Understanding functioning in schizophrenia through the lens of social cognition: a phenomenological study
摘要
Impairments in social cognition are recognized as a key factor contributing to functional disabilities in individuals with schizophrenia. This study aims to understand the essence of how functioning is subjectively experienced within the context of social cognition.
MethodsA descriptive phenomenological approach was employed. Ten discharged patients from the largest psychiatric hospital in Khorasan Razavi Province, Iran, were selected using purposive sampling. Data were collected through in-depth, semi-structured interviews and analyzed based on Amedeo Giorgi’s phenomenological method. The COREQ checklist was utilized to guarantee transparency and methodological rigor.
ResultsThe analysis identified five overarching themes and 21 subthemes: (1) Restoring Identity through Employment; (2) The Struggle between Motivation and Functional Barriers; (3 Living on the Margins of Social Engagement: Cognitive–Emotional Isolation; (4) Dysfunctional Engagement with the Social Environment; and (5) The Family’s Role in Psychosocial Rehabilitation and Identity Reconstruction. Functioning within the domain of social cognition was revealed to be a multifaceted and dynamic process, marked by internal struggles, fluctuating motivation, and sustained social withdrawal. Employment emerged as a vital avenue for rebuilding a sense of self, while the family context acted as both a facilitating and constraining force in the psychosocial recovery journey.
ConclusionFunctioning in schizophrenia is a dynamic process of identity reconstruction shaped by psychological vulnerability, cognitive-emotional detachment, and disrupted social engagement. Social cognition—particularly intention recognition, emotional regulation, and attributional tendencies—plays a central role in how individuals relate to themselves and others. Employment and family offer key contexts for meaning-making, self-renewal, and belonging. A nuanced understanding of functioning requires a biopsychosocial perspective that integrates cultural, interpersonal, and intrapsychic dimensions.