What is the Role of Social Cognition in the Relationship between Affect Regulation and Positive Symptom Severity in Psychotic Patients?

Abstract

Impaired affect regulation has been associated with positive symptoms in patients suffering a psychotic disorder. Impaired social cognition may be a mechanism responsible for this association. This study examined the mediating and moderating effect of social cognition on the association between affect regulation and positive symptom severity. Eighty-five patients were included. Affect regulation was measured with the SOM-PSY ratio of the DSFM; social cognition was measured with the TAT (scored with the Social Cognition and Object Relations Scale) and the Hinting Task (HT); positive symptom severity was measured using the PANSS. The data collected was analysed using IMB SPSS version 25 with Hayes’s PROCESS macro model 1 and 6. No mediating effect for none of the social cognition measures was found. This study did find that affect regulation was significantly associated with positive symptom severity but only with low levels of Theory of Mind(HT ≤ 17.56). So, instead of the expected mediation effect, a moderation effect of ToM on the relationship between affect regulation and positive symptom severity was found (this relation only accounts for 46% of the participants). Although more research is necessary to understand more about this moderation effect, it does implicate that addressing affect regulation in the treatment of psychotic patients may be effective as do stress-reducing interventions for psychotic patients scoring low on ToM tasks.