Theory of mind performances in first-episode schizophrenia patients: An 18-month follow-up study

Language Can Obscure as Well as Facilitate Apparent-Theory of Mind Performance: Part 2-The Case of Dyslexia in Adulthood

Many studies imply causal links between linguistic competencies and Theory of Mind (ToM). But despite Dyslexia being a prime example of linguistic deficits, studies on whether it is related to ToM have been relatively unforthcoming. In the first of 2 studies (N = 89), independently-diagnosed dyslexic adults and non-dyslexic adults were presented with false-belief vignettes via computer, answering 4 types of question (Factual, Inference, 1st-order ToM & 2nd-order ToM). Dyslexia related to lower false-belief scores. Study 2 (N = 93) replicated this result with a non-computer-based variant on the false-belief task. We considered the possibility that the apparent-issue with ToM is caused by processing demands more associated to domains of cognition such as language, than to ToM itself. Addressing this possibility, study 2 additionally utilised the ToM30Q questionnaire, designed largely to circumvent issues related to language and memory. Principal-Components analysis extracted 4 factors, 2 capturing perceptual/representational ToM, and the other 2 capturing affective components related to ToM. The ToM30Q was validated via its associations to a published measure of empathy, replication of the female gender advantage over males, and for one factor from the ToM30Q there was a correlation with an existing published index of ToM. However, when we considered the performance of dyslexic and non-dyslexic participants using the ToM30Q, we found absolutely no difference between them. The contrasting findings from our 2 studies here, arguably offer the first experimental evidence with adults, that there is in fact no ToM deficit in dyslexia. Additionally, this finding raises the possibility that some other groups considered in some sense atypical, failed ToM tasks, not because they actually have a ToM deficit at all, but rather because they are asked to reveal their ToM competence through cognitive domains, such as language and memory.

Validation of the Questionnaire of Cognitive and Affective Empathy in patients with schizophrenia, major depressive disorder and bipolar disorder

INTRODUCTION

Alteration of empathy is common in patients with psychiatric disorders. Reliable and valid assessment tools for measuring empathy of clinical samples is needed. The Questionnaire of Cognitive and Affective Empathy (QCAE) is a newly-developed instrument to capture cognitive and affective components of empathy. This study aimed to validate the QCAE and compared self-reported empathy between clinical groups with varied psychiatric diagnoses and healthy sample.

METHODS

The present study performed factor analysis for the QCAE on clinical samples in the Chinese setting (n = 534), including patients with schizophrenia (n = 158), bipolar disorder (n = 213) and major depressive disorder (n = 163). Internal consistency, internal correlation and convergent validity was examined in the subsample (n = 361). Group comparison among patients with schizophrenia, bipolar disorder, major depressive disorder and healthy controls (n = 107) was conducted to assess the discriminant validity.

RESULTS

Our results indicated acceptable factor model, good reliability and validity of the QCAE. Impaired cognitive empathy was found in clinical samples, especially in patients with schizophrenia, while higher affective empathy was found in patients with bipolar disorder and major depressive disorder.

CONCLUSION

The QCAE is a useful tool in assessing empathy in patients with varied psychiatric diagnoses.