Abstract
Abstract Introduction People with schizophrenia-spectrum disorders (SSDs) and bipolar disorders (BDs) experience difficulty with social cognition, or the mental processes that underlie social interactions, but determinants of social cognitive impairment are still under investigation. Research suggests that poor sleep quality is related to reduced social cognitive ability in BDs, but it is unclear if sleep quality is related to social cognition in SSDs and if sleep may be related to different types of social cognition (e.g., emotion recognition, biases) in different ways. This study aimed to examine relationships between sleep and different types of social cognition in SSDs and BDs. Given known relationships between blaming and untrustworthiness biases and paranoia in these populations, paranoia was also examined as potential mediator of these relationships. Methods Participants (SSDs n=91; BDs with psychotic features n=87) completed tasks of social cognitive ability (e.g., facial and multi-modal emotion recognition, attributional bias, untrustworthiness bias). Participants self-reported their sleep quality. Paranoia was assessed via clinical interview. Results In the BD group, poor sleep quality (r=-.23, p=.04) and shorter sleep duration (r=-.25, p=.02) were associated with a bias towards untrustworthiness. For those with SSDs, increased use of sleep medication was associated with poorer multi-modal emotion recognition (r=-.22, p=.04). Additionally, poor sleep quality and overall poor sleep were associated with increased blaming (r=.22, p=.03; r=.21, p=.04) and untrustworthiness biases (r=-.24, p=.03; r=-.24, p=.03) in this group. Higher daytime tiredness was also associated with untrustworthiness bias (r=-.23, p=.03) in SSDs. Regarding mediation results, paranoia did serve as a mediator in the relationships between sleep and blaming and untrustworthiness biases across the sample. Conclusion Results suggest that poor sleep quality is linked to increased attributional and untrustworthiness biases, and that these relationships may be at least partially explained by paranoia symptoms. Of note, however, is that indirect effect sizes in mediation models were small. Contrary to expectations, poor sleep quality was not consistently associated with reduced social cognitive ability in the current sample. Findings from the current study require further exploration and replication. Support (if any) This work was supported by the National Institute of Mental Health (grant number R01 MH116902-04 awarded to C.A.D).