Understanding functioning in schizophrenia through the lens of social cognition: a phenomenological study

从社会认知视角理解精神分裂症患者的功能:一项现象学研究

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Abstract

BACKGROUND: 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. METHODS: A 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. RESULTS: The 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. CONCLUSION: Functioning 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. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12888-025-07290-5.

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