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Summary: Researchers have identified a brain function that could transform the way schizophrenia is treated, focusing on social inference, the ability to interpret social cues and intentions. The study found that strengthening this skill early can help young patients regain independence and prevent long-term cognitive decline.
Rather than relying solely on memory or attention training, social inference programs that use structured exercises and games can produce greater improvements in daily functioning. This advance could lead to personalized and community-based treatments that help patients recover faster and reintegrate into society.
Key facts:
Social inference approach: Researchers found that improving the brain’s ability to “read between the lines” in social situations increases functional recovery. Early intervention: Focusing on this skill during the early stages of schizophrenia could prevent long-term disability. New therapeutic approach: Structured social training programs can outperform traditional cognitive treatments focused on memory or attention.
Source: Case Western Reserve
Researchers at Case Western Reserve University’s Jack, Joseph and Morton Mandel School of Applied Social Sciences have discovered a target in brain function that could change the way patients with schizophrenia are treated.
“We’ve been treating schizophrenia with a one-size-fits-all approach for decades,” said Jessica Wojtalik, an assistant professor at Case Western Reserve’s Jack, Joseph and Morton Mandel School of Applied Social Sciences.
“We now have a specific target that could help young patients get back to their lives much faster.”
Their findings were recently published in Psychiatry Research.
Most mental health problems, including schizophrenia, a serious mental illness that affects the way people think, feel and behave, begin in adolescence, when their brains are still developing and can be easily damaged, according to the National Institute of Mental Health.
When mental illness occurs during this critical transition from childhood to adulthood, it can cause lifelong struggles in school, with friendships, and controlling emotions and actions—problems that often last well into adulthood.
The main factor in determining whether patients can function in daily life is known as social inference skills: the ability to “read between the lines” in social situations. The researchers identified how this brain function can be targeted independently for treatment, and that early intervention during this critical window could prevent long-term damage.
“Think of social inference as your brain’s social detective work,” said the study’s lead researcher, Anju Kotwani, a doctoral student at the Mandel School. “It’s how you find out what someone really means when they say ‘fine’ in a certain tone or how to tell when someone is being sarcastic or serious.”
Researchers found that teaching patients to better understand social cues through targeted training programs consisting of structured computer games or worksheets could be more effective than traditional approaches that focus solely on memory and attention skills.
The study of 102 patients revealed that social cognition (the brain’s ability to understand and navigate social interactions) acts as the crucial bridge between basic thinking skills and functioning in daily life during the critical early stages of schizophrenia.
The researchers call for the development of training programs in social inference for young people with early-stage schizophrenia to be made available to their communities. “Addressing both thinking skills and social understanding offers the best hope for functional recovery in early schizophrenia,” Kotwani said.
Key questions answered:
A: They identified social inference (the brain’s ability to interpret tone, context, and social cues) as a key skill that determines how well patients function in daily life.
A: Because schizophrenia typically develops during adolescence, strengthening social cognition early could reduce the long-term impact on education, relationships, and emotional control.
A: It suggests moving away from generalized approaches based solely on medication and toward personalized cognitive training that fosters social understanding through interactive, skills-based programs.
About this research news on schizophrenia
Author: William Lubinger
Source: Case Western Reserve
Contact: William Lubinger – Case Western Reserve
Image: Image is credited to Neuroscience News.
Original research: Open access.
“Social cognition as a mediator between neurocognition and functional outcome in early course schizophrenia” by Jessica Wojtalik et al. Research in psychiatry
Abstract
Social cognition as a mediator between neurocognition and functional outcome in early course schizophrenia
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 mediating model of social cognition 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 used baseline cognitive and functional outcome data from a cognitive remediation trial for outpatients with early-onset schizophrenia (N = 102).
A path analysis approach was used to estimate the 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 not significant.
The 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.
Furthermore, social inference is possibly an important target of functional recovery treatment in the early course of the disease, highlighting a possible future research direction.
These findings further support the provision of comprehensive cognitive remediation approaches to facilitate functional recovery.
