliminary study has also demonstrated the effectiveness of board games in improving cognitive functioning, which seems to be a highly promising therapeutic avenue owing to its ease of use. [ABSTRACT FROM AUTHOR]

Abstract: Unique deficits in synthetic metacognition have been found in schizophrenia when compared with other psychiatric conditions and community controls. Although persons with autism spectrum disorders (ASD) display similar deficits in social cognition relative to those with schizophrenia, to date no study has compared metacognitive function between these groups. We aimed to compare the metacognitive capacities of persons with schizophrenia and ASD and their associations with other outcomes (neurocognition, social cognition, depression, and quality of life). Fifty-six outpatients with schizophrenia or ASD (mean age, 32.50 [9.05]; 67.9% male) were recruited from two French Centers of Reference for Psychiatric Rehabilitation of the REHABase cohort. Evaluation included the Indiana Psychiatric Illness Interview, Metacognition Assessment Scale-Abbreviated, Movie for the Assessment of Social Cognition, and a large cognitive battery. Compared with those with schizophrenia, participants with ASD had higher self-reflectivity ( p = 0.025; odds ratio, 1.38 [1.05-1.86]) in univariable analyses. Metacognitive deficits may be found in ASD with a profile that varies from what is found in schizophrenia. It is possible that methods for enhancing metacognitive abilities during psychiatric rehabilitation may be refined to assist adults with ASD to better manage their own recovery. [ABSTRACT FROM AUTHOR]

Abstract: Social cognition, which refers to how people think about themselves and others in the social world, is a core component for social, professional and interpersonal functioning and is commonly impaired in schizophrenia. This cognitive domain has strong associations with daily activities and could act as a link between social functioning and neurocognition. Two primary domains of social cognition: theory of mind and emotions perception have been studied for long and many arguments highlighted the direct relationship between impairments of these processes and the alteration of functional outcomes in schizophrenia. During the past 15years, researchers are interested in social cognition and developed, in the field of cognitive remediation, some therapeutic approaches with the aim of reducing difficulties and handicaps. The first programs were supported by the assumption that the improvement of neurocognition was necessary before enhancing social cognition. At the same time, other authors hypothesized that it is possible to improve the performance of people with schizophrenia by directly targeting impaired functions, and so developed specific programs. More recently, researchers intend to develop global programs that take into account all components of social cognition impaired in schizophrenia in order to improve functional outcomes. [Copyright &y& Elsevier]

Résumé Les troubles cognitifs, dont ceux qui touchent la cognition sociale, sont présents dès la phase précoce des troubles psychotiques. Avec les troubles de la motivation, de la métacognition et de l’insight, ces facteurs ont été identifiés comme ayant un rôle primordial dans la genèse du handicap psychique. Par ailleurs, les interventions proposées qui répondent aux besoins spécifiques des usagers, indépendamment d’une certitude diagnostique et la prise en compte des difficultés d’insight, ont été identifiées comme des facteurs permettant de réduire la durée de psychose non traitée, favorisant ainsi le pronostic d’évolution des personnes présentant une psychose émergente. Une enquête a été conduite pendant quatre mois auprès de 16 personnes présentant une schizophrénie ou un trouble schizo-affectif ayant bénéficié de l’ERF-CS et auprès des quatre infirmières ayant conduit les entretiens. Elle était destinée à interroger les effets de la conduite d’un entretien évaluant les répercussions fonctionnelles des troubles de la cognition sociale (ERF-CS) sur l’engagement dans les soins des personnes présentant une psychose en stimulant différentes composantes de la motivation pour les soins. Les résultats sont en faveur d’un impact positif de la définition d’objectifs fonctionnels sur la motivation à participer à une remédiation de la cognition sociale et sur l’alliance thérapeutique. Un impact positif sur l’insight et une meilleure compréhension des difficultés éprouvées par les participants dans leurs relations avec autrui ont été rapportés. L’étude pointe aussi les limites de l’ERF-CS : certaines questions sont trop peu claires et une formation préalable est nécessaire. L’ERF-CS peut donc être considéré comme un support favorisant l’engagement dans les soins, y compris en début de maladie. Cette dernière perspective reste toutefois à confirmer par des études menées directement auprès de cette population. Objective Cognitive impairments and particularly social cognitive deficits are present from the early stages of schizophrenia. With other factors such as motivation, metacognitive processes and insight, social cognition appeared as having an essential role in the genesis of psychosocial disability of patients suffering from this disease. Furthermore, it seems that interventions which meet the specific needs of users, despite both the uncertainly of the diagnosis and the lack of insight, have been identified as a determinant factor to reduce the period of untreated psychosis and thus favoring long-term prognosis. The study here aims to observe if the assessment of functional outcomes of social cognitive impairments, thanks to a semi-structured interview (Social Cognition-Functional Outcomes Scale ERF-CS), could favor involvement of people with psychosis in their health care, by encouraging motivation and therapeutic alliance. The ERF-CS is composed of 14 items that depict different social situations in which each component of social cognition is likely to have an impact. The scale provides qualitative information on difficulties lived by patients in social situations in the daily life and an overall score of functional outcomes ranging from 0 to 154. The questionnaire took around one hour to complete. Materials and methods For this purpose, a survey was carried out of 16 people with schizophrenia or schizoaffective disorder and the 4 nurses who have conducted the interviews. Symptomatic activity, level of social autonomy and social cognition performances were controlled. Data have been collected thanks to questionnaires proposed to the patients and the caregivers during the 24 hours following the ERF-CS interview. Questions focused on: (1) interest, advantages and disadvantages felt during the interview, (2) the possibility of identifying concrete goals for cognitive remediation after the interview, (3) the motivation for care, and (4) the therapeutic alliance. Concerning advantages and disadvantages of the interview, a thematic analysis has been conducted on patients and nurses comments. Results Results revealed globally more benefits than inconvenient of the ERF-CS. According to both patients and caregivers, it allows a greater awareness of cognitive or functional impairments. A criticism often been expressed by patients and nurses concerns the complexity of some items of the scale. Moreover, professionals pointed both the necessity of a prior training to the interview, and the importance of having strong skills concerning social cognition. The ERC-CS is perceived by the caregivers and patients has a valuable tool for favoring the identification of concrete goals for the intervention, Even if feedbacks of patient population are here not as positive as those of professionals. Results highlighted for both the patients and the nurses a positive impact of the semi-structured interview on direct and indirect motivation. They seem to be both more implicated in the care proposed after the ERF-CS interview. Moreover, the ERF-CS has been judged positively on therapeutic alliance in both populations surveyed. Conclusions This study encourages the use of the ERF-CS interview prior to starting social cognitive remediation therapy. Actually, the scale promotes motivation of patients and caregivers and helps therapists to define concrete goals, which are crucial to ensure the transfer of skills to daily life. The ERF-CS also constitutes a mediating tool promoting the therapeutic alliance between the patient and his/her therapist. However, these results should be confirmed with larger populations of patients and caregivers, working in different teams. To conclude, while this study did not concern specifically people with early psychosis, the ERF-CS interview seems useful to favor involvement of this population in health care. Further studies should consider this assumption. [ABSTRACT FROM AUTHOR]