Adults with a history of childhood trauma often experience impairments in social cognition, but these difficulties are rarely therapeutically targeted. We designed ‘SOCIAbLE’ as a novel virtual reality (VR)-assisted intervention to improve social cognitive functioning and real-world social function in adults with childhood trauma histories.

This single-arm proof-of-concept study evaluated the feasibility, acceptability, and preliminary outcomes of the SOCIAbLE intervention. Adults with a history of early-life adversity and ongoing social difficulties completed eight weekly one-hour intervention sessions combining psychoeducation, cognitive-behavioral strategies, and immersive VR role-play, targeting social cognition. Outcome assessments were conducted at baseline, 6, 12 (end of treatment), and 18 weeks. Acceptability was assessed based on post-intervention qualitative interviews.

Of 32 participants who completed baseline, n = 25 completed the full 8-week intervention; n = 23 completed the 12-week intervention, and n = 24 completed the 18-week follow-up assessments. Improvements relative to baseline were observed at 12 weeks on both our primary (BLERT emotional recognition: g = 1.04) and secondary outcome measures, which persisted at 18 weeks. Data from qualitative interviews (n = 24) indicated a high level of intervention acceptability to participants, highlighting perceived gains in confidence, self-awareness, and real-world social functioning.

In this pilot study, SOCIAbLE was observed to be feasible and acceptable and showed preliminary evidence of benefits to social cognition, clinical symptoms, and social functioning. These data suggest that immersive VR-assisted interventions warrant further investigation in a full randomized controlled trial as a potentially effective, engaging way to target social cognitive difficulties in adults with a history of CT.

Cognitive complaints in body dysmorphic disorder (BDD) remain poorly characterized. This study examined subjective cognitive complaints across clinical and community BDD samples.

A two-stage exploratory design was used. Study 1 included a clinically diagnosed BDD sample (n = 15) and healthy controls (n = 29). Study 2 comprised a large international community sample reporting clinically significant BDD symptoms (N = 433). Participants completed BodyThink, an exploratory BDD-focused measure of subjective cognitive complaints. In Study 1, additional clinical and performance-based cognitive measures contextualized subjective reports.

Across both studies, endorsed items spanned multiple cognitive domains, with processing speed, attention, memory, executive functioning, and social cognition items consistently reported. Processing speed complaints were particularly salient. In Study 1, individuals with BDD reported markedly elevated cognitive complaints relative to controls, with large group differences (d = 1.64–1.95) on both BodyThink and an established measure of subjective cognition. Cognitive complaints showed a preliminary association with perceived social self-efficacy (ρ = −.71) but not with BDD symptom severity, objective cognitive performance, or emotional distress. Across both samples, social cognition items were disproportionately endorsed during symptom exacerbation.

Individuals with BDD reported markedly elevated cognitive complaints relative to controls, with substantial individual variation. Patterns were broadly consistent across symptom severity, with social cognition difficulties showing greater salience during symptom exacerbation. The variability in complaints highlights the importance of individualized assessment, while associations with perceived social self-efficacy suggest that cognitive complaints may reflect negatively biased self-appraisals that may be relevant to treatment engagement.

Poor social function in people with psychosis has been linked to impairments in social cognition and neurocognition, which in turn have been identified as promising treatment targets. We developed a novel social cognitive intervention, Understanding Social Situations (USS), that minimizes cognitive load by leveraging delivery methods common to cognitive rehabilitation. USS focuses on making good judgments about what others may be feeling and thinking, and how they might respond in various social scenarios. In the current trial, we evaluated the efficacy of USS versus an active control.

103 Veterans with psychotic spectrum disorders were randomized to two months of USS training or a problem-solving training matched for nonspecific treatment factors. Comprehensive assessments included clinician-aided self-report social functioning, social skills performance, and pre/post/follow-up ecological momentary assessments about the extent and quality of social interactions.

Participants in USS had significant within but not between group improvements on a clinician-aided self-report measure of social function. Social skills performance did not change for either condition. Momentary assessments revealed no change in frequency of social contacts, but those in the USS condition showed within-group improvements on comfort level during current social interactions and anticipated positive appraisals of future interactions. Those randomized to problem-solving training had significantly greater improvements in depression at post-training.

More rigorous trials are needed evaluating the impact of social cognitive interventions on real-world social functioning. It may be particularly important to link interventions to lived social experience and to assess the quality of social interactions.

Difficulties with social cognition, particularly with mentalising, have been hypothesised to increase the risk of, and affect recovery from, trauma and post-traumatic stress disorder (PTSD). We lack a comprehensive picture of the nature of social cognitive impairments in people with PTSD.

To assess whether variation in social cognition is associated with trauma and PTSD.

Ninety-eight participants with PTSD symptoms and 99 controls were recruited from tertiary PTSD services and the Prolific online platform. All participants completed a battery of social cognition tasks covering face emotion recognition, social attribution and mentalisation. They also completed a trauma measure, PTSD screening measure and verbal IQ task. Logistic regression analyses were used to examine the relationship between social cognition and PTSD, and were adjusted for age, gender, autism and verbal IQ.

There was some evidence that hypomentalisation, measured via the Reflective Functioning Questionnaire, was associated with exposure to trauma (adjusted odds ratio 1.80, 95% CI 1.03–3.14, p = 0.040) and increased odds of PTSD symptoms (adjusted odds ratio 4.29, 95% CI 2.76–6.66, p < 0.001). Higher scores for use of mentalising language on a naturalistic video-based spontaneous mentalising task (Modified-STOMP; potentially reflecting hypermentalising) were also associated with increased odds of PTSD symptoms (adjusted odds ratio 1.65, 95% CI 1.17–2.33, p = 0.004) in the main analysis, but not in the sensitivity analysis restricted to the Prolific-only sample.

Our results show an association between mentalising difficulties and PTSD symptoms, indicating mentalising might be a target for future risk prediction.

Clinical neuropsychology historically emphasized the assessment of “cold” cognitive functions, whereas emotional and motivational processes remain rarely evaluated. This point-of-view article argues for the inclusion of affective–motivational assessment into neuropsychological practice and outlines the key domains that should be routinely considered.

Drawing on neuroscience and clinical research, we review four core affective–motivational domains: emotional reactivity, emotion regulation, emotion recognition, and social cognition. For each domain, we summarize self-report instruments and performance-based tasks. Beyond these domains, we discuss emotional-cognitive interference as a cross-cutting modulatory mechanism that may influence overall neuropsychological performance.

Evidence indicates that emotional and motivational processes shape cognitive functioning, predict functional outcomes, and contribute uniquely to diagnosis, rehabilitation adherence, and quality of life. Validated tools are available for assessing each domain, and many clinical conditions present affective and social disturbances that may be more disabling than cognitive deficits. Despite this, surveys consistently show that affective–motivational domains are rarely assessed in practice.

Integrating emotional–motivational assessment is essential for achieving a comprehensive characterization of clinically relevant dimensions of everyday functioning. We propose a modular framework guided by referral questions and emphasize the need to develop a brief affective–motivational screener analogous to cognitive screeners such as the Mini-Mental State Examination or Montreal Cognitive Assessment. Systematic assessment of these domains can enhance diagnostic accuracy, strengthen rehabilitation planning, and more accurately reflect the complexity of everyday functioning.

Social cognitive deficits are common across many psychiatric conditions and contribute to broader social dysfunction. One hypothesized mechanism involves altered basic visual processing, which may disrupt the perception of low-level social cues and, in turn, compromise broader social cognitive processes. Here, we examined relations between basic visual processing and different levels of social cognition in a transdiagnostic youth sample.

A sample of 148 youth, ranging from healthy individuals to individuals with neuropsychiatric diagnoses and significant social dysfunction, completed two measures of basic visual processing (contrast sensitivity and visual integration) and a battery of social cognition tasks spanning lower-level (gaze perception) to mid-level (emotion recognition) to higher-level (theory of mind) social cognition. We used a four-level path model to test whether basic visual processing predicts gaze perception, which in turn predicts emotion recognition, which predicts theory of mind.

Poorer contrast sensitivity and visual integration were associated with less precise gaze perception, which was, in turn, associated with worse emotion recognition, which was associated with worse theory of mind. This four-level path model demonstrated good fit and showed superior fit compared to alternative models.

These findings suggest that basic visual processing influences the perception of basic social cues (e.g. gaze direction), which subsequently impairs more complex social perception and inference. Notably, this study extends prior observations from individuals with chronic schizophrenia to a transdiagnostic youth sample, indicating that altered basic visual processing may be a shared mechanism contributing to social cognitive deficits across psychiatric disorders and illness stages.

Schizophrenia (SZ) is a debilitating psychiatric disorder where patients experience cognitive decline. Antipsychotic drugs alleviate positive symptoms but do not improve cognitive performance. We previously demonstrated that Toll-like receptors (TLRs), involved in cytokine production, can predict cognitive deficits in SZ patients. In this study, we aim to investigate the potential moderating effects of antipsychotic drugs on the associations between cytokines, TLRs, and cognition.

In total, 280 participants (201 controls and 79 cases of SZ) were recruited in Ireland. Venous blood from the participants was stimulated with TLR ligands. Levels of cytokines were measured from plasma and post-blood stimulation. The participants were administered a battery of cognitive tasks using the Cambridge Neuropsychological Test Automated Battery and Wechsler Adult Intelligence Scale-IIIR. Olanzapine equivalents were calculated using the defined daily dose method.

The results indicate that antipsychotic drug dose does not predict TLR activity or cognition, indicating that antipsychotic drug dose does not have a direct effect on cognition or TLR activity. However, the relationship between TLR4 activity and visual learning and memory is moderated by the antipsychotic drug dose (B = −0.065; p < 0.001), where increasing doses have a decreasing impact on their relationship.

Our data indicate that the dose of antipsychotic drugs alone cannot predict changes in cognitive performance and TLR4-activity. It also suggests that antipsychotic drug doses significantly affect TLR activity and its relationship with cognition. These effects are more pronounced on some domains than others. These findings open up new avenues for understanding the complex interplay between antipsychotic drugs, TLRs, and cognitive deficits in SZ.

Social cognitive impairments are a fundamental aspect of schizophrenia, exerting a substantial influence on patients’ functional outcomes. However, to date, there have been no meta-analyses of comprehensive pharmacological interventions covering all domains of social cognition. The aim of the present study was to address this knowledge gap by conducting a network meta-analysis, a comprehensive approach that systematically compares the efficacy of pharmacological interventions across all domains of social cognition.

A literature search for randomized controlled trials (RCTs) was conducted using PubMed, Embase, the Cochrane Central Register of Controlled Trials, PsycINFO, ClinicalTrials.gov, and the International Clinical Trials Registry Platform. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis guidelines were followed.

A total of 8,752 records were screened, and 60 RCTs involving 4,270 subjects were included in the systematic review. Thirty-six pharmacological interventions were extracted, but no compounds had a significant ameliorative effect on social cognition in comparison with placebo. In each domain of social cognition, the following compounds were identified as the most probable candidates for treatment selection: selective glycine uptake inhibitor (standardized mean difference [SMD], 0.46; 95% credible interval [CI], −0.52 to 1.44) and stimulant (SMD, 0.44; 95% CI, −0.57 to 1.45) for emotion perception in comparison with placebo. In the context of emotion processing, γ-aminobutyric acid (A) α2/α3 partial agonist (SMD, 0.33; 95% CI, −0.53 to 1.19) emerged as the top compound.

To date, no pharmacological interventions have demonstrated efficacy for social cognitive impairments in schizophrenia.

Neurocognitive assessment is an essential research instrument for autism spectrum disorder (ASD), as the clinical manifestations are rooted in diverse neurocognitive processes that cause variation in clinical presentation. Few instruments comprehensively capture relevant neurocognitive domains, and most require professional assessors. The Penn Computerized Neurocognitive Battery (CNB) is widely used in child and adolescent psychiatry research across cultures. This study adapted and validated the CNB for a clinical ASD cohort in Hong Kong.

In this Hong Kong version of the CNB (CNB-HK), thirteen cognitive tasks were translated and adapted, with one task for sensorimotor speed and twelve belonging to four specific domains (episodic memory, social cognition, complex cognition, and executive function). The CNB-HK was administered to 636 normal-IQ children with ASD (mean age: 8.4 years, 87.1% male) and 412 children without ASD (mean age: 8.6 years, 55.1% male). Factor structure was examined using factor analyses.

The CNB-HK had high feasibility for children with ASD, with <7% invalid data across all tasks. The original four-factor and bi-factor structures were replicated with good model fit, and partial scalar invariance was achieved between children with and without ASD. The factor scores correlated positively with estimated IQ in the ASD group. The ASD group had worse performance across all four cognitive domains and the g factor compared to the group without ASD.

The CNB-HK is a valid, multi-domain cognitive assessment tool for children with ASD in Hong Kong, offering a feasible and reliable approach for research and clinical settings.

Exposure to adverse life events (ALE) during the prenatal and early postnatal period has been linked to social cognition impairments in offspring, but whether effects differ by developmental stage and domain of social cognition remains unclear. This study examined the role of maternal ALE exposure from early pregnancy to 8 weeks postpartum in offspring social communication and emotion recognition from childhood to adolescence.

Data from the Avon Longitudinal Study of Parents and Children (ALSPAC) were used. Social cognition was assessed using the Social Communication Disorders Checklist (SCDC) at ages 8, 11, 14, and 17, alongside emotion recognition tasks: the Diagnostic Analysis of Non-Verbal Accuracy (DANVA) (age 8) and Emotional Triangles (age 14). Growth curve modeling and regression analyses examined associations between maternal ALE and child social cognition, adjusting for key demographic and maternal factors.

Greater ALE exposure was associated with poorer social communication (b = 0.013, SE = 0.005, p < .05) and a slower rate of improvement (b = 0.001, SE = 0.000, p < .001). ALE exposure was unrelated to DANVA but predicted better Emotional Triangles performance (b = 0.015, SE = 0.007, p < .05).

Prenatal adversity has lasting effects on offspring social communication, while its influence on emotion recognition appears weaker and less consistent.

Euthymic bipolar disorder (euBD) patients exhibit deficits in neurocognitive and social cognitive functioning compared to healthy controls (HCs). Our prior research has shown that the excitatory/inhibitory (E/I) imbalance in the default mode network (DMN) is linked to executive function in euBD. Neurocognitive impairments are associated with social cognition deficits in individuals with mental disorders. Given this connection, this study posits E/I imbalance within the DMN is associated with social cognition, with executive function as a mediator.

Seventy-five HCs and 49 euBD individuals were recruited. Using the emotion recognition task, Diagnostic Analysis of Nonverbal Accuracy 2-Taiwan version (DANVA-2-TW) and cognitive flexibility task, Wisconsin Card Sorting Test (WCST), we assessed emotion recognition and prefrontal function. Proton magnetic resonance spectroscopy (1H-MRS) measured metabolites in the posterior cingulate cortex (PCC) and medial prefrontal cortex/anterior cingulate cortex (mPFC/ACC), quantifying excitatory glutamate+glutamine (Glx) and inhibitory GABA to calculate the E/I ratio.

euBD patients showed poorer emotion recognition (p = 0.020) and poorer cognitive flexibility (fewer WCST categories completed, p = 0.002). A negative association was found between emotion recognition and the E/I ratio in the mPFC/ACC of the BD patients (r = −0.30, p = 0.034), which was significantly mediated by cognitive flexibility (Z = −2.657, p = 0.007).

The BD patients demonstrate deficits in emotion recognition, linked to an altered E/I balance in the prefrontal cortex, and the cognitive flexibility, a key aspect of executive function, mediates the impact of the E/I ratio on emotion recognition accuracy in euBD patients.