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Mad? Sad? Glad? People with severe mental illness can’t easily “read” their partner’s feelings; but there may be help

Getting along as a couple in a romantic relationship is never easy, but it’s even harder for people struggling with severe mental illness. One reason for that might be the lack of an important social ability called “social cognition” — the ability to accurately read everyday social cues from partners, such as anger, sadness, frustration or annoyance — say SMU psychologists Amy Pinkham and Lorelei Simpson.

For a healthy couple in a romantic relationship, getting along can be hard enough. But what if one person has been diagnosed with schizophrenia, bipolar disorder or major depression?

Adding severe mental illness into the mix can make it even harder to keep a relationship healthy, happy and satisfying, say psychologists Amy Pinkham and Lorelei Simpson, both assistant professors in the Department of Psychology at Southern Methodist University, Dallas.

A new research project by Pinkham and Simpson aims to understand how relationships function where one person has been diagnosed with a severe mental illness. Their study takes a close look at how couple relationships function when one partner has difficulties with the important social ability called “social cognition.”

Failure to understand emotional cues

Lorelei Simpson
Amy Pinkham

Social cognition is the ability to understand social information and accurately read and interpret another person’s feelings, to understand their perspective, and then respond appropriately.

Social cognition is commonly lacking or deficient in people with severe mental illness, say Pinkham and Simpson. For example, an ill individual may think their partner is angry when in fact the person is unhappy.

Understanding these deficits could lead to treatments to address social cognition deficits within relationships, say Pinkham and Simpson.

Pinkham and Simpson hope to develop programs for people with severe mental illness to help them improve the social skills critical for them to maintain a happy relationship.

“Understanding a partner’s viewpoint and emotions is key to many relationship skills,” says Simpson. “The social cognition deficits among people with severe mental illness may help explain their greater risk for relationship distress.”

More episodes of domestic abuse
People with severe mental illness tend to have more episodes of intimate partner violence and greater relationship discord, say Pinkham and Simpson. It’s possible that deficits in social cognition may play a role in these negative outcomes, they say.

Over the next few months, the researchers will recruit 60 couples from ethnically diverse backgrounds between the ages of 18 and 65. They will compare social cognition deficits and relationship functioning in couples in which one partner has a severe mental illness to couples in which neither partner has severe mental illness.

The researchers will assess the couples and analyze the data over the next 12 months. The Texas-based Hogg Foundation for Mental Health has awarded the psychologists a one-year, $15,000 grant to fund the study.

Study may provide treatment roadmap

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Pinkham and Simpson say they expect to find that impairments in social cognition do detract from a couple’s efforts at a happy relationship.

They hope this initial study will improve understanding of the problems leading to relationship distress that are commonly seen in these couples.

They also expect that the study will lead to longitudinal and treatment studies that will enable them to develop recommendations for treatment and therapy that can help people with severe mental illness overcome the deficit.

“In the last five years, several treatment programs have been developed that show considerable promise for improving social cognitive abilities in individuals with a severe mental illness. If we find that social cognition does contribute to relationship satisfaction, we may be able to extend these same treatments to couples therapy,” says Pinkham.

Pinkham has expertise in social cognition and has investigated social cognitive impairments in people with severe mental illness for the past 10 years. Simpson’s expertise is with couple relationship functioning, couples therapy and couples facing severe mental illness.

About 6 percent of people in the United States suffer from serious mental illness, according to the National Institute of Mental Health.

Due to newer, more effective medications, as well as advances in behavioral therapy, more people with severe mental illness are able to function at higher levels, including maintaining long-term relationships like marriage, say the psychologists.

First study of its kind
However, the illness still takes a toll on people with severe mental illness and their relationships with others. Improving their ability to function is essential for better quality of life, say Pinkham and Simpson.

Over the past 20 years, researchers have studied severe mental illness and social cognitive impairment. But this will be the first study to examine the role of social cognition in how couple relationships function when one person has severe mental illness, say Pinkham and Simpson.

Much of the research on severe mental illness has focused on treating symptoms. But treating symptoms doesn’t necessarily give them skills by which to improve their relationships, say Pinkham and Simpson.

The Pinkham-Simpson study is one of 12 Texas research projects to receive funding from the Hogg Foundation, which was founded to promote improved mental health for Texans.

“Academic research is an important tool in our quest to understand the complexities of mental health,” said Octavio N. Martinez Jr., executive director of the foundation in announcing the awards. “The Hogg Foundation selected these projects because they address issues that profoundly affect people’s lives.”

Related links:
Amy Pinkham
Lorelei Simpson
SMU Department of Psychology
Hogg Foundation for Mental Health

By Margaret Allen

Senior research writer, SMU Public Affairs