Linking Brain and Behavior to Understand Social Cognitive Impairment in Schizophrenia
Social Deficits and Schizophrenia
This condition robs people with schizophrenia of their ability to interact with people and enjoy the company of others.
By Connie Brichford
Medically Reviewed by Niya Jones, MD, MPH
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People with schizophrenia often have problems relating to or socializing with others. Social deficits may be the byproducts of other symptoms of schizophrenia, or they may be a separate schizophrenia symptom, not yet fully understood. Ken Duckworth, MD, medical director of the National Alliance on Mental Illness (NAMI) and an assistant professor at Harvard Medical School in Boston, says, "We don’t have a good way to conceptually organize social deficits."
Schizophrenia symptoms fall into three categories: positive, negative, and cognitive. Social issues appear in each group of symptoms.
- Positive symptoms:Positive symptoms describe those that schizophrenia adds to a person — symptoms that should not be there, like hallucinations and delusions. The positive symptoms of schizophrenia tend to make the general population uneasy, which can interfere with a person's ability to socialize with others.
- Negative symptoms:Negative symptoms reflect the absence of traits and abilities that most other people have. These include: lack of interest in activities, a flat emotional affect, indifference about relationships, and an inability to complete tasks. Duckworth says low motivation, a negative symptom, may be a factor in social deficits; some people are simply not motivated to interact with others.
- Cognitive symptoms:Cognitive symptoms are related to thinking, memory and decision-making processes. "Some people have difficulty organizing their thinking," Duckworth says, and this can affect how they express themselves in social situations.
Schizophrenia and Social Skills Training
Social skills training can help people with schizophrenia learn to overcome social deficits and function more successfully. While classes that focus on illness management or job training are useful, to get the maximum social benefits, a class that focuses on social cognition skills is also necessary. A recent study found that people in a social cognition class became more aware of the facial expressions of others, an essential tool for successful social interaction, than a control group in illness management classes.
Support groups provide a welcoming environment for people who deal with mental illness to get together and share their experiences. Support group members may have advice on how to cope with social deficits, and at the very least will be an understanding audience for people who need to practice expressing themselves, and other social skills.
NAMI offers support groups around the country. It also offers a class called Peer-to-Peer. Taught by mentors who live successfully with mental illness, these classes help people to interact more effectively with care providers and also help them deal with the public.
Other organizations such as Recovery International and , a Web-based community for schizophrenics and their loved ones, also offer a wealth of resources to help people with schizophrenia navigate social situations.
Schizophrenia and Social Skills Training: One-On-One Strategies
Therapists or counselors can also help people with schizophrenia work on their social skills during individualized sessions. Caregivers can then help them practice their skills at home. A study found that participants who practiced what they learned in a real-world setting, with the help of a skills trainer, were better able to apply their learned skills to new situations. This research indicates that using multiple strategies to help with social skills training can help people with schizophrenia successfully overcome social deficits.
However, no two people experience schizophrenia in the same way, according to Duckworth — some will have difficulty coping with social situations, whereas others don't. Duckworth says, "I picture the Olympic rings with the five colors, no two alike.
Video: Cognitive impairment in schizophrenia
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