Experiential but not expressive negative symptoms are associated with social cognition and functioning in schizophrenia –findings of a preliminary study with rehabilitation inpatients and Clinical Research Portfolio

Background: Functional disability represents a significant barrier to recovery in people with schizophrenia, often impacting those in in-patient rehabilitation to the greatest extent. There is evidence that social cognition is an important predictor of functional outcomes but the relationship between social cognition and functioning and other key variables such as symptoms remain unclear. Previous research has examined negative symptoms as a unitary construct. This study aims to clarify whether there is a differential association between experiential and expressive symptoms, functioning and social cognition, and whether experiential negative symptoms mediate a relationship between social cognition and functioning. Methods: 11 participants with schizophrenia or schizoaffective disorder were recruited. Participants were administered a battery of cognitive, social cognition and symptoms measures and an observer rated measure of functioning was completed with a named nurse. Results:. Due to the sample size obtained, data was visually examined and Spearman’s Rho correlations used to estimate effect sizes of linear relationships.. Higher levels of experiential but not expressive negative symptoms appeared to be associated with poorer social cognitive ability and worse functioning.. Due to recruitment challenges, post-hoc exploration of recruitment feasibility was conducted which demonstrated that recruitment figures were poor with only 33% of eligible patients participating. Ward turnover rates were low and indicate long recruitment periods to be necessary to recruit adequate samples Discussion and conclusion: The small sample reflects the difficulty of testing predictors of functioning in people who, by definition, do not readily engage in everyday roles. With acknowledgement of the limited generalisability, these preliminary data suggest a differential association between experiential and expressive negative symptoms and their relationship to functioning and social cognition. This highlights the importance of motivational constructs in determining functioning and may be a potential pathway from social cognition to functioning. Suggestions are made to address the low recruitment rates and increase participation