Deficits of Social-Cognitive and Social-Perceptual Aspects of Theory of Mind in Remitted Patients With Schizophrenia

Melbourne Neuropsychiatry Centre, Psychiatry Department of Melbourne University, Victoria, Australia.
The Journal of nervous and mental disease (Impact Factor: 1.69). 03/2008; 196(2):95-9. DOI: 10.1097/NMD.0b013e318162a9e1
Source: PubMed


Although ToM deficit in schizophrenia is widely accepted, findings regarding remitted schizophrenia patients are contradictory. Because residual symptoms are present out of psychotic exacerbation periods, the differences between definition of remission may be important to interpret these findings. The purpose of this study was to investigate the relationship between performance of 2 different aspects of theory of mind (ToM) and residual clinical symptoms and other cognitive deficits in schizophrenia. Ninety-one stable outpatients with schizophrenia and 55 healthy controls were assessed with a neuropsychological battery. Both social-cognitive and social-perceptual aspects of ToM were impaired in schizophrenia, even in patients who were totally free of residual symptoms. Still, the results showed that ToM deficit is related to residual symptoms of schizophrenia. Social-cognitive ToM abilities seem to be related to both positive and negative symptoms. The ToM deficits of fully remitted patients without persistent negative symptoms may be secondary to a more general cognitive dysfunction in schizophrenia.

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    • "Ceiling effects – in which participants perform at 100% or near 100% accuracy – are ubiquitously observed with these tasks, and their variants, in healthy control participants as well as patient groups (although less often; e.g., [29,31,32,34,36,39,45-59]). For example, in studies investigating ToM in schizophrenia, using papers identified in two meta-analyses [1,3], the comparison group of healthy control participants scored >90% accuracy in 6 of 7 studies using the Hinting Task [29,54,60-63] and 5 of 7 studies using the Faux Pas Task [64-68]. Clearly, these tasks are inadequate for addressing questions related to individual differences and normal variation in ToM ability. "
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    ABSTRACT: Social functioning depends on the ability to attribute and reason about the mental states of others - an ability known as theory of mind (ToM). Research in this field is limited by the use of tasks in which ceiling effects are ubiquitous, rendering them insensitive to individual differences in ToM ability and instances of subtle ToM impairment. Here, we present data from a new ToM task - the Short Story Task (SST) - intended to improve upon many aspects of existing ToM measures. More specifically, the SST was designed to: (a) assess the full range of individual differences in ToM ability without suffering from ceiling effects; (b) incorporate a range of mental states of differing complexity, including epistemic states, affective states, and intentions to be inferred from a first- and second-order level; (c) use ToM stimuli representative of real-world social interactions; (d) require participants to utilize social context when making mental state inferences; (e) exhibit adequate psychometric properties; and (f) be quick and easy to administer and score. In the task, participants read a short story and were asked questions that assessed explicit mental state reasoning, spontaneous mental state inference, and comprehension of the non-mental aspects of the story. Responses were scored according to a rubric that assigned greater points for accurate mental state attributions that included multiple characters' mental states. Results demonstrate that the SST is sensitive to variation in ToM ability, can be accurately scored by multiple raters, and exhibits concurrent validity with other social cognitive tasks. The results support the effectiveness of this new measure of ToM in the study of social cognition. The findings are also consistent with studies demonstrating significant relationships among narrative transportation, ToM, and the reading of fiction. Together, the data indicate that reading fiction may be an avenue for improving ToM ability.
    PLoS ONE 11/2013; 8(11):e81279. DOI:10.1371/journal.pone.0081279 · 3.23 Impact Factor
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    • "It could be said in general terms that, beyond nosologic differences, a considerable number of studies have revealed defi cits associated with the mentalizing capacity of patients with schizophrenia (Corcoran et al., 1995; Frith & Corcoran, 1996; Corcoran, Cahill, & Frith, 1997; Langdon et al., 1997, 2001, 2002; Mazza et al., 2001; Brüne, 2003; Couture et al., 2008; Bora et al., 2008 "
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    ABSTRACT: Background: Theory of mind (ToM) is the natural ability to attribute/infer mental states about ourselves and others. The study of the limits of this capacity in autism-spectrum disorders has been projected more recently to the case of schizophrenia. Method: We review the studies on ToM deficiency in schizophrenia, based on the link observed by Chris Frith between psychotic symptoms and mentalizing anomalies, with particular attention to the implications of ToM in linguistic communication in the field of figurative language comprehension. Results: The data support a connection between ToM deficits and psychotic symptoms. In schizophrenia, the deficit in ToM appears to be specific and not dependent on more general cognitive abilities, and according to the evidence examined, it resembles a trait more than a state condition. The analysis of results shows that anomalies in ToM have projections on pragmatic aspects of language comprehension. Conclusions: ToM deficits showed by schizophrenic patients are especially linked to difficulties in understanding figurative language, beyond the influence of intelligence and executive functions.
    Psicothema 11/2013; 25(4):440-445. DOI:10.7334/psicothema2012.357 · 0.96 Impact Factor
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    • "Some authors suggested that the RMET reflects emotional and affective processes of ToM (Bora et al. 2008). Patients regarded as clinically remitted or " well " might still be suffering from deficits in ToM abilities which might lead to poor social functioning and problems in interpersonal relationships (Bora et al. 2008). The RMET has also become a useful instrument for studies on the neurobiological substrates of social and emotional skills (Domes et al. 2007). "

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