The relationship between social cognition and bipolar disorder with and without psychotic features

Bipolar disorder (BD) is characterized by both neurocognitive and social cognitive impairments, though research on social cognitive impairments in this population remains still sparse. Existing findings on such impairments generally suggest that individuals with this disorder exhibit deficits in theory of mind and emotional recognition. However, studies on emotional recognition are mixed and some findings have recently suggested that individuals with BD do not exhibit substantial impairments in this domain. Surprisingly, no studies have yet controlled for the presence of psychosis in BD as a moderating factor influencing performance. This is an issue, as individuals with a history of psychotic features (BD+) exhibit additional neurocognitive impairments that are spared in individuals without such a history (BD-). In addition to this, studies on social cognition in schizophrenia (SZ) confirm that both positive and negative symptoms correlate strongly with performance.;The current investigation therefore set out to resolve some of the inconsistencies of previous studies as well as be among the first to separate BD+ and BD- groups, while also examining a third normal control (NC) group for comparison. All groups had 24 participants and did not differ on age, gender, years of education, socioeconomic status, or IQ. Participants with BD were euthymic and had no significant mood episodes in the month prior to assessment. Based on the literature, it was hypothesized that individuals with BD+ would exhibit substantial impairments in emotional recognition compared to controls, while those with BD- have relative sparing. It was also hypothesized that individuals with BD+ would exhibit impairments on social perception, given that this population generally has more functional impairment and cognitive deficits than individuals with BD-. Theory of mind (ToM) was divided into two subtypes: affective ToM and cognitive ToM. Based on preexisting studies, we hypothesized that cognitive, but not affective ToM, would be impaired in both BD groups while affective ToM would only be impaired in the BD+ group.;Three of our four null hypotheses were rejected and suggested that individuals with BD+ do have impairment on social perception and emotional recognition compared to individuals with BD- and controls, while individuals with BD+ and BD- had impairment on cognitive ToM compared to controls. Factor and correlational analyses did not support the structure of the proposed social cognitive constructs, so additional exploratory analyses compared groups on the individual tests. Results suggested that the BD+ group performed poorest on an auditory affect identification task and the Wechsler Adult Intelligence Scale - Third Edition Picture Arrangement subtest (WAIS-III PA), and that both groups did poorly on a cognitive ToM task. The WAIS-III PA and auditory task remained significant after controlling for relevant clinical and symptom rating variables. These results provide additional hypotheses regarding the underlying social cognitive and neurological impairments found in BD, and the unique impairments exhibited by the subset of patients who have a history of psychosis.