University Of Texas At Dallas Professor On Global Effort To Unify Schizophrenia Assessment
A psychology professor from The University of Texas at Dallas has been chosen by the Schizophrenia International Research Society (SIRS) to convene a worldwide team of researchers to determine ways of measuring social cognition in schizophrenia that can be used cross-culturally.
“Social cognition is the process by which you understand other people,” Pinkham said. “How people interact is a big part of what defines a culture. We need to find a way to measure this in comparable ways across cultures where there are differences in norms and expectations.
“This award puts our group at the forefront of social cognition research. It’s a huge amount of work, but I think it’s work that can be really impactful if we do it well.”
For patients affected by psychosis, social cognition relates strongly to functional outcomes. Improving how well a patient understands the world and people around them in turn improves their day-to-day life.
“The problem with measuring social cognition is that we still don’t have a great universal measure,” Pinkham said. “All the people doing work in this area, from country to country, use very different measures, and very few of those measures are being translated and validated in other cultures.”
“This award puts our group at the forefront of social cognition research. It’s a huge amount of work, but I think it’s work that can be really impactful if we do it well.”
Dr. Amy Pinkham, professor of psychology in the School of Behavioral and Brain Sciences
Two examples help illustrate the problem. To test emotion recognition — one of the core aspects of social cognition — researchers show subjects pictures of someone’s face or a video of somebody expressing emotion. In the vast majority of the photos or videos, the people are white, she said, because that’s the demographic creating the tests.
“Even the best of these exercises becomes limited when transported to an Asian or African country, because we know it’s more difficult to process faces of another race relative to one’s own race,” Pinkham said.
The ability to understand behavior in terms of intentions or mental states — called mentalizing — is another key factor in social cognition. To assess this, researchers use hinting tasks: A story is told about an exchange between two people with questions at the end asking about the subtext of what someone said or hinted at.
“For example, saying ‘Couldn’t you find the Ajax?’ might mean that the bathtub is dirty, or saying ‘I wanted to wear this shirt, but it’s awfully wrinkled’ could mean the person wants it ironed,” Pinkham said. “The ability to detect and decode these hints is important, but the social context of each story might not fit what’s normative in another culture. Beyond that, even knowledge of what Ajax is can vary from culture to culture, and that can significantly alter one’s ability to decode the hint.”
Pinkham is the convener for the project; co-conveners are Dr. T.B. (Tim) Ziermans of the University of Amsterdam and Dr. Michal Hajdúk of Comenius University in Bratislava, Slovakia. Hajdúk was a Fulbright Fellow at UT Dallas in 2017. Members of their group represent seven countries and a wide range of career stages, and include two experiential experts — people with lived experience as consumers of mental health services who advocate for individuals with mental illness.
“We’re not setting out to design a new measure. Instead, we are surveying a wide range of researchers on what they think is the best current measure; what might be a suitable, translatable measure; and what biggest hurdles need to be tackled,” Pinkham said.
Finding a way to compare and combine results is increasingly important as schizophrenia research, like many other fields, moves toward utilizing big data to its fullest extent. Large data sets combined across studies yield much larger samples and more robust conclusions, but researchers run into roadblocks because of the variety of measurements being used.
“The goal, like with most scientific research, is to have results that apply to as many people as possible,” Pinkham said. “Ultimately, we need to be able to draw broad conclusions about the meaningfulness of social cognition across cultures and across diagnoses, but we need to know how to assess it.”
She also said that the usefulness of a standardized assessment for social cognition would go beyond schizophrenia research.
“Though this award is from the SIRS, we recognize that social cognition is something that’s important across many disorders, like autism and mood and anxiety disorders,” she said. “We’re interested in assessments that may be useful trans-diagnostically, too, and we believe that there’s real potential to borrow from other disciplines to find something suitable for cross-cultural comparisons.”