| dc.description.abstract | Abstract: Background: Executive functions (EF) are one of the most commonly impaired cognitive domains in individuals with schizophrenia spectrum disorders. In the last few decades, it has been increasingly apparent that the EF can be divided into an affective ("hot") dimension and a cognitive ("cool") dimension based on different brain networks and processes. There are few studies investigating both objective and subjective assessments of hot and cool EF in individuals with schizophrenia spectrum disorders. EF deficits are known to have a negative impact on a variety of functional outcomes such as social functioning. Schizophrenia is also frequently characterised by social functioning difficulties. Although the association between cool EF and social functioning is well established, the strength of the association between hot EF and social functioning is less known. The usage of multiple measures, as well as both objective and subjective assessments, may be beneficial to understanding the broader effect of EF on social functioning. The first aim of the current investigation is to investigate hot and cool EF using objective and subjective assessment in individuals with schizophrenia. The second aim is to investigate the associations between hot and cool EF and social functioning using both objective and subjective measures. Methods: The present study used data from a study on Goal Management Training in participants with schizophrenia spectrum disorders and psychosis risk syndromes. Sixty-five participants with schizophrenia spectrum disorders were included in this cross-sectional study. The measures of objective cool EF were the Color-Word-Interference-Test 3, Color-Word-Interference-Test 4, Letter-Number Sequencing and Tower Test. The Iowa Gambling Task was used as a measure of objective hot EF. The Behavior Rating Inventory of Executive Function - Adult version was used to measure subjective hot and cool EF. Objective and subjective social functioning were measured with the Global Assessment of Functioning and the Social Functioning Scale, respectively. Results were analysed using linear regression analysis while controlling for presence of psychotic symptoms and the use of antipsychotic medication. Results: The individuals with schizophrenia spectrum disorders demonstrated impairments in both hot and cool EF relative to norms. Objective cool EF was significantly, positively associated with objective social functioning. Hot EF increased the explained variance of EF on objective social functioning. Moreover, objective hot EF was significantly negatively associated with objective social functioning. When including the presence of psychotic symptoms in the regression, the explained variance increased. Contrary to our assumptions, there was a lack of association between objective hot EF and subjective social functioning. Further, objective cool EF was associated with subjective social functioning, albeit in an unexpectedly negative direction. When including the presence of psychotic symptoms and the use of antipsychotic medication in the regression, the explained variance increased. Conclusion: The current investigation proposes that individuals with schizophrenia have impairments on both hot and cool EF, indicating the possible benefits of targeting these aspects of EF in cognitive remediation. Interestingly, individuals with better objective cool EF have more self-reported social difficulties. Self-criticism, insight-related problems, and avoidance of negative occurrences may be possible explanations. Furthermore, those with better objective cool EF may be able to compare themselves to healthier individuals based on prior social relationships, whereas those with a lower objective cool EF may have less social experience and, as a result, a smaller basis for comparison. Although the inclusion of objective hot EF increased the explained variance of EF on objective social functioning, our results suggest that hot EF is not as important for impairments in social functioning as initially thought. Understanding the complexity of EF may also help enhance social functioning in individuals with schizophrenia. | eng |