Comparative analysis of social cognitive performance in autism spectrum disorder and schizophrenia.

Abstract

Social cognitive impairments are widely documented in both schizophrenia (SCZ) and autism spectrum disorder (ASD); however, whether these conditions differ in their qualitative mentalizing profiles remains unclear. The present study compared young adults with SCZ (n = 30), ASD (n = 29), and healthy controls (HC; n = 40) using measures of selected domains of social cognition (SC), including the Movie for the Assessment of Social Cognition-Turkish Version (MASC-TR), the Reading the Mind in the Eyes Test (RMET), and the Faux Pas Recognition Test (FPRT). Group differences were examined using multivariate analyses, and the contribution of global neurocognition was statistically controlled. Significant overall group effects emerged across SC measures. Both clinical groups performed significantly worse than HC in overall mentalizing accuracy (MASC-TR total), the ability to infer mental and emotional states (RMET), and faux pas control stories. Although SCZ and ASD did not differ in overall accuracy, distinct error patterns were observed. Individuals with schizophrenia showed a pronounced tendency toward under-mentalizing, reflected in a higher frequency of responses indicating insufficient mental state attribution. In contrast, autism was characterized by a heterogeneous error profile. Group differences remained significant after controlling for global neurocognitive functioning, indicating that social cognitive impairments were not explained by generalized cognitive deficits. These findings support a transdiagnostic framework of impairments in selected social cognitive domains while demonstrating disorder-specific qualitative differences in mentalizing style. Distinguishing between shared impairments and distinct error patterns may contribute to targeted assessment and intervention strategies to improve real-world social functioning.