Affective predictors of social support in individuals with schizophrenia

Background: Social Support has been found to contribute to lower mental illness burden, higher treatment adherence, enhanced social functioning, and better quality of life. Individuals with schizophrenia report lower social support compared to non-clinical populations, yet the factors contributing to this discrepancy are not fully clear. Specifically, the person-related variables that may enhance or hinder SS in people with schizophrenia are unknown. Evidence from affective neuroscience research has implicated emotion awareness and regulation as key predictors of social functioning, a correlate of social support. However, their potential impact on social support in schizophrenia has not been investigated. Methods: We examined emotion awareness, emotion regulation and social support in 90 individuals with schizophrenia and 26 healthy controls. Results: The schizophrenia group reported significantly poorer emotion awareness, more frequent use of suppression to regulate emotions, as well as lower social support. Within the schizophrenia group, results from mediation analyses pointed to significant indirect effects of specific emotion regulation strategies on social support through emotion awareness, with use of suppression predicting lower social support via decreased emotion awareness, and conversely, use of cognitive reappraisal predicting greater social support via increased emotion awareness. Notably, emotion awareness was more strongly associated with social support from friends than from family members. Conclusions: The results highlight poor emotion awareness as a key variable critical to enhancing social support in people schizophrenia. We discuss potential mechanisms underlying the links between emotion awareness, emotion regulation, and SS, along with the therapeutic implications of the findings.