title: Social competence versus negative symptoms as predictors of real world social functioning in schizophrenia.
abstract: Deficits in real world social functioning are common in people with schizophrenia and the treatment of social skills deficits has been a long-time treatment strategy. However, negative (i.e., deficit) symptoms also appear to contribute to real-world social dysfunction. In this study, we combined data from three separate studies of people with schizophrenia (total n=561) who were assessed with identical methods. We examined the prediction of real-world social functioning, rated by high contact clinicians, and compared the influence of negative symptoms and social skills measured with performance-based methods on these outcomes. Negative symptom severity accounted for 20% of the variance in real-world social functioning, with social skills adding an incremental 2%. This 2% variance contribution was the same when social skills were forced into a regression model prior to negative symptom severity. When we examined individual negative symptoms, prediction of real-world social functioning increased to 28%, with active and passive social avoidance entering the equation. Adding depression into the predictor model improved the prediction of real-world social functioning significantly, but minimally (4% variance). Social skills contribute to real-world social outcomes, but treating negative symptoms appears to be a possible path for improving real-world social functioning in this population.
authors.affiliation: University of Miami Miller School of Medicine, United States.
authors.forename: Belinda R
authors.initials: BR
authors.lastname: Robertson
authors.affiliation: University of Miami Miller School of Medicine, United States; University of Genoa, Italy.
authors.forename: Davide
authors.initials: D
authors.lastname: Prestia
authors.affiliation: University of California, San Diego Department of Psychiatry, United States; Center of Excellence for Stress and Mental Health, VA San Diego Healthcare System, United States.
authors.forename: Elizabeth W
authors.initials: EW
authors.lastname: Twamley
authors.affiliation: University of California, San Diego Department of Psychiatry, United States.
authors.forename: Thomas L
authors.initials: TL
authors.lastname: Patterson
authors.affiliation: Queens University, Ontario, Canada.
authors.forename: Christopher R
authors.initials: CR
authors.lastname: Bowie
authors.affiliation: University of Miami Miller School of Medicine, United States; Research Service, Bruce W. Carter VA Medical Center, Miami, FL, United States. Electronic address: Philipdharvey1@cs.com.
authors.forename: Philip D
authors.initials: PD
authors.lastname: Harvey
mesh_terms: D000328:Adult; D015331:Cohort Studies; D003863:Depression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008960:Models, Psychological; D011569:Psychiatric Status Rating Scales; D011618:Psychotic Disorders / Q000175:diagnosis* / Q000523:psychology*; D012044:Regression Analysis; D012559:Schizophrenia / Q000175:diagnosis*; D012565:Schizophrenic Psychology; D012917:Social Adjustment; D066107:Social Skills
keywords: Negative symptoms; Schizophrenia; Social competence; Social functioning