Social Support in Schizophrenia: The Role of Emotional Awareness and Regulation

Announcer:
You’re listening to NeuroFrontiers on ReachMD. On this episode, we’ll hear from Dr. David Kimhy, who’s an Associate Professor, the Director of the Experimental Psychopathology Laboratory, and the Program Leader for New Interventions in Schizophrenia at the Department of Psychiatry at the Icahn School of Medicine at Mount Sinai. He’ll be discussing the relationship between social support and emotion awareness in individuals with schizophrenia. Let’s hear from Dr. Kimhy now.

Dr. Kimhy:
Social support is important because we have robust findings from many studies that underscore the critical role that social support plays in determining clinical and functional outcomes. For example, among people with schizophrenia, the availability of social support has been linked to multiple benefits including lower symptom burden, lower risk of relapse, higher treatment adherence, better insight, lower stigmatization, and overall higher quality of life. It also helps as a buffer against the impact of stressors. The definition of social support is the provision of assistance or comfort to others to help them cope with psychological, social, or health-related stressors. It’s typically provided within the context of interpersonal relationships with members who want social networks, such as family, friends, neighbors, and colleagues.

The reason we decided to focus on emotions is because emotions are data that informs coping and behavior. For example, if someone experienced anxiety, they may act in a certain way. If they feel anger, that will call for behaving or coping in a different way. And even though emotions are universal, how people navigate them is deeply personal, and we find that emotions are particularly important for managing social interactions because understanding others starts with understanding yourself. So in our previous studies, we found that emotional awareness and emotional regulation were both strong predictors of social functioning in both people with schizophrenia as well as those at risk for psychosis. And again, the idea here is that once people can name and understand what they’re feeling, they can take steps toward responding in a thoughtful way instead of reacting impulsively.

So we were interested to see—given that social support is such a strong predictor of well-being in people with schizophrenia and emotional awareness and regulation are predictors of social functioning in these populations—whether those variables will also predict social support. Because what we know about social support is that, generally, the focus has been on the part that gives, like the family members and caretakers. There have been no studies on any individual aspects of people that predict whether they’d be able to get and maintain social support. And we hypothesize that emotional awareness and regulation would be likely candidates here.

So what we did is we examined emotional awareness, emotional regulation, and social support in 90 individuals with schizophrenia and 26 healthy controls. And what we found is that, consistent with previous studies, the schizophrenia group reported significantly poorer emotional awareness, more frequent use of suppression to regulate emotion, and lower social support. Now, within the schizophrenia groups, results from mediation analysis pointed to significant effects of specific emotional regulation strategies on social support through emotional awareness. So in other words, the emotional awareness mediated the link between emotional regulation and social function.  

There are a couple of implications here. One is that in order to improve social support, we may first need to help some individuals develop better emotional awareness so they will be able to navigate those relationships in a more effective way. Obviously, this still needs to be looked in a clinical trial or an intervention, but the results suggest that. The second part is that the results show that emotional awareness is consistent with what we found in other types of relationships that are really important to social functioning.

Announcer:
That was Dr. David Kimhy discussing how difficulties with emotion awareness and regulation can impact social support among schizophrenia patients. To access this and other episodes in our series, visit NeuroFrontiers onReachMD.com, where you can Be Part of the Knowledge. Thanks for listening!