Social cognition and functional outcome in schizophrenia: The moderating role of cardiac vagal tone

Holly K. Hamilton, Jane C. Sun, Michael F. Green, Kimmy S. Kee, Junghee Lee, Mark Sergi, Gretchen L. Sholty, Kristopher I. Mathis, Christopher Jetton, Terrance J. Williams, Robert Kern, William Horan, Alan Fiske, Kenneth L. Subotnik, Joseph Ventura, Gerhard Hellemann, Keith H. Nuechterlein, Cindy M. Yee

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Individuals with schizophrenia face significant challenges in daily functioning, and although social cognition predicts how well patients respond to these challenges, associated physiological mechanisms remain unspecified. The present study draws from polyvagal theory and tested the hypothesis that respiratory sinus arrhythmia (RSA), an established indicator of the capacity to self-regulate and adapt to environmental demands, combines with social cognition to predict functional outcome. Using data from 41 schizophrenia patients and 36 healthy comparison subjects, we replicated group differences in RSA and social cognition and also demonstrated that RSA and social cognition interact to predict how effectively patients manage work and independent living activities. Specifically, RSA did not enhance functional outcomes when social cognition was already strong, but higher levels of RSA enabled effective role functioning when social- cognitive performance was impaired. Jointly, RSA and social cognition accounted for 40% of the variance in outcome success, compared with 21% when evaluating social cognition alone. As polyvagal theory suggests, physiological flexibility and self-regulatory capacity may compensate for poorer social- cognitive skills among schizophrenia patients.

Original languageEnglish
Pages (from-to)764-770
Number of pages7
JournalJournal of Abnormal Psychology
Issue number4
StatePublished - 2014
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2014 American Psychological Association.


  • Cardiac vagal tone
  • Functional outcome
  • Respiratory sinus arrhythmia
  • Schizophrenia
  • Social cognition


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