The relationship of neurocognitive and social cognitive performance to social competence and appropriateness on a performance-based social skills assessment in individuals with psychosis and unaffected controls

Social deficits are common in psychosis. The Social Skills Performance Assessment (SSPA) is a performance-based measure used to approximate an individual's social skills. Those with psychosis perform worse than do unaffected controls. Prior work has examined two social skills domains derived from the SSPA: social competence and social appropriateness. Social competence and appropriateness are associated with neurocognition and functioning outcomes. However, no study to date has examined the relationship of social cognition to social competence and appropriateness. We aimed to examine the relationships among different aspects of social cognition and performance-based social functioning and hypothesized that social cognitive performance would be related to social competence and appropriateness. We also hypothesized that after controlling for neurocognition, social cognition would account for unique variance in social competence and appropriateness in separate regression models. Forty-one participants who had experienced psychosis and 42 unaffected controls completed a comprehensive battery of neurocognitive, social cognitive, and social functioning measures. Social competence was associated with neurocognition and some aspects of social cognition, while social appropriateness was only marginally associated with neurocognition. Regression models revealed that social cognition did not account for additional and unique variance in social competence or appropriateness, after adjusting for demographic covariates and neurocognition. Findings suggest that aspects of social functioning performance are differentially related to neurocognitive and social cognitive skills. Social skill interventions may be most effective when targeting both neurocognitive and social cognitive skills in treatment.