Social cognition and self-reported ASD traits in young adults who have reported psychotic experiences: A population-based, longitudinal study

Objective: Social cognition is considered a trait marker of psychosis, and has rarely been investigated in young adults who have reported psychotic experiences (PE). The aim of the present study was to explore whether social cognition, self-reported Autism Spectrum Disorder (ASD) traits and functioning were associated with PE.

Methods: Participants were invited to take part in a 10-year follow-up study (mean age 20.9 years), of whom 103 participants returned, including 41 who had reported PE either past or current. Social cognition (theory of mind, social perception and locus of control) was assessed and a self-report measure of ASD traits was administered. Psychopathology and global functioning were assessed using the SCID-5. Analyses investigated group differences between PE and controls, and the association between social cognition and functioning in the PE group. A mediation analysis investigated if the association between PE and social cognition was explained by ASD traits.

Results: The PE group had poorer theory of mind scores (F = 4.22, p = .043), specifically for neutral and negative stimuli, and an external locus of control (F = 5.73, p = .019) in young adulthood. The PE group had a significantly greater number of self-reported ASD traits than the controls (χ2(2) = 10.65). External locus of control had a significant negative correlation with current role functioning in the PE group. The association between PE and social cognition abilities was not mediated by ASD traits.

Conclusion: Psychotic experiences are associated with poorer theory of mind and an external locus of control, as well as proportionally more self-reported ASD traits, in young adulthood.