Domain-specific associations between social cognition and aggression in schizophrenia spectrum disorders

Aggression in schizophrenia spectrum disorders (SSD) is rare but elevated relative to the general population. Existing studies have not identified reliable personal predictors of aggression in SSD. In line with social information processing models suggesting that difficulties interpreting social cue...

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Main Authors: Sarah A. Berretta, Lindsay D. Oliver, Courtland S. Hyatt, Ricardo E. Carrión, Katrin Hänsel, Aristotle Voineskos, Robert W. Buchanan, Anil K. Malhotra, Sunny X. Tang
Format: Article
Language:English
Published: Elsevier 2025-09-01
Series:Schizophrenia Research: Cognition
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Online Access:http://www.sciencedirect.com/science/article/pii/S2215001325000198
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author Sarah A. Berretta
Lindsay D. Oliver
Courtland S. Hyatt
Ricardo E. Carrión
Katrin Hänsel
Aristotle Voineskos
Robert W. Buchanan
Anil K. Malhotra
Sunny X. Tang
author_facet Sarah A. Berretta
Lindsay D. Oliver
Courtland S. Hyatt
Ricardo E. Carrión
Katrin Hänsel
Aristotle Voineskos
Robert W. Buchanan
Anil K. Malhotra
Sunny X. Tang
author_sort Sarah A. Berretta
collection DOAJ
description Aggression in schizophrenia spectrum disorders (SSD) is rare but elevated relative to the general population. Existing studies have not identified reliable personal predictors of aggression in SSD. In line with social information processing models suggesting that difficulties interpreting social cues and others' intentions may lead to aggression, we evaluated whether social cognitive domains or global social cognition could be modifiable risk factors in SSD.We examined aggression and social cognition in 59 participants with SSD and 43 healthy volunteers (HV). Self-reported aggression was measured via the Reactive-Proactive Aggression Questionnaire (RPAQ). Social cognition was assessed using five tasks measuring emotion processing, theory of mind, and social perception. Group differences were analyzed using Mann-Whitney-Wilcoxon tests. Multiple regressions examined effects of social cognition on aggression, controlling for demographic and clinical covariates. Supplemental mediation analyses tested whether impairments in emotion processing, theory of mind, or overall social cognition explained the relationship between SSD diagnosis and increased aggression.Reported aggression was higher in the SSD group, and social cognitive abilities were impaired across domains (p < .001). Better emotion processing (β = −0.35, p = .03) and theory of mind (β = −0.32, p = .03) predicted lower aggression in SSD, even when accounting for demographic and neurocognitive variables. Exploratory models adjusting for overall psychiatric symptom severity showed that theory of mind remained significant, while emotion processing attenuated. However, social cognition did not mediate the relationship between diagnosis and aggression. Future studies should examine other social processing factors, such as attributional bias.
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spelling doaj-art-d3fdf086bfaf4bb5a060cb7055cbc91b2025-08-20T03:47:09ZengElsevierSchizophrenia Research: Cognition2215-00132025-09-014110036110.1016/j.scog.2025.100361Domain-specific associations between social cognition and aggression in schizophrenia spectrum disordersSarah A. Berretta0Lindsay D. Oliver1Courtland S. Hyatt2Ricardo E. Carrión3Katrin Hänsel4Aristotle Voineskos5Robert W. Buchanan6Anil K. Malhotra7Sunny X. Tang8School of Behavioral and Brain Sciences, The University of Texas at Dallas, Richardson, TX, USA; Institute of Behavioral Science, Feinstein Institutes for Medical Research, Manhasset, NY, USA; Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA; Corresponding author at: School of Behavioral and Brain Sciences, The University of Texas at Dallas, Richardson, TX, USA.Centre for Addiction and Mental Health, University of Toronto, Toronto, Ontario, CanadaDepartment of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USAInstitute of Behavioral Science, Feinstein Institutes for Medical Research, Manhasset, NY, USAInstitute of Behavioral Science, Feinstein Institutes for Medical Research, Manhasset, NY, USACentre for Addiction and Mental Health, University of Toronto, Toronto, Ontario, CanadaMaryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, MD, USADepartment of Psychiatry, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA; Institute of Behavioral Science, Feinstein Institutes for Medical Research, Manhasset, NY, USA; Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USADepartment of Psychiatry, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA; Institute of Behavioral Science, Feinstein Institutes for Medical Research, Manhasset, NY, USA; Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USAAggression in schizophrenia spectrum disorders (SSD) is rare but elevated relative to the general population. Existing studies have not identified reliable personal predictors of aggression in SSD. In line with social information processing models suggesting that difficulties interpreting social cues and others' intentions may lead to aggression, we evaluated whether social cognitive domains or global social cognition could be modifiable risk factors in SSD.We examined aggression and social cognition in 59 participants with SSD and 43 healthy volunteers (HV). Self-reported aggression was measured via the Reactive-Proactive Aggression Questionnaire (RPAQ). Social cognition was assessed using five tasks measuring emotion processing, theory of mind, and social perception. Group differences were analyzed using Mann-Whitney-Wilcoxon tests. Multiple regressions examined effects of social cognition on aggression, controlling for demographic and clinical covariates. Supplemental mediation analyses tested whether impairments in emotion processing, theory of mind, or overall social cognition explained the relationship between SSD diagnosis and increased aggression.Reported aggression was higher in the SSD group, and social cognitive abilities were impaired across domains (p < .001). Better emotion processing (β = −0.35, p = .03) and theory of mind (β = −0.32, p = .03) predicted lower aggression in SSD, even when accounting for demographic and neurocognitive variables. Exploratory models adjusting for overall psychiatric symptom severity showed that theory of mind remained significant, while emotion processing attenuated. However, social cognition did not mediate the relationship between diagnosis and aggression. Future studies should examine other social processing factors, such as attributional bias.http://www.sciencedirect.com/science/article/pii/S2215001325000198PsychosisSchizophreniaAggressionSocial cognitionEmotion processingTheory of Mind
spellingShingle Sarah A. Berretta
Lindsay D. Oliver
Courtland S. Hyatt
Ricardo E. Carrión
Katrin Hänsel
Aristotle Voineskos
Robert W. Buchanan
Anil K. Malhotra
Sunny X. Tang
Domain-specific associations between social cognition and aggression in schizophrenia spectrum disorders
Schizophrenia Research: Cognition
Psychosis
Schizophrenia
Aggression
Social cognition
Emotion processing
Theory of Mind
title Domain-specific associations between social cognition and aggression in schizophrenia spectrum disorders
title_full Domain-specific associations between social cognition and aggression in schizophrenia spectrum disorders
title_fullStr Domain-specific associations between social cognition and aggression in schizophrenia spectrum disorders
title_full_unstemmed Domain-specific associations between social cognition and aggression in schizophrenia spectrum disorders
title_short Domain-specific associations between social cognition and aggression in schizophrenia spectrum disorders
title_sort domain specific associations between social cognition and aggression in schizophrenia spectrum disorders
topic Psychosis
Schizophrenia
Aggression
Social cognition
Emotion processing
Theory of Mind
url http://www.sciencedirect.com/science/article/pii/S2215001325000198
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