Naked in the Zendo : Stories of Uptight Zen, Wild-Ass Zen, and Enlightenment Wherever You Are

Social functioning deficits have long been a defining feature in schizophrenia, but relatively little research has examined how emotional processes affect social functioning. Studies have shown that perception of emotion in others and understanding and acting on social cues (forms of social cognition) are impaired in schizophrenia (e.g. Edwards et al., 1999; Bellack et al., 1996), and these impairments are associated with worse social functioning (e.g. Ihnen et al., 1998; Kee et al., 2003). Research on emotional processing (i.e., self-reported experience, autonomic indicators, brain activation) in schizophrenia has been mixed, with evidence for both impaired and intact processing (e.g. Kring & Neale, 1996; Paradiso, 2003). No study has yet examined how social cognition and emotional processing interact to influence social functioning in schizophrenia. This dissertation aimed to expand upon our current knowledge of the relationship between social cognition, emotional processing, and social functioning in schizophrenia. Participants were 41 outpatients with DSM-IV schizophrenia or schizoaffective disorder and 32 healthy controls. Each participant was administered measures of emotional processing (self-reports of valence to affective, high arousal stimuli while brain function is measured using fMRI), social cognition (affect discrimination and social inference), and social function (self-reports of social, educational, and occupational function). Results indicated both social cognition and emotional processing were significantly correlated with social functioning, and that emotional processing contributed significantly more variance to social functioning than did social cognition in individuals with schizophrenia. In addition, social cognition did not mediate the influence of emotional processing on social functioning in individuals with schizophrenia or the entire group (including controls) controlling for group status. However, in the entire group, when controlling for group status, emotional processing was a significant mediator in the relationship between social cognition and social functioning. This finding suggests that emotional processing is an important factor that is closely related to social functioning outcomes in schizophrenia. Further studies are needed to examine the exact nature and direction of the relationship between emotional processing components and social functioning components, as well as the interaction between these components and social cognition by using more powerful tests of mediation, such as SEM.