Social Cognition Measurement Validation in Latines with Schizophrenia

This dissertation evaluates social cognition assessments for (1) psychometric properties, (2) associations to functional outcomes in a cultural context, and (3) cultural measurement biases among Latine individuals with schizophrenia. Given the functional implications of social cognition in schizophrenia, and the growing Latine population in the United States, ensuring the cultural relevance and accuracy of assessment is paramount. Three studies investigate the cultural relevance of four social cognition measures: the Bell-Lysaker Emotion Recognition Task (BLERT), Emotion Recognition-40 (ER-40), the Hinting Task, and The Awareness of Social Inference Test (TASIT). In the first study, a comprehensive psychometric evaluation revealed that Latine participants scored lower on Theory of Mind (ToM) tasks compared to non-Latine Whites, with emotion recognition tasks performing better. However, lower internal consistency and test-retest reliability were noted in ToM measures. The second study explores the role of acculturation in social cognition task performance and its relationship to functional outcomes, finding that acculturation did not contribute to variance in task scores and did not moderate the functional relationship. However, acculturation does interact with other predictors of social competence as a functional outcome such as education and symptomatology. The final study is a qualitative investigation of cognitive processes and cultural measurement bias in social cognition tasks using cognitive interviewing. Participants favored BLERT for its multiple social cues, whereas method- and construct- level bias was detected in ER-40 due to cultural variations in emotion expression and interpretation. Measurement bias was also identified in measures of ToM due to their use of Western-centric social situations and stimuli, unfamiliar vocabulary and idiomatic expressions, and cultural differences in use and interpretation of indirect speech. Cross-cutting cultural themes were identified, including the role of work, family relationships, bilingualism, socio-political context, and holistic thinking. These findings underscore the importance of culturally sensitive assessments that reflect the diverse experiences and contexts of Latine individuals. This research contributes to a more inclusive understanding of social cognition and highlights the need for continuous evaluation and adaptation of psychological tools to meet the needs of diverse populations.