Case Control Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Psychiatr. Jan 19, 2021; 11(1): 13-26
Published online Jan 19, 2021. doi: 10.5498/wjp.v11.i1.13
What gets in the way of social engagement in schizophrenia?
Lauren P Weittenhiller, Megan E Mikhail, Jasmine Mote, Timothy R Campellone, Ann M Kring
Lauren P Weittenhiller, Megan E Mikhail, Jasmine Mote, Timothy R Campellone, Ann M Kring, Department of Psychology, University of California, Berkeley, CA 94720, United States
Megan E Mikhail, Department of Psychology, Michigan State University, East Lansing, MI 48824, United States
Jasmine Mote, Department of Occupational Health, Tufts University, Medford, MA 02155, United States
Author contributions: Mote J, Campellone TR, and Kring AM were involved in the conception of the study; Weittenhiller LP, Mikhail ME, and Kring AM contributed to the study design and coding manual development; Weittenhiller LP and Mikhail ME conducted didactic trainings and managed coding implementation; Weittenhiller LP performed the analyses and wrote the initial drafts of the manuscript with significant contributions made by Kring AM; all authors edited and approved the final version of the manuscript.
Supported by National Science Foundation Graduate Research Fellowship Program, No. 1752814.
Institutional review board statement: The study was approved by the University of California, Berkeley Institutional Review Board.
Informed consent statement: All study participants provided informed written consent.
Conflict-of-interest statement: None declared.
Data sharing statement: Data available on request from the corresponding author at
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Corresponding author: Lauren P Weittenhiller, MA, Academic Research, Department of Psychology, University of California, 2121 Berkeley Way No. 1650, Berkeley, CA 94720, United States.
Received: October 23, 2020
Peer-review started: October 23, 2020
First decision: December 4, 2020
Revised: December 16, 2020
Accepted: December 27, 2020
Article in press: December 27, 2020
Published online: January 19, 2021
Research background

Though limited social engagement is common in schizophrenia, the reasons for this remain unclear. People with schizophrenia report a desire to be with others, and yet spend more time alone.

Research motivation

Better understanding of the factors that contribute to limited social engagement can be an important first step toward helping people with schizophrenia to meet their social needs.

Research objectives

To identify and compare motivations and barriers for social engagement with friends and family among those with and without schizophrenia.

Research methods

Thirty-five people with schizophrenia or schizoaffective disorder and 27 nonclinical controls were recruited from the community to participate in this study. Participants completed measures of symptoms and functioning, as well as a negative symptoms interview, which asked participants to describe their engagement in and motivation for social activities in the past and upcoming weeks. Using a novel coding system, we coded the frequency with which participants described six types of social motivations and barriers.

Research results

People with schizophrenia were less likely to interact with and initiate contact with friends, but not family, compared to nonclinical controls. The groups differed in reported barriers, such that people with schizophrenia reported more internal and conflict-based barriers than those without schizophrenia. People with and without schizophrenia reported similar numbers and types of motivations for social engagement. Barriers and motivations were associated with symptoms and functioning.

Research conclusions

This study suggests that barriers, such as conflicts with other people or negative beliefs about the self may interfere with social engagement in schizophrenia. People with schizophrenia report interest and motivation for social interactions, but social barriers may get in the way of them following through.

Research perspectives

Further exploration of social barriers in terms of types, frequency, and relative contribution to limiting social engagement is warranted.