Comparing Social Cognitive Profiles of Autism and Schizophrenia

Background: Autism Spectrum Disorder (ASD) and Schizophrenia (SCZ) are categorically distinct conditions that debilitate functioning and quality of life. Recent genetic, behavioral and neuroimaging data suggest substantial overlap in the social cognitive phenotypes in the two disorders, yet no study to date has systematically examined social cognitive profiles in ASD and SCZ to elucidate patterns of similarity and distinction. Applications of social cognitive treatments developed in SCZ to individuals with ASD show limited efficacy, suggesting critical differences in social cognitive deficits across disorders. Delineating these patterns within matched samples on a common set of standardized tasks is imperative for identifying areas of convergence and divergence that can inform treatment efforts optimized for each disorder.

Objectives: To examine common and distinct features of social cognition in ASD and SCZ, and assess the relative contribution of general cognition to these profiles.

Methods: One hundred adults (46 SCZ, 40 typically developing controls, and 14 ASD) completed tasks of face perception (Benton Test of Facial Recognition), emotion recogntion (Penn Emotion Recognition Task; the ER40) and theory of mind (Cartoon Theory of Mind task; the CToM). We also obtained an estimate of general cognitive ability (the verbal section of The Wide Range Achievement Test), on which the groups did not differ.

Results: The ASD and SCZ groups performed worse than controls on the Benton face task (F(2,98)=6.12, p=.003, h²=.113) and the ER40 (F(2,99)=9.18, p<.001, h²=.159), and a trend emerged for the ASD and control groups to outperform the SCZ group on the CTOM, with no difference occurring between the ASD and control groups (F(2,99)=2.01, p=.14, h²=.40). Direct comparison of ASD and SCZ revealed that the ASD group performed significantly better on the CTOM (d=0.51), while the SCZ group outperformed the ASD group on the Benton face task (d=0.54) and the ER40 (d=0.42). For SCZ, general cognitive ability was significantly correlated with each of our three social cognitive tasks: Benton (r=.38), ER40 (r=.51), CTOM (r=.53). For ASD, however, general cognitive ability did not correlate even minimally with the Benton (r=.01) or the CTOM (r=-.04) and non-significantly with the ER40 (r=.38).

Conclusions: Although both the ASD and SCZ groups generally performed worse than controls across all social cognitive tasks, they differed relative to each other on specific social cognitive abilities. Social cognition may therefore be comprised of distinct components that are differentially affected in ASD and SCZ. Additionally, because estimated IQ was associated with social cognitive performance for the SCZ but not the ASD group, cognitive functioning may contribute to social cognitive impariment in SCZ to a larger degree than in ASD. These distinct patterns of social cognitive deficit suggest that unique factors contribute to social dysfunction in ASD and SCZ, a finding that may help explain why individuals with ASD have derived limited benefit from social cognitive treatments developed for SCZ. Future remediation efforts may demonstrate improved efficacy by addressing disorder-specific areas of impairment.  More data from participants with ASD are currently being collected, and will be included in analyses presented at the conference.