Published online Jan 19, 2021. doi: 10.5498/wjp.v11.i1.13
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
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.
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.
To identify and compare motivations and barriers for social engagement with friends and family among those with and without schizophrenia.
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.
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.
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.
Further exploration of social barriers in terms of types, frequency, and relative contribution to limiting social engagement is warranted.