Contents lists available at ScienceDirect Psychiatry Research journal homepage: www.elsevier.com/locate/psychres Neuro-cognition and social cognition elements of social functioning and social quality of life Ilanit Hasson-Ohayon a, ⁎ , Michal Mashiach-Eizenberg b , Nitzan Arnon-Ribenfeld a , Shlomo Kravetz a , David Roe c a Department of Psychology, Bar Ilan University, Ramat Gan, Israel b Department of Health System Management, Max Stern Academic College of Emek Yezreel, Israel c Department of Community Mental Health, Faculty of Social Welfare and Health Sciences University of Haifa, Haifa, Israel ARTICLE INFO Keywords: Serious mental illness Social-cognition Neuro-cognition Social functioning Social quality of life ABSTRACT Previous studies have shown that deficits in social cognition mediate the association between neuro-cognition and functional outcome. Based on these findings, the current study presents an examination of the mediating role of social cognition and includes two different outcomes: social functioning assessed by objective observer and social quality of life assessed by subjective self-report. Instruments measuring different aspects of social cog- nition, cognitive ability, social functioning and social quality of life were administered to 131 participants who had a diagnosis of a serious mental illness. Results showed that emotion recognition and attributional bias were significant mediators such that cognitive assessment was positively related to both, which in turn, were nega- tively related to SQoL. While one interpretation of the data suggests that deficits in emotion recognition may serve as a possible defense mechanism, future studies should re-assess this idea. 1. Introduction Research has shown that persons with serious mental illness (SMI) experience a decreased social quality of life (SQoL) and social func- tioning compared to people without SMI (e.g. Ulas et al., 2008). This lower SQoL and functioning are attributed to deficits in social cognition that includes attribution errors, theory of mind (TOM), and emotion recognition abilities (Brüne et al., 2011; Penn et al., 2008). These def- icits impede their ability to accurately identify the emotions of others, leading them to make faulty attributions regarding other people's be- haviors as well as faulty inferences about others' thinking and inten- tions (Augoustinos et al., 2006; Penn et al., 2008). In addition, deficits in their neuro-cognitive abilities to plan and perform goal-based ac- tivities (e.g. verbal and visual memory as well as executive functions) are also thought to account for the low SQoL and social functioning (e.g. Schmidt et al., 2011; Sergi et al., 2007; Green et al., 2000). Empirical studies as well as research in neuro-imaging suggests that neuro-cognition and social cognition are related yet distinct in their contribution to outcome (Allen et al., 2007; Brunet-Gouet and Decety, 2006; Pinkham et al., 2008). In addition, social cognition has been found to mediate the association between neuro-cognition and func- tional outcomes (Bell et al., 2009; and reviews of Couture et al. (2006) and Schmidt et al. (2011)). According to this mediation, cognitive ability increases social cognition which in turn increases functional outcomes (Schmidt et al., 2011). Notably, the abovementioned studies measured general functional outcomes such as GAF (e.g. Schmidt et al., 2011) or more specific ones such as vocational performance (e.g. Bell et al., 2009), which reflects relatively objective measures of functioning. To gain a more complete understanding of the complex patterns between neuro-cognition, social cognition and outcome, however, it is necessary to study also subjective outcomes which are considered distinct yet related and complementary to the often assessed objective ones (Silverstein and Bellack, 2008; Roe et al., 2011). Thus, while social functioning refers to the social skills one has in order to perform a variety of social roles (Priebe, 2007), SQoL refers to the level of satisfaction one has with regard to his or her social network and activity and is considered an important domain of the overall quality of life construct (Connell et al., 2014). Thus, SQoL presents a subjective appraisal of ones' social activity and status based on positive aspects such as feeling belongings, fitting in with society and negative aspects such as being in a relationship where constantly criticized and stigmatization (Connell et al., 2014). Studies on SQoL among persons with SMI revealed lower SQoL than people without SMI and that this lower SQoL is related to aspects of metacognition and social cognition (Hasson-Ohayon et al., 2014; Ofir-Eyal et al., 2014). In addition to the significant illness burden (Nordstroem et al., 2017), it http://dx.doi.org/10.1016/j.psychres.2017.09.004 Received 7 January 2017; Received in revised form 13 July 2017; Accepted 5 September 2017 ⁎ Corresponding author. E-mail address: ilanithasson@gmail.com (I. Hasson-Ohayon). Psychiatry Research 258 (2017) 538–543 Available online 06 September 2017 0165-1781/ © 2017 Elsevier B.V. All rights reserved. MARK