Revisiting the validity of measures of social cognitive bias in schizophrenia: Additional results from the Social Cognition Psychometric Evaluation (SCOPE) study

Objective: The ongoing Social Cognition Psychometric Evaluation (SCOPE) study is in the process of forming a gold-standard battery of social cognition tests for use in clinical trials. Previous SCOPE phases have not acknowledged key differences between social cognition skills and biases, and psychometric validity analyses might provide important information if tailored to bias-related outcomes. This study aims to validate these measures with such bias-related outcomes. Methods: Two measures of social cognitive bias – the Ambiguous Intention Hostility Questionnaire (AIHQ; hostile attribution bias) and Trustworthiness Task (distrust bias) – were reviewed according to their relationships to (1) current and prospective symptom levels, (2) questionnaires of trait paranoia and hostility and informant-rated hostility, (3) interpersonal conflict, as well as (4) relationships to measures of trait paranoia, hostility, and interpersonal conflict above and beyond the influence of clinically rated symptoms. Results: Results supported hypotheses that social cognitive bias provides information about cognition, symptoms, and functioning related to interpersonal conflict. Each bias demonstrated relationships to trait paranoia questionnaires, hostility, or interpersonal conflict outcomes, and these persisted above and beyond the influence of clinically rated symptoms. Hostile attribution bias also predicted change in symptom levels over a brief interval. Conclusions: Overall, the current bias-specific psychometric analysis provides support for continued study of social cognitive biases. Practitioner points: Hostile attribution bias may play a role in important outcome variables given relationships to emotional discomfort and suspiciousness symptoms, trait paranoia and hostility, interpersonal conflict, as well as prospective hostility symptoms. Distrust bias may also impact real-world functioning, as it is related to hostility, suspiciousness, and positive symptoms, trait paranoia, and hostility. Relationships of social cognitive biases to interpersonal conflict outcomes exist independently of interview-rated symptoms and persist above and beyond the influence of social cognitive skills, which appear to demonstrate weaker relationships to these outcomes. Understanding and assessing the individual's biases towards distrust or blame might help practioners predict interpersonal conflict and future increases in symptoms.