Comparative profiles of anomalous self-experiences and social cognition in clinical high risk for psychosis and autism spectrum disorder.

Background: Self-disorders, or anomalous disturbances in the basic sense of self, have been described in psychosis-risk states and may contribute to social cognitive impairment and functioning. This study examined self-disorder severity and associations with social cognition and functioning across individuals at clinical high risk for psychosis (CHR-P), autism spectrum disorder (ASD), and controls. ASD was included due to overlapping difficulties in social cognition/functioning with CHR-P. We hypothesized a graded pattern of self-disorders (CHR-P > ASD > controls) and stronger associations between self-disorders and social cognition in CHR-P. Methods: We included 39 CHR-P, 39 ASD, and 30 controls (mean age ≈24 years; 51% female). Self-disorders were assessed with the Inventory of Psychotic-Like Anomalous Self-Experiences (IPASE). Social cognitive domains included social cognitive bias and theory of mind alongside measures of social functioning. Analyses of covariance and bootstrapped regression models with IPASE as predictor were used, adjusting for age, sex, and IQ. Multiple comparisons were Benjamini-Hochberg corrected. Results: Self-disorders followed a graded distribution (CHR-P > ASD > controls) across all IPASE subscores. Both clinical groups showed elevated social cognitive bias and reduced social functioning compared to controls. Self-disorders were associated with social cognitive bias in ASD (B = 0.392, 95%CI 0.236-0.544, Conclusion: Self-disorders showed a graded distribution across groups but was only associated with social cognitive deficits in ASD. Findings suggest that shared symptom profiles may reflect divergent experiential processes across groups. Further research is needed to clarify clinical implications and generalizability.