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Schizophrenia Research 104 (2008) 255 – 264 www.elsevier.com/locate/schres
Emotional intelligence and social functioning in persons with schizotypy Fabian Aguirre a , Mark J. Sergi b,⁎, Cynthia A. Levy c a Department of Psychology, University of Texas, Austin, TX, USA Department of Psychology, California State University, Northridge, CA, USA Department of Psychology, Alliant International University, San Diego, CA, USA b
c
Received 3 December 2007; received in revised form 9 May 2008; accepted 9 May 2008 Available online 13 June 2008
Abstract The present study is the first to examine emotional intelligence in persons with schizotypy. Over 2100 undergraduates were screened for schizotypy with the Schizotypal Personality Questionnaire – Brief Version. Forty participants identified as persons with high schizotypy and 56 participants identified as persons with low schizotypy completed assessments of emotional intelligence (Mayer–Salovey–Caruso Emotional Intelligence Test), social functioning (Social Adjustment Scale – Self Report), verbal episodic (secondary) memory (California Verbal Learning Test), and executive functioning (Wisconsin Card Sorting Test). Persons high in schizotypy were impaired in overall emotional intelligence and two aspects of emotional intelligence, the ability to perceive emotions and the ability to manage emotions. Persons high in schizotypy were also impaired in three aspects of social functioning: peer relationships, family relationships, and academic functioning. Group differences in verbal episodic (secondary) memory and executive functioning were not observed. For persons with high schizotypy, overall emotional intelligence and two aspects of emotional intelligence, the ability to perceive emotions and the ability to manage emotions, were associated with peer relationship functioning. Overall emotional intelligence was associated with verbal episodic (secondary) memory, but not executive functioning, in persons with high schizotypy. The current findings suggest that emotional intelligence is impaired in persons with schizotypy and that these impairments affect their social functioning. © 2008 Published by Elsevier B.V. Keywords: Emotional intelligence; Social cognition; Social functioning; Schizotypy; Schizophrenia
1. Introduction Social cognition, the ability to construct mental representations about others, oneself, and relations ⁎ Corresponding author. Department of Psychology, California State University, 18111 Nordhoff Street, Northridge, CA 91330-8255, USA. Tel.: +1 818 677 7352; fax: +1 818 677 2829. E-mail address:
[email protected] (M.J. Sergi). 0920-9964/$ - see front matter © 2008 Published by Elsevier B.V. doi:10.1016/j.schres.2008.05.007
between others and oneself (Adolphs, 2001), is impaired in persons with schizophrenia (Green et al., 2005). Relative to healthy persons, schizophrenia patients display impairments in social cognitive domains such as emotion perception (for reviews see Edwards et al., 2002; Kohler and Martin, 2006), social perception (Sergi and Green, 2003; Toomey et al., 2002), relationship perception (Sergi et al., in press), theory of mind (Greig et al., 2004; Roncone et al., 2002), and social
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knowledge (Corrigan and Addis, 1995; Penn et al., 2002). Social cognition's relevance for the functional status of schizophrenia patients is supported by correlational and structural equation modeling analyses that strongly suggest that social cognition mediates relations between neurocognition and social functioning in schizophrenia (e.g., Addington et al., 2006; Brekke et al., 2005; Sergi et al., 2006; Vauth et al., 2004). Emotional intelligence, an aspect of social cognition, concerns one's capacity for emotional processing, the capacity to reason about emotions in oneself and others, and the capacity to use emotion to facilitate thought (Mayer et al., 2002). The Four-Branch Model of emotional intelligence (Table 1; Mayer and Salovey, 1997) identifies four components (branches) of emotional intelligence: perceiving emotions, facilitating thought, understanding emotions, and managing emotions. Studies of non-clinical persons indicate that emotional intelligence assessed with the Mayer–Salovey–Caruso Emotional Intelligence Test (MSCEIT; Mayer et al., 2002) is associated with aspects of social functioning such as relationships with parents, friends, and romantic partners (Lopes et al., 2004), interpersonal effectiveness (Rode et al., 2007), and academic success (Barchard, 2003). Emotional intelligence has received little study in persons with schizophrenia spectrum disorders. While studies of similar emotion processing constructs in schizotypy suggest that attention to one's emotions, identification of one's emotions, and regulation of one's emotions show differential patterns of deficit depending on whether persons are high in positive, negative, or disorganized schizotypy (e.g., Kerns, 2005, 2006), only
Table 1 Overview of the four-branch model of emotional intelligence a Branch
Brief description of the skills involved
Perceiving Emotions (Branch 1)
The ability to perceive emotions in oneself and others, as well as objects, art, stories, music, and other stimuli. Facilitating Thought The ability to generate, use, and feel (Branch 2) emotion as necessary to communicate feelings, or employ them in other cognitive processes. Understanding Emotions The ability to understand emotional (Branch 3) information, how emotions combine and progress through relationship transitions, and to appreciate such emotional meanings. Managing Emotions The ability to be open to feelings, and to (Branch 4) modulate them in oneself and others so as to promote personal understanding and growth. a
From table on page 7 of Mayer et al. (2002).
one schizophrenia study has examined emotional intelligence using the MSCEIT. Eack et al. (2007) used the MSCEIT to examine changes in the emotional intelligence of persons with schizophrenia resulting from Cognitive Enhancement Therapy. However, as that study did not include a comparison group of healthy participants, conclusions about the status of emotional intelligence in persons with schizophrenia were not offered. The study of emotional intelligence in schizophrenia spectrum disorders is likely to increase significantly as the managing emotions branch of the MSCEIT was selected by the investigators of the NIMH Initiative Measurement and Treatment Research to Improve Cognition in Schizophrenia (MATRICS, Green et al., 2004) as the lone measure of social cognition in the MATRICS Consensus Cognitive Battery (Nuechterlein and Green, 2006), a test battery designed for use in clinical trial studies of schizophrenia. Schizotypy is conceptualized as a non-clinical manifestation of the same underlying biological factors that give rise to schizophrenia and other schizophreniaspectrum disorders (Claridge, 1994; Claridge and Beech, 1995). Investigators interested in identifying the key features of schizophrenia value studies of persons with schizotypy (psychometric schizotypes or persons diagnosed with schizotypal personality disorder) because performance impairments in these persons cannot be explained by confounds often present in schizophrenia patients such as antipsychotic medication usage, social isolation, and recurrent hospitalization. Do studies of social cognition in schizotypy indicate that impaired social cognition is a key feature of schizophrenia? The answer appears to depend on the complexity of the social cognitive task. Studies finding impairments in simple emotion recognition abilities (Poreh et al., 1994; Mikhailova et al., 1996; Platek et al., 2005) are matched in number by those finding no differences between schizotypes and comparison participants (Jahshan and Sergi, 2007; Toomey and Schuldberg, 1995; Van't Wout et al., 2004; Waldeck and Miller, 2000). In contrast, most schizotypy studies of theory of mind – a more complex social cognitive skill – observe impairments (e.g., Pickup and Frith, 2001; Pickup, 2006; note the null finding of Jahshan and Sergi, 2007). In fact, schizotypal personality traits appear to be related to deficits in understanding false-beliefs and attributing mental states to others (Langdon and Coltheart, 1999, 2001; Platek et al., 2003a), as well as impairments in the ability to detect deception (Malcolm and Keenan, 2003), appreciate ironical statements (Langdon and Coltheart, 2004), and process information about the self (Platek and Gallup, 2002; Platek et al., 2003b). A similar pattern involving
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simple and more complex social cognitive tasks has also been observed in the first-degree relatives of schizophrenia patients. Relatives of patients are impaired in social perception and theory of mind (Toomey et al., 1999; Janssen et al., 2003) but not in facial affect recognition (Loughland et al., 2004; Kee et al., 2004; Kelemen et al., 2004; Toomey et al., 1999). The primary aim of the present study was to examine emotional intelligence in persons with schizotypy. Undergraduates identified as high or low in schizotypy based on their responses to the Schizotypal Personality Questionnaire – Brief Version (Raine and Benishay, 1995) were administered the Mayer–Salovey–Caruso Emotional Intelligence Test (MSCEIT; Mayer et al., 2002). Although the MSCEIT has been infrequently used in clinical studies, the MSCEIT is a well-established, theory-based measure of emotional intelligence with sound psychometric properties (Mayer et al., 2002). As our review of the literature indicates that persons with schizotypy evidence deficits in more complex social cognitive tasks, we hypothesized that persons high in schizotypy would be impaired in emotional intelligence and its components relative to persons low in schizotypy. The second aim of this study was to examine relations between the emotional intelligence of persons with high schizotypy and aspects of their social and neurocognitive functioning. The Social Adjustment Scale – Self Report (Weissman et al., 1978) was used to assess three aspects of social functioning: academic functioning, relations with peers, and relations with family. As emotional intelligence assessed with the MSCEIT has been associated with social functioning in non-clinical samples (Lopes et al., 2003, 2004), we hypothesized that emotional intelligence would be associated with social functioning in persons with high schizotypy. Executive functioning and verbal episodic (secondary) memory, although only two of many potential areas of cognitive impairment in schizotypy, were selected as neurocognitive constructs because they are often impaired in schizophrenia spectrum disorders. The California Verbal Learning Test (Delis et al., 1983) and the Wisconsin Card Sorting Test (Heaton et al., 1993), used to examine verbal episodic (secondary) memory and executive functioning respectively, are well-recognized measures that are frequently used in studies of schizophrenia. Given the links observed between social cognition and neurocognition in schizophrenia studies (e.g., Sergi et al., 2006; Vauth et al., 2004), we hypothesized that associations between emotional intelligence and neurocognition would be found in persons high in schizotypy.
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2. Method 2.1. Participants Undergraduate students enrolled in lower division psychology courses (N = 2102) were pre-screened for schizotypy with the Schizotypal Personality Questionnaire – Brief Version (SPQ-B; Raine and Benishay, 1995). Of the 79 participants who scored 16 or higher on the SPQ-B, the top 3.8% of the sample, 40 (51%) completed the assessment battery. Of the 170 participants who scored 2 or lower on the SPQ-B, the bottom 8.1% of the sample, 56 (33%) completed the assessment battery. Both groups were mainly comprised of females (persons high in schizotypy: 9 males, 31 females; persons low in schizotypy: 11 males, 45 females); this is consistent with the gender distribution of students enrolled in psychology courses at California State University, Northridge (CSUN). The groups did not differ in age (persons high in schizotypy: mean = 20.3 years, SD = 5.3 years; persons low in schizotypy: mean = 21.5 years, SD = 7.1 years) or education (persons high in schizotypy: mean = 12.8 years, SD = 1.0; persons low in schizotypy: mean = 13.0 years, SD = 1.0 years). All participants agreed to participate in the current study after reading and signing an informed consent form approved by the Standing Advisory Committee for the Protection of Human Subjects at CSUN. 2.2. Procedure Participants in this cross-sectional study were individually administered measures of emotional intelligence (Mayer–Salovey–Caruso Emotional Intelligence Test), verbal episodic (secondary) memory (California Verbal Learning Test), executive functioning (Wisconsin Card Sorting Test-64), and social functioning (Social Adjustment Scale – Self Report). Four research assistants, blind to the schizotypy status of the participants, administered the assessment battery after receiving extensive training in the standardized procedures of each measure. 2.3. Measures 2.3.1. Schizotypy The Schizotypal Personality Questionnaire – Brief Version (SPQ-B; Raine and Benishay, 1995) contains 22 true/false items that assess the cognitive-perceptual, interpersonal, and disorganized aspects of schizotypy. The total score of the SPQ-B has adequate internal consistency (KR-20 = .83, Compton et al., 2007). In
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support of the SPQ-B's concurrent validity, Compton et al. (2007) found that the total score of the SPQ-B was correlated (r = .49) with the total score of the schizotypal personality disorder criteria of the Structured Clinical Interview for DSM-IV Axis II Disorders (First et al., 1996). 2.3.2. Emotional intelligence The Mayer–Salovey–Caruso Emotional Intelligence Test (MSCEIT; Mayer et al., 2002) consists of 141 items and 8 subtests that assess overall emotional intelligence and four components (branches) of emotional intelligence: perceiving emotions, facilitating thought, understanding emotions, and managing emotions. The first branch, perceiving emotions, consists of two subtests that assess the ability to perceive emotions from photographed facial expressions and photographed landscapes or artwork. The second branch, facilitating thought, consists of a sensations subtest and facilitation subtest. Items of the sensations subtest require participants to generate an emotion and then use that emotion in other cognitive processes. For example, “Imagine feeling content on a wonderful day, with terrific news about your job and family. How much is the feeling of contentment like each of the following sensations? Warm? Salty? Purple?” Items of the facilitation subtest require participants to evaluate the usefulness of three different emotions (e.g., happiness, surprise, and sadness) during a specific cognitive task or behavior. For example, “What mood(s) might be helpful to feel when figuring out what caused a fight among three young children?” The third branch, understanding emotions, consists of two subtests that examine the participant's
understanding of how emotions may be combinations of other emotions (blends subtest) and the participant's understanding of how emotions progress during social interactions (changes subtest; e.g., “Matt had been hurt by one of his friends and was feeling angry. Matt told his friend how he felt, and when the friend did it again, Matt became _____.” The choices are 1 = angry; 2 = fearful; 3 = very annoyed; 4 = worried; and 5 = enraged). The fourth branch, managing emotions, consists of two subtests that examine the participant's appreciation for ways of regulating emotions in oneself and others. Participants read vignettes describing interpersonal situations and the emotions produced in the participant or in another person, and then rate the effectiveness of potential strategies for emotion regulation. The split-half reliability coefficients for the MSCEIT suggest moderate to very strong internal consistency (full scale, r = .93; perceiving emotions, r = .91; facilitating thought, r = .79; understanding emotions, r = .80; managing emotions, r = .83; Mayer et al., 2002). The test–retest reliability of the MSCEIT is high (r = .86; Brackett and Mayer, 2001). The four-factor structure of the MSCEIT has been supported by confirmatory factor analyses (Mayer et al., 2002). Studies of non-clinical persons indicate that performance on the MSCEIT is associated with aspects of social functioning such as relationships with parents, friends, and romantic partners (Lopes et al., 2004), interpersonal effectiveness (Rode et al., 2007), and academic success (Barchard, 2003). 2.3.3. Neurocognition and social functioning The measures used to assess neurocognition and social functioning are described in Table 2.
Table 2 Measures of neurocognition and social functioning Measure California Verbal Learning Test (CVLT; Delis et al., 1983)
Construct
Description
Verbal episodic This word list learning task asks participants (secondary) to recall 16 words from four taxonomic memory categories presented over a series of five trials. Participants are later asked to recall words from the list after short and long delays, with and without taxonomic cues. Wisconsin Card Sorting Test Executive Participants use performance feedback to (WSCT; Heaton et al., 1993) functioning match individually presented stimulus cards to one of four key cards based on the shape, number, or color of the symbols on each card. Computer version used. Social Adjustment Scale – Self Report Social This self-report scale assesses several areas of (SAS-SR; Weissman et al., 1978) functioning functioning with questions measuring instrumental and expressive role performance over the past two weeks.
Variables List words recalled in the five learning trials; in the short delay, free recall condition; in the short delay, cued recall condition; in the long delay, cued recall condition. Higher scores indicate greater skill for all variables. Categories completed; cards sorted correctly; perseverative errors. Higher scores indicate greater skill for all variables except for perseverative errors. Academic functioning; peer relationship functioning; family relationship functioning. Lower scores indicate better functioning for all variables.
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2.4. Data analyses Two-tailed t-tests were employed to examine differences between the persons with high and low schizotypy in emotional intelligence, social functioning, and neurocognition. The assumption of equality of variances was met for all t-tests. Correlational analyses were used to examine associations between the varied aspects of emotional intelligence, neurocognition, and social functioning. All correlational analyses used Pearson r coefficients. Cohen's d with pooled standard deviations was used to calculate the effect sizes of differences between the high and low schizotypy groups. Simultaneous regression analysis was used to examine the influence of emotional intelligence on the social functioning of persons with high schizotypy, while controlling for the contribution of neurocognitive factors. 3. Results 3.1. Group differences in emotional intelligence Table 3 displays the participants' performance on the MSCEIT. Persons high in schizotypy, relative to persons low in schizotypy, were impaired in overall emotional intelligence (total score on the MSCEIT, t(94) =
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3.19, p b .005, Cohen's d = 0.67) and two of the four branches of emotional intelligence (perceiving emotions, t(94) = 2.80, p b .01, Cohen's d = 0.58; managing emotions, t(94) =2.88, p = .005, Cohen's d = 0.60). These group differences remained significant after Bonferroni correction to minimize the risk of type I error. A trend level difference was observed between persons with high and low schizotypy for the facilitating thought branch, t(94) = 1.76, p = .08, Cohen's d = 0.37. Persons with high and low schizotypy did not differ in the understanding emotions branch, t(94) = 1.01, p = .32, Cohen's d = 0.21. 3.2. Group differences in social functioning Table 3 also displays the participants' performance on the SAS-SR (higher scores indicate greater impairment). Persons with high schizotypy were impaired relative to those with low schizotypy in all three areas of functioning, even after Bonferroni correction. The academic functioning of persons with high schizotypy was impaired relative to that of persons with low schizotypy, t(94) = − 4.26, p b .001, Cohen's d = 0.90, indicating that they were less able to keep up with schoolwork, less able to attend class regularly, more likely to feel upset at school, and more likely to argue
Table 3 Emotional intelligence, social functioning, and neurocognition of persons with high and low schizotypy Low schizotypy N = 56 Mean (SD) Mayer–Salovey–Caruso Emotional Intelligence Test Perceiving emotions 105.8 (14.3) Facilitating thought 100.3 (12.7) Understanding emotions 93.8 (8.7) Managing emotions 98.5 (9.5) Overall emotional intelligence 100.1 (10.4) Social Adjustment Scale a Academic functioning 9.8 (2.1) Peer relationship functioning 14.7 (2.5) Family relationship functioning 10.4 (2.8) California Verbal Learning Test T1-5 56.1 (7.7) SDFR 11.8 (2.3) SDCR 12.2 (2.4) LDFR 12.2 (2.2) LDCR 12.7 (2.3) Wisconsin Card Sorting Test CSC 48.5 (8.5) PE 8.6 (8.7) CC 3.5 (1.4)
High schizotypy N = 40 Mean (SD)
Schizotypy group main effects df
t
p
d
97.6 (14.0) 95.8 (11.7) 91.9 (9.1) 92.7 (10.0) 93.1 (10.7)
94 94 94 94 94
2.80 1.76 1.01 2.88 3.19
.006 .082 .316 .005 .002
0.58 0.37 0.21 0.60 0.67
12.0 (2.9) 21.5 (5.1) 15.4 (3.7)
94 93 90
−4.26 −8.54 −7.46
b.001 b.001 b.001
0.90 1.90 1.57
57.0 (8.3) 11.7 (2.7) 12.6 (2.6) 12.5 (3.1) 12.8 (2.8)
94 94 94 94 94
−0.52 0.20 −0.71 −0.44 −0.20
.602 .840 .479 .663 .843
0.11 0.04 0.16 0.12 0.04
48.3 (8.1) 8.1 (5.1) 3.6 (1.4)
94 94 94
0.12 0.37 −0.29
.905 .710 .772
0.02 0.07 0.07
a Higher scores indicate greater impairment in social adjustment; T1-5 = Learning Trials 1 through 5; SDFR = Short Delay Free Recall; SDCR = Short Delay Cued Recall; LDFR = Long Delay Free Recall; LDCR = Long Delay Cued Recall; CSC = Cards Sorted Correctly; CC = Categories Completed; PE = Perseverative Errors; df = degrees of freedom; d = effect size calculated pooling the variance of the samples.
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with people at school. Likewise, the peer relationship functioning of persons with high schizotypy was less than that of persons with low schizotypy, t(93) = − 8.54, p b .001, Cohen's d = 1.90, indicating that they more often felt bored or lonely, more often felt uncomfortable around others, socialized with friends less frequently, and had more problems or arguments with friends. The family relationship functioning of persons with high schizotypy was impaired relative to that of persons with low schizotypy, t(90) = − 7.46, p b .001, Cohen's d = 1.57, indicating that they more often experienced conflicts and arguments with family members, more often worried about events in their family, and more often thought that their family had let them down. 3.3. Group differences in neurocognition Table 3 displays the participants' performance on the CVLT and the WCST. Persons high and low in schizotypy did not differ on these assessments of verbal episodic (secondary) memory and executive functioning. 3.4. Emotional intelligence's relationships with social functioning and neurocognition in persons high in schizotypy Table 4 displays the zero order correlations between the aspects of emotional intelligence assessed by the
MSCEIT and the aspects of social functioning measured by the SAS-SR for the persons with high schizotypy. The elements of emotional intelligence that were impaired in persons with high schizotypy – overall emotional intelligence, the branch labeled perceiving emotions, and the branch labeled managing emotions – were significantly associated with peer relationship functioning in the persons with high schizotypy. Associations between the varied aspects of emotional intelligence and the other aspects of social functioning were not significant. Table 4 also displays the zero order correlations between the elements of emotional intelligence assessed by the MSCEIT and the elements of verbal episodic (secondary) memory and executive functioning measured by the CVLT and WCST for the persons with high schizotypy. Emotional intelligence (total score on the MSCEIT) was associated with aspects of verbal episodic (secondary) memory (total words recalled over the five learning trials, words recalled with taxonomic cueing after a 15 min delay) in the persons with high schizotypy, but emotional intelligence was not associated with aspects of executive functioning. The understanding emotions branch of emotional intelligence was associated with several indicators of verbal episodic (secondary) memory and executive functioning in the persons with high schizotypy. The managing emotions branch of emotional intelligence was associated with
Table 4 Zero order correlations between aspects of emotional intelligence and aspects of social functioning and neurocognition for the persons with high schizotypy Mayer–Salovey–Caruso Emotional Intelligence Test Perceiving emotions Social Adjustment Scalea Academic functioning Peer relationship functioning Family relationship functioning CVLT T1-5 SDFR SDCR LDFR LDCR WCST CSC PE CC
− .20 − .46** − .10
Facilitating thought −.05 −.31 −.10
Understanding emotions −.06 −.22 −.27
.30 .09 .02 .00 .10
.23 .10 .14 .17 .11
.28 .39* .25 .36* .42**
− .27 .10 − .24
.08 −.22 .08
.40* −.27 .43**
Managing emotions − .22 − .47** − .25 .38* .20 .34* .30 .32* − .18 .10 − .04
Overall emotional intelligence − .23 − .54** − .24 .45** .27 .24 .27 .32* − .02 − .08 .05
* p b .05; ** p b .01; two-tailed. Higher scores indicate greater social impairment; CVLT = California Verbal Learning Test; T1-5 = Learning Trials 1 Through 5; SDFR = Short Delay Free Recall; SDCR = Short Delay Cued Recall; LDFR = Long Delay Free Recall; LDCR = Long Delay Cued Recall; WCST = Wisconsin Card Sorting Test; CSC = Cards Sorted Correctly; CC = Categories Completed; PE = Perseverative Errors.
a
F. Aguirre et al. / Schizophrenia Research 104 (2008) 255–264 Table 5 Summary of simultaneous regression analysis for variables predicting peer relationship functioning in persons with high schizotypy (N = 37) Variable
B
SE B
Beta
t
p
MSCEIT overall emotional intelligence CVLT T1-5 WCST CSC
−.171
.080
−.391
− 2.14
.04
.061 .018
.101 .095
.114 .032
0.60 0.19
.55 .85
R2 = .13; MSCEIT = Mayer Salovey Caruso Emotional Intelligence Test; CVLT = California Verbal Learning Test; T1-5 = Learning Trials 1 Through 5; WCST = Wisconsin Card Sorting Test; CSC = Cards Sorted Correctly.
several indicators of verbal episodic (secondary) memory in the persons with high schizotypy. Simultaneous regression analysis was used to examine the influence of emotional intelligence on the social functioning of persons with high schizotypy, while controlling for the contribution of neurocognitive factors. The regression analysis (Table 5) indicates that the peer relationship functioning of the persons with high schizotypy, the area of social functioning that evidenced zero order correlations with emotional intelligence, was related to their emotional intelligence (total score on the MSCEIT; p = .04) even when the influence of secondary verbal memory (total words recalled over the five learning trials of the CVLT; p = .55) and executive functioning (cards correct on the WCST; p = .85) was considered, R2 = .13. 4. Discussion Psychometric schizotypes displayed deficits in emotional intelligence relative to persons low in schizotypy. Assessed with the Mayer–Salovey–Caruso Emotional Intelligence Test, persons high in schizotypy were impaired in overall emotional intelligence and two aspects of emotional intelligence, the ability to perceive emotions and the ability to manage emotions. To our knowledge, this study is the first to report impaired emotional intelligence in persons with schizotypy. The current finding of impaired emotional intelligence in schizotypes is consistent with the prior studies of social cognition in schizotypy that have identified impairments in emotion perception and theory of mind (e.g., Langdon and Coltheart, 2004; Pickup, 2006; Platek et al., 2005). The pattern in the literature suggests that schizotypes are impaired in more complex social cognitive skills (e.g., emotional intelligence, theory of mind) that require more than facial affect recognition. While there are limits to our ability to extrapolate from schizotypy findings to the description of schizophrenia, the current
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findings of social cognitive deficits in schizotypes are consistent with the notion that impaired social cognition is a key feature of schizophrenia, not merely the result of the medication treatments or impoverished socialization. Persons high in schizotypy were impaired in their social functioning relative to persons low in schizotypy; they reported impairments in their academic performance and in their relationships with peers and family. This finding is consistent with a previous study from this laboratory with a similar sample of psychometric schizotypes (Jahshan and Sergi, 2007) as well as an earlier study that found that scores on schizotypal personality scales were inversely related to peer, family, and academic functioning as assessed by the Social Adjustment Scale (Melley et al., 2002). The social impairments of the persons with high schizotypy relative to those with low schizotypy suggest that the Schizotypal Personality Questionnaire – Brief, the screening measure used in the current study, was truly identifying schizotypes. Contrary to our expectations, persons high in schizotypy did not differ from those low in schizotypy in executive functioning as assessed with the Wisconsin Card Sorting Test (WCST) or in verbal episodic (secondary) memory as assessed with the California Verbal Learning Test (CVLT). The lack of impairment on the WCST conflicts with studies that have found WCSTbased evidence of executive functioning deficits in schizotypy (e.g., Suhr, 1997; Gooding et al., 1999). In contrast, the lack of impairment on the CVLT is not inconsistent with the mixed findings generated by studies of verbal episodic (secondary) memory in schizotypy (e.g., Jahshan and Sergi, 2007; Lenzenweger and Gold, 2000; Mitropoulou et al., 2002). Emotional intelligence and its elements were associated with neurocognition and social functioning in persons with high schizotypy. Overall emotional intelligence was associated with aspects of verbal episodic (secondary) memory in the persons with high schizotypy. The understanding emotions and managing emotions branches of emotional intelligence were associated with indicators of verbal episodic (secondary) memory and executive functioning in the persons with high schizotypy. Overall emotional intelligence, the branch labeled perceiving emotions, and the branch labeled managing emotions were associated with peer relationship functioning in the persons with high schizotypy. The interpersonal linkages suggested by these findings fit with everyday observations of what cause relationships to succeed or fail. Schizotypes who are less skillful in perceiving emotions in others may make a lesser number of the empathic comments that facilitate
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friendship bonds. Likewise, schizotypes who are less skillful in managing their emotions may be more inclined to express their emotions in words and actions that offend and repel their friends and acquaintances. Role play studies could be conducted to examine these hypothesized impairments in the interpersonal behavior of persons with schizotypy. Growing evidence suggests that social cognitive variables such as emotional intelligence mediate relations between neurocognition and social functioning in schizophrenia (e.g., Addington et al., 2006; Brekke et al., 2005; Sergi et al., 2006; Vauth et al., 2004). Whether such a relationship exists in persons with schizotypy remains an open question. As the current sample was not large enough for structural equation modeling, regression analysis was used to examine whether emotional intelligence influences the social functioning of persons with high schizotypy even when the contribution of neurocognitive factors is considered. The regression analysis showed that the peer relationship functioning of the persons with high schizotypy was related to their emotional intelligence even when the influence of secondary verbal memory and executive functioning was considered, a finding that is consistent with but not direct evidence of emotional intelligence's role as a mediator of relations between neurocognition and social functioning in schizotypy. Studies with larger samples would support the structural equation modeling needed to examine emotional intelligence's potential as a mediator of neurocognition and social functioning in schizotypy. The present study has several limitations. The fact that all participants were undergraduates at a four-year university is problematic for two reasons. One, it limits our ability to generalize the present findings to the broader schizotypy population. Such conclusions would require studies comparing community samples of persons high and low in schizotypy. Two, the homogeneity in the educational attainment of the sample may have restricted the range of neurocognitive abilities in the sample, therefore influencing the lack of neurocognitive differences between the persons with high and low schizotypy. The generalizability of the findings is also limited by the fact that only a percentage of the psychometrically identified persons completed the assessments. Perhaps persons who were amenable to completing the full assessment were somehow different from those who elected not to participate due to apprehension or limited motivation in fulfilling the research participation requirement of their course. Another important limitation of the study is that only select aspects of social cognition and neurocognition were assessed. Although emotional intel-
ligence is gaining importance as a key aspect of social cognition, many other areas of social cognition such as theory of mind, social knowledge, relationship perception, and social context processing were not studied. Likewise, while executive functioning and verbal memory are important areas of neurocognition, they represent only a subset of the many cognitive abilities that allow persons to function well. Future studies of persons with schizotypy should be more comprehensive, assessing many aspects of social cognition and neurocognition. Despite these limitations, the current study adds to the growing number of studies that indicate that schizotypes are impaired in social cognition and social functioning; making a greater argument for social skills interventions designed for schizotypes who may be at risk for developing schizophrenia. In this direction, Liberman and Robertson (2005) found that high school students, identified as schizotypes with the Schizotypal Personality Questionnaire, evidenced improved social skills and functioning and reduced schizotypal traits after participating in an eight-week social skills training program. More studies are needed to determine the intervention components – social cognition, social behaviors, basic cognition – that would maximally reduce the risk of persons with schizotypy for developing schizophrenia. Role of funding source This study was supported by a grant from the National Institute of Health's Bridges to the Doctorate Program (NIH 2R25 GM062019). The NIH had no further role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; and in the decision to submit the paper for publication. Contributors Dr. Sergi designed the study, contributed heavily to the writing of the manuscript, and assisted with the data analyses. Mr. Aguirre wrote the first draft of the manuscript and conducted the statistical analyses. Ms. Levy helped design the study and contributed to the writing of the manuscript. All authors contributed to and have approved the final manuscript. Conflict of interest Dr. Sergi, Mr. Aguirre, and Ms. Levy declare that they have no conflicts of interest. Acknowledgements This study was supported by a grant from the National Institute of Health's Bridges to the Doctorate Program (NIH 2R25 GM062019). The authors thank Saba Borghei, Rebecca Coutin, Leah Kushman, and Karina Shokat-Fadai for their help with participant enrollment and data collection.
References Addington, J., Saeedi, H., Addington, D., 2006. Facial affect recognition: a mediator between cognitive and social functioning in psychosis? Schizophr. Res. 85, 142–150.
F. Aguirre et al. / Schizophrenia Research 104 (2008) 255–264 Adolphs, R., 2001. The neurobiology of social cognition. Curr. Opin. Neurobiol. 11, 231–239. Barchard, K.A., 2003. Does emotional intelligence assist in the prediction of academic success? Educ. Psychol. Meas. 63, 840–858. Brackett, M., Mayer, J.D., 2001. Comparing Measures of Emotional Intelligence. Paper presented at the Third Positive Psychology Summit, Washington, DC. Brekke, J.S., Kay, D.D., Kee, K.S., Green, M.F., 2005. Biosocial pathways to functional outcome in schizophrenia. Schizophr. Res. 80, 213–225. Claridge, G., 1994. Single indicator of risk for schizophrenia: probable fact or likely myth? Schizophr. Bull. 20, 151–168. Claridge, G., Beech, T., 1995. Fully and quasi-dimensional constructions of schizotypy. In: Raine, A., Lenex, T., Mednick, S.A. (Eds.), Schizotypal Personality. Cambridge University Press, New York, pp. 192–216. Compton, M.T., Chien, V.H., Bollini, A.M., 2007. Psychometric properties of the Brief Version of the Schizotypal Personality Disorder Questionnaire in relatives of patients with schizophrenia spectrum disorders and non-psychiatric controls. Schizophr. Res. 91, 122–131. Corrigan, P.W., Addis, I.B., 1995. The effect of cognitive complexity on a social sequencing task in schizophrenia. Schizophr. Res. 16, 137–144. Delis, D.C., Kramer, J.H., Kaplan, E., Ober, B.A., 1983. California Verbal Learning Test (CVLT) manual. Psychological Corporation, New York. Eack, S.M., Hogarty, G.E., Greenwald, D.P., Hogarty, S.S., Keshavan, M.S., 2007. Cognitive enhancement therapy improves emotional intelligence in early course schizophrenia: preliminary effects. Schizophr. Res. 89, 308–311. Edwards, J., Jackson, H.J., Pattison, P.E., 2002. Emotion recognition via facial expression and affective prosody in schizophrenia: a methodological review. Clin. Psychol. Rev. 22, 1267–1285. First, M.B., Gibbon, M., Spitzer, R.L., Williams, J.B.W., Benjamin, L., 1996. The Structured Clinical Interview for DSM-IV Axis II Personality Disorders. Biometrics Research, New York. Gooding, D.C., Kwapil, T.R., Tallent, K.A., 1999. Wisconsin Card Sorting Test deficits in schizotypic individuals. Schizophr. Res. 40, 201–209. Green, M.F., Nuechterlein, K.H., Gold, J.M., 2004. Approaching a consensus cognitive battery for clinical trials in schizophrenia: the NIMH-MATRICS conference to select cognitive domains and test criteria. Biol. Psychiatry 56, 301–307. Green, M.F., Olivier, B., Crawley, J.N., Penn, D.L., Silverstein, S., 2005. Social cognition in schizophrenia: recommendations from the measurement and treatment research to improve cognition in schizophrenia new approaches conference. Schizophr. Bull. 31, 882–887. Greig, T.C., Bryson, G.J., Bell, M.D., 2004. Theory of mind performance in schizophrenia: diagnostic, symptom, and neuropsychological correlates. J. Nerv. Ment. Dis. 192, 12–18. Heaton, R.K., Chelune, G.J., Talley, J.L., Kay, G.G., Curtiss, G., 1993. Wisconsin Card Sorting Test (WCST) Manual – Revised and Expanded. PAR, Odessa, FL. Jahshan, C.S., Sergi, M.J., 2007. Theory of mind, neurocognition, and social functioning in schizotypy. Schizophr. Res. 89, 278–286. Janssen, I., Krabbendam, L., Jolles, J., Van Os, J., 2003. Alterations in theory of mind in patients with schizophrenia and non-psychotic relatives. Acta Psychiatr. Scand. 108, 110–117. Kee, K.S., Horan, W.P., Mintz, J., Green, M.F., 2004. Do the siblings of schizophrenia patients demonstrate affect perception deficits? Schizophr. Res. 67, 87–94.
263
Kelemen, O., Keri, S., Must, A., Benedek, G., Janka, Z., 2004. No evidence for impaired ‘theory of mind’ in unaffected first-degree relatives of schizophrenia patients. Acta Psychiatr. Scand. 110, 146–149. Kerns, J.G., 2005. Positive schizotypy and emotion processing. J. Abnorm. Psychology 114, 392–401. Kerns, J.G., 2006. Schizotypy facets, cognitive control, and emotion. J. Abnorm. Psychology 115, 418–427. Kohler, C.G., Martin, E.A., 2006. Emotional processing in schizophrenia. Cogn. Neuropsychiatry 11, 250–271. Langdon, R., Coltheart, M., 1999. Mentalizing schizotypy and schizophrenia. Cognition 71, 43–71. Langdon, R., Coltheart, M., 2001. Visual perspective taking and schizotypy: evidence for a simulation-based account of mentalizing in normal adults. Cognition 82, 1–26. Langdon, R., Coltheart, M., 2004. Recognition of metaphor and irony in young adults: the impact of schizotypal personality traits. Psychiatry Res. 125, 9–20. Lenzenweger, M.F., Gold, J.M., 2000. Auditory working memory and verbal recall memory in schizotypy. Schizophr. Res. 42, 101–110. Liberman, R.P., Robertson, M.J., 2005. A pilot, controlled skills training study of schizotypal high school students. Verhaltenstherapie 15, 176–180. Lopes, P.N., Salovey, P., Straus, R., 2003. Emotion intelligence, personality, and the perceived quality of social relationships. Pers. Individ. Differ. 35, 641–658. Lopes, P.N., Brackett, M.A., Nexlek, J.B., Schutz, A., Sellin, I., Salovey, P., 2004. Emotional intelligence and social interaction. Soc. Person Soc. Psych. 30, 1018–1034. Loughland, C.M., Williams, L.M., Harris, A.W., 2004. Visual scanpath dysfunction in first degree relatives of schizophrenia probands: evidence for a vulnerability marker? Schizophr. Res. 67, 11–21. Malcolm, S., Keenan, J.P., 2003. My right I: deception detection and hemispheric differences in self-awareness. Soc. Behav. Pers. 31, 767–772. Mayer, J.D., Salovey, P., 1997. What is emotional intelligence? In: Salovey, P., Sluyter, D. (Eds.), Emotional Development and Emotional Intelligence: Educational Implications. Basic Books, New York, pp. 3–31. Mayer, J.D., Salovey, P., Caruso, D.R., 2002. Mayer–Salovey–Caruso Emotional Intelligence Test (MSCEIT): User's Manual. MultiHealth Systems, Inc., Toronto, Canada. Melley, A.H., Oltmanns, T.F., Turkheimer, E., 2002. The Schedule for Nonadaptive and Adaptive Personality (SNAP): temporal stability and predictive validity of the diagnostic scales. Assessment 9, 181–187. Mikhailova, E.S., Vladimirova, T.V., Iznak, A.F., Tsusulkovskaya, E.J., Sushko, N.V., 1996. Abnormal recognition of facial expressions of emotions in depressed patients with major depression disorder and schizotypal personality disorder. Biol. Psychiatry 40, 697–705. Mitropoulou, V., Harvey, P.D., Maldari, L.A., Moriarty, P.J., New, A.S., Silverman, J.M., Siever, L.J., 2002. Neuropsychological performance in schizotypal personality disorder: evidence regarding diagnostic specificity. Biol. Psychiatry 52, 1175–1182. Nuechterlein, K.H., Green, M.F., 2006. Manual of the MATRICS Consensus Cognitive Battery. MATRICS. Assessment Inc., Los Angeles, CA. Penn, D.L., Ritchie, M., Francis, J., Combs, D., Martin, J., 2002. Social perception in schizophrenia: the role of context. Psychiatry Res. 109, 149–159. Pickup, G.J., 2006. Theory of mind and its relation to schizotypy. Cogn. Neuropsychiatry 11, 177–192.
264
F. Aguirre et al. / Schizophrenia Research 104 (2008) 255–264
Pickup, G.J., Frith, C.D., 2001. Schizotypy, theory of mind, and weak central coherence. Schizophr. Res. 49 (Suppl. 1–2), 118. Platek, S.M., Gallup, G.G., 2002. Self-face recognition is affected by schizotypal personality traits. Schizophr. Res. 57, 81–85. Platek, S.M., Critton, S.R., Myers, T.E., Gallup Jr., G.G., 2003a. Contagious yawning: the role of self-awareness and mental state attribution. Cogn. Brain Res. 17, 223–227. Platek, S.M., Myers, T.E., Critton, S.R., Gallup Jr., G.G., 2003b. A left-hand advantage for self description and the effects of schizotypal personality traits. Schizophr. Res. 65, 147–151. Platek, S.M., Fonteyn, L.C.M., Myers, T.E., Izzetoglu, M., Ayaz, H., Li, C., Chance, B., 2005. Functional near infrared spectroscopy reveals differences in self-other processing as a function of schizotypal personality traits. Schizophr. Res. 73, 125–127. Poreh, A.M., Whitman, R.D., Weber, M., Ross, T., 1994. Facial recognition in hypothetically schizotypic college students: the role of generalized poor performance. J. Nerv. Ment. Dis. 182, 503–507. Raine, A., Benishay, D., 1995. The SPQ-B: a brief screening instrument for Schizotypal personality disorder. J. Pers. Disord. 9, 346–355. Rode, J.C., Mooney, C.H., Arthaud-Day, M.L., 2007. Emotional intelligence and individual performance: evidence of direct and moderated effects. J. Organ. Behav. 28, 399–421. Roncone, R., Falloon, R.H., Mazza, M., DeRisio, A., Pollice, R., Necozione, S., Morosini, P., Casacchia, M., 2002. Is theory of mind in schizophrenia more strongly associated with clinical and social functioning than with neurocognitive deficits? Psychopathology 35, 280–288. Sergi, M.J., Green, M.F., 2003. Social perception and early visual processing in schizophrenia. Schizophr. Res. 59, 233–241.
Sergi, M.J., Rassovsky, Y., Nuechterlein, K.H., Green, M.F., 2006. Social perception as a mediator of the influence of early visual processing on functional status in schizophrenia. Am. J. Psychiatry 163, 448–454. Sergi, M.J., Fiske, A.P., Horan, W., Kern, R.S., Kee, K.S., Subotnik, K.L., Nuechterlein, K.H., Green, in press. Development of a measure of relationship perception in schizophrenia. Psychiatry Res. Suhr, J.A., 1997. Executive functioning deficits in hypothetically psychosis-prone college students. Schizophr. Res. 27, 29–35. Toomey, R., Schuldberg, D., 1995. Recognition and judgment of facial stimuli in schizotypal subjects. J. Commun. Disord. 28, 193–203. Toomey, R., Seidman, L.J., Lyons, M.J., Faraone, S.V., Tsuang, M.T., 1999. Poor perception of nonverbal social-emotional cues in relatives of schizophrenic patients. Schizophr. Res. 40, 121–130. Toomey, R., Schuldberg, D., Corrigan, P., Green, M.F., 2002. Nonverbal social perception and symptomatology in schizophrenia. Schizophr. Res. 53, 83–91. Van't Wout, M., Aleman, A., Kessels, R.P., Laroi, F., Kahn, R.S., 2004. Emotional processing in a non-clinical psychosis-prone sample. Schizophr. Res. 68, 271–281. Vauth, R., Rusch, N., Wirtz, M., Corrigan, P.W., 2004. Does social cognition influence the relation between neurocognitive deficits and vocational functioning in schizophrenia? Psychiatry Res. 128, 155–165. Waldeck, T.L., Miller, L.S., 2000. Social skills deficits in schizotypal personality disorder. Psychiatry Res. 93, 237–246. Weissman, M.M., Prusoff, B.A., Thompson, W.D., Harding, P.S., Myers, J.K., 1978. Social adjustment by self-report in a community sample and in psychiatric outpatients. J. Nerv. Ment. Dis. 166, 317–326.