Social exclusion in schizophrenia: Psychological and cognitive consequences

Social exclusion is associated with reduced self-esteem and cognitive impairments in healthy samples. Individuals with schizophrenia experience social exclusion at a higher rate than the general population, but the specific psychological and cognitive consequences for this group are unknown. We manipulated social exclusion in 35 participants with schizophrenia and 34 demographically-matched healthy controls using Cyberball, a virtual ball-tossing game in which participants believed that they were either being included or excluded by peers. All participants completed both versions of the task (inclusion, exclusion) on separate visits, as well as measures of psychological need security, working memory, and social cognition. Following social exclusion, individuals with schizophrenia showed decreased psychological need security and working memory. Contrary to expectations, they showed an improved ability to detect lies on the social cognitive task. Controls showed a decrease in psychological security after exclusion that was larger than that seen in the schizophrenia group. The results suggest that social support and interventions targeting social integration may benefit community functioning by reducing cognitive impairments and psychological stress.