Document Type
Article
Publication Date
9-1-2025
Abstract
Social cognition is an established mediator between neurocognition and functional outcome in schizophrenia, but there is limited evidence for this model specifically in the early course, which is a critical window for intervention to reduce long-term disability. This study aimed to test the social cognition mediator model in the early course of schizophrenia and identify social cognitive subdomains that may have stronger indirect effects on the relationship between neurocognition and functional outcome. This secondary analysis utilized baseline cognitive and functional outcome data from a cognitive remediation trial for outpatients with early course schizophrenia (N = 102). A path analysis approach was used to compute mediation of social cognition (mediator; composite index and subdomain scores) on the relationship between neurocognition (predictor; composite index) and functional outcome (outcome; composite index). Significant positive associations were observed between neurocognition, social cognition, and functional outcome. As previously observed, the mediation effect of the social cognition composite was significant (p = 0.042). Of the seven social cognitive subdomains, only social inference (p < 0.001) emerged as a significant mediator. Reverse mediation models (mediator; neurocognition) were non-significant. Results suggest that the impact of cognition on functional outcome in the early course occurs, in part, through the impact of neurocognition on social cognition, which subsequently influences functional outcome. In addition, social inference is possibly an important treatment target of functional recovery in the early course of the condition, highlighting a potential future research direction. These findings further support the provision of comprehensive cognitive remediation approaches to facilitate functional recovery.
Keywords
early course, functional outcome, mediation, neurocognition, schizophrenia, social cognition
Language
English
Publication Title
Psychiatry Research
Grant
R01 MH092440
Rights
© 2025 The Authors. This is an Open Access work distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Creative Commons License
This work is licensed under a Creative Commons Attribution 4.0 International License.
Recommended Citation
Kotwani, A., Wojtalik, J. A., Gunzler, D. D., Smith, M. J., Brown, W. J., Honarvar, R. L., ... & Eack, S. M. (2025). Social cognition as a mediator between neurocognition and functional outcome in early course schizophrenia. Psychiatry Research, 351, 116594. https://doi.org/10.1016/j.psychres.2025.116594
Manuscript Version
Final Publisher Version