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Neurocognitive and Metacognitive Profiles of Intact Social Cognition in Prolonged Schizophrenia

James, Alison V., PsyD*; Johannesen, Jason K., PhD†‡; Lysaker, Paul H., PhD§∥

The Journal of Nervous and Mental Disease: December 2018 - Volume 206 - Issue 12 - p 907–912
doi: 10.1097/NMD.0000000000000900
Original Article

Social cognition (SC) appears to contribute to long-term outcomes in schizophrenia; however, little is known about whether different forms of SC are supported by the same cognitive processes. Accordingly, we examined the relationship of two domains of SC: emotion recognition (ER), using the Bell-Lysaker Emotion Recognition Test, and social inference (SI), using the Social Attribution Task–Multiple Choice, to measures of neurocognition, metacognition, theory of mind (ToM), and symptoms. Participants were 72 adults with schizophrenia in a nonacute phase. Multivariate analysis of variance and univariate analysis of variance revealed participants with intact ER had better neurocognition (MATRICS Consensus Cognitive Battery [MCCB]), metacognition (Metacognition Assessment Scale–Abbreviated), ToM (The Hinting Task), and higher emotional discomfort symptoms than participants with impaired scores. Participants with intact SI had higher MCCB visual and verbal learning and SC scores. Stepwise regressions revealed neurocognition and metacognition uniquely contribute to ER performance. Results suggest ER and SI are differentially related to cognitive processes.

*Department of Psychiatry, Kaiser Permanente, Redwood City, California;

Department of Psychiatry, Yale University School of Medicine, New Haven;

Psychology Service 116-B, VA Connecticut Health Care System, West Haven, Connecticut;

§Roudebush VA Medical Center; and

Department of Psychiatry, Indiana University School of Medicine, Indianapolis, Indiana.

Send reprint requests to Paul H. Lysaker, PhD, Roudebush VA Med Center (116H), Roudebush VA Medical Center, 1481 West 10th Street, Indianapolis, IN 46202. E-mail:

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