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Tsui HKH, Liao Y, Hsiao J, Suen YN, Yan EWC, Poon LT, Siu MW, Hui CLM, Chang WC, Lee EHM, Chen EYH, Chan SKW. Mentalizing impairments and hypermentalizing bias in individuals with first-episode schizophrenia-spectrum disorder and at-risk mental state: the differential roles of neurocognition and social anxiety. Eur Arch Psychiatry Clin Neurosci 2024:10.1007/s00406-024-01830-y. [PMID: 38960910 DOI: 10.1007/s00406-024-01830-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/06/2024] [Accepted: 05/10/2024] [Indexed: 07/05/2024]
Abstract
Mentalizing, or theory of mind (ToM), impairments and self-referential hypermentalizing bias are well-evident in schizophrenia. However, findings compared to individuals with at-risk mental states (ARMS) are inconsistent, and investigations into the relationship between social cognitive impairments and social anxiety in the two populations are scarce. This study aimed to examine and compare these deficits in first-episode schizophrenia-spectrum disorder (FES) and ARMS, and to explore potential specific associations with neurocognition and symptomatology. Forty patients with FES, 40 individuals with ARMS, and 40 healthy controls (HC) completed clinical assessments, a battery of neurocognitive tasks, and three social cognitive tasks. The comic strip and hinting tasks were used to measure non-verbal and verbal mentalizing abilities, and the gaze perception task was employed to assess self-referential hypermentalizing bias. FES and ARMS showed comparable mentalizing impairments and self-referential hypermentalizing bias compared to HC. However, only ambiguous self-referential gaze perception (SRGP) bias remained significantly different between three groups after controlling for covariates. Findings suggested that self-referential hypermentalizing bias could be a specific deficit and may be considered a potential behavioral indicator in early-stage and prodromal psychosis. Moreover, working memory and social anxiety were related to the social cognitive impairments in ARMS, whereas higher-order executive functions and positive symptoms were associated with the impairments in FES. The current study indicates the presence of stage-specific mechanisms of mentalizing impairments and self-referential hypermentalizing bias, providing insights into the importance of personalized interventions to improve specific neurocognitive domains, social cognition, and clinical outcomes for FES and ARMS.
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Affiliation(s)
- Harry Kam Hung Tsui
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong SAR
| | - Yingqi Liao
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong SAR
| | - Janet Hsiao
- Division of Social Science, Hong Kong University of Science & Technology, Clear Water Bay, Hong Kong SAR, China
| | - Yi Nam Suen
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong SAR
| | | | - Lap-Tak Poon
- Department of Psychiatry, United Christian Hospital, Kwun Tong, Hong Kong SAR
| | - Man Wah Siu
- Department of Psychiatry, Kwai Chung Hospital, Kwai Chung, Hong Kong SAR
| | - Christy Lai Ming Hui
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong SAR
| | - Wing Chung Chang
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong SAR
- The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Pok Fu Lam, Hong Kong SAR
| | - Edwin Ho Ming Lee
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong SAR
| | - Eric Yu Hai Chen
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong SAR
- The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Pok Fu Lam, Hong Kong SAR
| | - Sherry Kit Wa Chan
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong SAR.
- The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Pok Fu Lam, Hong Kong SAR.
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López-Carrilero R, Lo Monaco M, Frígola-Capell E, Ferrer-Quintero M, Díaz-Cutraro L, Verdaguer-Rodríguez M, García-Mieres H, Vila-Badia R, Punsoda-Puche P, Birulés I, Peláez T, Pousa E, Grasa E, Barajas A, Ruiz-Delgado I, Barrigón ML, Gonzalez-Higueras F, Lorente-Rovira E, Gutiérrez-Zotes A, Cid J, Legido T, Ayesa-Arriola R, Moritz S, Ochoa S. Cognitive insight in first-episode psychosis: Exploring the complex relationship between executive functions and social cognition. SPANISH JOURNAL OF PSYCHIATRY AND MENTAL HEALTH 2024; 17:160-167. [PMID: 38219901 DOI: 10.1016/j.sjpmh.2024.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Revised: 12/18/2023] [Accepted: 01/09/2024] [Indexed: 01/16/2024]
Abstract
Social cognition (SC) and executive function (EF) have been described as important variables for social functioning and recovery of patients with psychosis. However, the relationship between SC and EF in first-episode psychosis (FEP) deserves further investigation, especially focusing on gender differences. AIMS To investigate the relationship between EF and different domains of SC in FEP patients and to explore gender differences in the relationship between these domains. METHODS A cross-sectional study of 191 patients with new-onset psychosis recruited from two multicenter clinical trials. A comprehensive cognitive battery was used to assess SC (Hinting Task, Face Test and IPSAQ) and EF (TMT, WSCT, Stroop Test and digit span - WAIS-III). Pearson correlations and linear regression models were performed. RESULTS A correlation between Theory of Mind (ToM), Emotional Recognition (ER) and EF was found using the complete sample. Separating the sample by gender showed different association profiles between these variables in women and men. CONCLUSIONS A relationship between different domains of SC and EF is found. Moreover, women and men presented distinct association profiles between EF and SC. These results should be considered in order to improve the treatment of FEP patients and designing personalized interventions by gender.
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Affiliation(s)
- Raquel López-Carrilero
- Etiopatogènia i Tractament dels Trastorns Mentals Greus (MERITT), Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain; Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain; Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Mercedes Lo Monaco
- Etiopatogènia i Tractament dels Trastorns Mentals Greus (MERITT), Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain; Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
| | - Eva Frígola-Capell
- Mental Health & Addiction Research Group, IdiBGi - Institut d'Assistencia Sanitària, Girona, Spain
| | - Marta Ferrer-Quintero
- Etiopatogènia i Tractament dels Trastorns Mentals Greus (MERITT), Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain; Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain; Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, 28029 Madrid, Spain; Social and Quantitative Psychology Department, University of Barcelona, Spain; Hospital Gregorio Marañón, Madrid, Spain
| | - Luciana Díaz-Cutraro
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain; Psychology Department, FPCEE Blanquerna, Universitat Ramon Llull, Barcelona, Spain
| | - Marina Verdaguer-Rodríguez
- Etiopatogènia i Tractament dels Trastorns Mentals Greus (MERITT), Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain; Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
| | - Helena García-Mieres
- Etiopatogènia i Tractament dels Trastorns Mentals Greus (MERITT), Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain; Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain; Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | - Regina Vila-Badia
- Etiopatogènia i Tractament dels Trastorns Mentals Greus (MERITT), Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain; Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain; Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, 28029 Madrid, Spain
| | | | - Irene Birulés
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain; Social and Quantitative Psychology Department, University of Barcelona, Spain
| | - Trinidad Peláez
- Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain
| | - Esther Pousa
- Department of Psychiatry, Institut d'Investigació Biomèdica-Sant Pau (IIB-Sant Pau), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain; Departament de Psicologia Clínica i de la Salut, Facultat de Psicologia, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Barcelona, Spain; Salut Mental Parc Taulí, Sabadell, Hospital Universitari, UAB Universitat Autònoma de Barcelona, Sabadell, Spain; Neuropsiquiatria i Addicions, Hospital del Mar, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Eva Grasa
- Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, 28029 Madrid, Spain; Department of Psychiatry, Institut d'Investigació Biomèdica-Sant Pau (IIB-Sant Pau), Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - Ana Barajas
- Serra Húnter Programme, Department of Clinical and Health Psychology, Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Barcelona, Spain; Centre d'Higiene Mental Les Corts, Department of Research, Barcelona, Spain
| | - Isabel Ruiz-Delgado
- Unidad de Salud Mental Comunitaria Málaga Norte, UGC Salud Mental Carlos Haya, Servicio Andaluz de Salud, Málaga, Spain
| | - María Luisa Barrigón
- Departamento de Psiquiatría, Hospital Universitario Virgen del Rocio, Sevilla, Spain; Hospital Gregorio Marañón, Madrid, Spain
| | | | - Esther Lorente-Rovira
- Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, 28029 Madrid, Spain; Psychiatry Service, Hospital Clínico Universitario de Valencia, Spain
| | - Alfonso Gutiérrez-Zotes
- Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, 28029 Madrid, Spain; Institut d'Investigació Sanitària Pere Virgili (IISPV), Hospital Universitari Institut Pere Mata, Universitat Rovira i Virgili, Reus, Spain
| | - Jordi Cid
- Mental Health & Addiction Research Group, IdiBGi - Institut d'Assistencia Sanitària, Girona, Spain
| | - Teresa Legido
- Neuropsiquiatria i Addicions, Hospital del Mar, IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
| | - Rosa Ayesa-Arriola
- Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, 28029 Madrid, Spain; Unidad de Investigación en Psiquiatría (IDIVAL), Hospital Universitario Marqués de Valdecilla, Santander, Spain
| | - Steffen Moritz
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg, Hamburg, Germany
| | - Susana Ochoa
- Etiopatogènia i Tractament dels Trastorns Mentals Greus (MERITT), Institut de Recerca Sant Joan de Déu, Esplugues de Llobregat, Spain; Parc Sanitari Sant Joan de Déu, Sant Boi de Llobregat, Spain; Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, 28029 Madrid, Spain.
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Bora E, Eyuboglu MS, Cesim E, Demir M, Yalincetin B, Ermis C, Özbek Uzman S, Sut E, Demirlek C, Verim B, Baykara B, İnal N, Akdede BB. Social cognition and neurocognition in first-episode bipolar disorder and psychosis: The effect of negative and attenuated positive symptoms. J Affect Disord 2024; 351:356-363. [PMID: 38290586 DOI: 10.1016/j.jad.2024.01.237] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/11/2023] [Revised: 01/13/2024] [Accepted: 01/26/2024] [Indexed: 02/01/2024]
Abstract
BACKGROUND Schizophrenia and bipolar disorder are associated with neurocognitive and social-cognitive impairments. To date very few studies investigated social cognition in first-episode bipolar disorder (FEBD). Our main aim was to investigate the differences in social cognition and neurocognition between FEBD and first-episode psychosis (FEP). Another aim was to investigate neurocognitive correlates of negative symptoms and attenuated psychotic symptoms in FEBD. METHODS This study included 55 FEBD, 64 FEP and 43 healthy controls. A comprehensive neuropsychological battery assessing social cognition, processing speed, verbal and visual memory, working memory, sustained attention, and executive functions was administered to all participants. RESULTS Both FEBD and FEP were associated with widespread deficits in all neurocognitive domains and social cognition. Both FEP (d = -1.19) and FEBP (d = -0.88) were also impaired in social cognition. In FEP, effect sizes (Cohen's d) of neurocognitive deficits ranged from -0.71 to -1.56. FEBD was also associated with relatively milder but similar neurocognitive deficits (d = -0.61 to-1.17). FEBD group performed significantly better than FEP group in verbal and visual memory, processing speed, and executive function domains (d = -0.40 to-0.52). Negative symptoms and social functioning were associated with neuropsychological impairment in both groups. The severity of attenuated psychotic symptoms was associated with poorer verbal memory in FEBD (r = -0.39, p < 0.01). LIMITATIONS The cross-sectional nature of the current study is the main limitation. CONCLUSIONS Neurocognitive and social-cognitive deficits are evident in both FEBD and FEP. In FEBD, more severe memory deficits might be markers of clinical overlap and shared neurobiological vulnerability with psychotic disorders.
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Affiliation(s)
- E Bora
- Department of Psychiatry, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey; Department of Neurosciences, Health Sciences Institute, Dokuz Eylul University, Izmir, Turkey; Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne and Melbourne Health, Carlton South, Victoria 3053, Australia.
| | - M S Eyuboglu
- Department of Neurosciences, Health Sciences Institute, Dokuz Eylul University, Izmir, Turkey
| | - E Cesim
- Department of Neurosciences, Health Sciences Institute, Dokuz Eylul University, Izmir, Turkey
| | - M Demir
- Department of Neurosciences, Health Sciences Institute, Dokuz Eylul University, Izmir, Turkey
| | - B Yalincetin
- Department of Neurosciences, Health Sciences Institute, Dokuz Eylul University, Izmir, Turkey
| | - C Ermis
- Queen Silvia Children's Hospital, Department Child and Adolescent Psychiatry, Gothenburg, Sweden
| | - S Özbek Uzman
- Department of Psychiatry, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - E Sut
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - C Demirlek
- Department of Neurosciences, Health Sciences Institute, Dokuz Eylul University, Izmir, Turkey; Department of Psychiatry, McLean Hospital, Harvard Medical School, Belmont, MA, USA
| | - B Verim
- Department of Neurosciences, Health Sciences Institute, Dokuz Eylul University, Izmir, Turkey
| | - B Baykara
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - N İnal
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
| | - B B Akdede
- Department of Psychiatry, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey; Department of Neurosciences, Health Sciences Institute, Dokuz Eylul University, Izmir, Turkey
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Cowman M, Godfrey E, Walsh T, Frawley E, Fowler D, Alvarez-Jimenez M, O’Connor K, Wykes T, Birchwood M, Donohoe G. Measures of Social and Occupational Function in Early Psychosis: A Systematic Review and Meta-analysis. Schizophr Bull 2024; 50:266-285. [PMID: 37173277 PMCID: PMC10919778 DOI: 10.1093/schbul/sbad062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
Deficits in social and occupational function are widely reported in psychosis, yet no one measure of function is currently agreed upon as a gold standard in psychosis research. The aim of this study was to carry out a systematic review and meta-analysis of functioning measures to determine what measures were associated with largest effect sizes when measuring between-group differences, changes over time, or response to treatment. Literature searches were conducted based on PsycINFO and PubMed to identify studies for inclusion. Cross-sectional and longitudinal observational and intervention studies of early psychosis (≤5 years since diagnosis) that included social and occupational functioning as an outcome measure were considered. A series of meta-analyses were conducted to determine effect size differences for between-group differences, changes over time, or response to treatment. Subgroup analyses and meta-regression were carried out to account for variability in study and participant characteristics. One hundred and sixteen studies were included, 46 studies provided data (N = 13 261) relevant to our meta-analysis. Smallest effect sizes for changes in function over time and in response to treatment were observed for global measures, while more specific measures of social and occupational function showed the largest effect sizes. Differences in effect sizes between functioning measures remained significant after variability in study and participant characteristics were accounted for. Findings suggest that more specific measures of social function are better able to detect changes in function over time and in response to treatment.
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Affiliation(s)
- Megan Cowman
- Centre for Neuroimaging, Cognition & Genomics (NICOG), School of Psychology, University of Galway, Galway, Ireland
| | - Emmet Godfrey
- Centre for Neuroimaging, Cognition & Genomics (NICOG), School of Psychology, University of Galway, Galway, Ireland
| | - Talissa Walsh
- Centre for Neuroimaging, Cognition & Genomics (NICOG), School of Psychology, University of Galway, Galway, Ireland
| | - Emma Frawley
- Centre for Neuroimaging, Cognition & Genomics (NICOG), School of Psychology, University of Galway, Galway, Ireland
| | - David Fowler
- School of Psychology, University of Sussex, Falmer, UK
| | - Mario Alvarez-Jimenez
- Orygen, Melbourne, Australia
- Centre for Youth Mental Health, The University of Melbourne, Parkville, Australia
| | - Karen O’Connor
- RISE Early Intervention in Psychosis Service, South Lee Mental Health Service, Cork, Ireland
- Department of Psychiatry and Neurobehavioural Science, University College Cork, Cork, Ireland
| | - Til Wykes
- School of Mental Health & Psychological Sciences, King’s College London, London, UK
| | - Max Birchwood
- Warwick Medical School, University of Warwick, Coventry, UK
| | - Gary Donohoe
- Centre for Neuroimaging, Cognition & Genomics (NICOG), School of Psychology, University of Galway, Galway, Ireland
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Giordano GM, Pezzella P, Mucci A, Austin SF, Erfurth A, Glenthøj B, Hofer A, Hubenak J, Libiger J, Melle I, Nielsen MØ, Rybakowski JK, Wojciak P, Galderisi S, Sachs G. Negative symptoms and social cognition as mediators of the relationship between neurocognition and functional outcome in schizophrenia. Front Psychiatry 2024; 15:1333711. [PMID: 38356912 PMCID: PMC10864497 DOI: 10.3389/fpsyt.2024.1333711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2023] [Accepted: 01/15/2024] [Indexed: 02/16/2024] Open
Abstract
Introduction In this study we assessed the contribution of psychopathology, including the two domains of negative symptoms (motivational deficit and expressive deficit), processing speed as an index of neurocognition, and emotion recognition, as an index of social cognition, to poor functional outcomes in people with schizophrenia. Methods The Positive and Negative Syndrome Scale was used to evaluate positive symptoms and disorganization and the Brief Negative Symptom Scale to assess negative symptoms. The Symbol Coding and the Trail Making Test A and B were used to rate processing speed and the Facial Emotion Identification Test to assess emotion recognition. Functional outcome was assessed with the Personal and Social Performance Scale (PSP). Regression analyses were performed to identify predictors of functional outcome. Mediation analyses was used to investigate whether social cognition and negative symptom domains fully or partially mediated the impact of processing speed on functional outcome. Results One hundred and fifty subjects from 8 different European centers were recruited. Our data showed that the expressive deficit predicted global functioning and together with motivational deficit fully mediated the effects of neurocognition on it. Motivational deficit was a predictor of personal and social functioning and fully mediated neurocognitive impairment effects on the same outcome. Both motivational deficit and neurocognitive impairment predicted socially useful activities, and the emotion recognition domain of social cognition partially mediated the impact of neurocognitive deficits on this outcome. Conclusions Our results indicate that pathways to functional outcomes are specific for different domains of real-life functioning and that negative symptoms and social cognition mediate the impact of neurocognitive deficits on different domains of functioning. Our results suggest that both negative symptoms and social cognition should be targeted by psychosocial interventions to enhance the functional impact of neurocognitive remediation.
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Affiliation(s)
- Giulia M. Giordano
- Department of Psychiatry, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Pasquale Pezzella
- Department of Psychiatry, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Armida Mucci
- Department of Psychiatry, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Stephen F. Austin
- Psychiatric Research Unit, Region Zealand Psychiatry, Slagelse, Denmark
| | - Andreas Erfurth
- 6th Psychiatric Department, Otto-Wagner-Spital, Vienna, Austria
| | - Birte Glenthøj
- Center for Neuropsychiatric Schizophrenia Research (CNSR) and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), Mental Health Center Glostrup, Glostrup, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Alex Hofer
- Medical University Innsbruck, Department of Psychiatry, Psychotherapy, Psychosomatics and Medical Psychology, Division of Psychiatry I, Innsbruck, Austria
| | - Jan Hubenak
- Department of Psychiatry, Charles University, Faculty of Medicine and University Hospital Hradec Králové, Hradec Králové, Czechia
| | - Jan Libiger
- Department of Psychiatry, Charles University, Faculty of Medicine and University Hospital Hradec Králové, Hradec Králové, Czechia
| | - Ingrid Melle
- NORMENT Centre, Institute of Clinical Psychiatry, University of Oslo and Oslo University Hospital, Oslo, Norway
| | - Mette Ø. Nielsen
- Center for Neuropsychiatric Schizophrenia Research (CNSR) and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research (CINS), Mental Health Center Glostrup, Glostrup, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Janusz K. Rybakowski
- Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland
| | - Pawel Wojciak
- Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland
| | - Silvana Galderisi
- Department of Psychiatry, University of Campania “Luigi Vanvitelli”, Naples, Italy
| | - Gabriele Sachs
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
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Uğurpala C, Tükel R, Ziylan EÇ, Ertekin E, Berberoğlu E. Social Cognition and Functioning in Patients With Social Anxiety Disorder and/or Attention-Deficit/Hyperactivity Disorder. J Nerv Ment Dis 2023; 211:828-834. [PMID: 37432028 DOI: 10.1097/nmd.0000000000001696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/12/2023]
Abstract
ABSTRACT In recent years, social cognition and one of its dimensions, the theory of mind, have been more commonly investigated in patients with social anxiety disorder (SAD) and attention-deficit/hyperactivity disorder (ADHD). In this study, SAD, ADHD, comorbid SAD-ADHD, and healthy control (HC) groups, each consisting of 30 participants, were included and compared in terms of social cognition and functionality. Mean global functioning assessment scores were found to be significantly higher in the HC group compared with the other three groups and in the ADHD group compared with the SAD and SAD-ADHD groups. Mean Dokuz Eylül Theory of Mind Index total scores were found to be significantly higher in the HC group compared with the other three groups and in the SAD and SAD-ADHD groups compared with the ADHD group. These findings suggest that SAD patients with or without ADHD show better social cognition but worse functioning compared with pure ADHD patients.
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Affiliation(s)
- Can Uğurpala
- Department of Psychiatry, Istanbul Faculty of Medicine, Istanbul University, Çapa, Fatih, Istanbul, Turkey
| | - Raşit Tükel
- Department of Psychiatry, Istanbul Faculty of Medicine, Istanbul University, Çapa, Fatih, Istanbul, Turkey
| | - Ege Çağın Ziylan
- Physiology and Pharmacology Laboratory, Beykent University Faculty of Medicine, Beykent University, Büyükçekmece, Istanbul, Turkey
| | - Erhan Ertekin
- Department of Psychiatry, Istanbul Faculty of Medicine, Istanbul University, Çapa, Fatih, Istanbul, Turkey
| | - Ertuğ Berberoğlu
- Department of Psychiatry, Istanbul Faculty of Medicine, Istanbul University, Çapa, Fatih, Istanbul, Turkey
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Joseph Fortuny J, Navarra-Ventura G, Fernández-Gonzalo S, Pousa Tomàs E, Crosas Armengol JM, Palao Vidal D, Jodar Vicente M. Social cognition in first-episode schizophrenia/schizoaffective disorder patients. SPANISH JOURNAL OF PSYCHIATRY AND MENTAL HEALTH 2023; 16:169-174. [PMID: 32499122 DOI: 10.1016/j.rpsm.2020.04.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Revised: 03/06/2020] [Accepted: 04/06/2020] [Indexed: 11/16/2022]
Abstract
INTRODUCTION People with schizophrenia have neurocognitive as well as social cognition deficits. Numerous studies have shown impairment in these domains in patients with chronic schizophrenia. However, these disturbances during the early phase of the disease have been less studied. OBJECTIVE The aim of the study is to explore the theory of mind (ToM) and emotional processing in first-episode patients, compared to healthy subjects. METHOD Forty patients with a first psychotic episode of less than 5 years' duration, and 40 healthy control subjects matched by age and years of schooling were assessed. The measures of social cognition included four stories of false belief, the Reading the Mind in the Eyes Test (RMET) and the Pictures Of Facial Affect (POFA) series. RESULTS The patients with a first psychotic episode performed significantly worse in all tasks of social cognition, compared to the healthy controls. The second-order ToM was impaired whereas the first-order ToM was preserved in the patients. Happiness was the emotion most easily identified by both patients and controls. Fear was most difficult for the patients, while for the controls it was disgust. CONCLUSIONS Deficits in ToM and emotional processing are present in patients with a first psychotic episode.
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Affiliation(s)
- Judit Joseph Fortuny
- Departamento de Psicología Clínica y de la Salud, Universitat Autònoma de Barcelona, International Excellence Campus Bellaterra, Barcerlona, Spain
| | - Guillem Navarra-Ventura
- Departamento Salud Mental, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Sanitària Parc Taulí (I3PT), Universitat Autònoma de Barcelona, Sabadell, Spain
| | - Sol Fernández-Gonzalo
- Departamento de Psicología Clínica y de la Salud, Universitat Autònoma de Barcelona, International Excellence Campus Bellaterra, Barcerlona, Spain; Departamento de Investigación, Instituto de Investigación e Innovación Parc Taulí, Sabadell, Spain; Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Esther Pousa Tomàs
- Departamento Salud Mental, Hospital del Mar, Institut de Neuropsiquiatria i Addiccions, Universitat Autònoma de Barcelona, Barcerlona, Spain
| | - Josep Maria Crosas Armengol
- Departamento Salud Mental, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Sanitària Parc Taulí (I3PT), Universitat Autònoma de Barcelona, Sabadell, Spain
| | - Diego Palao Vidal
- Departamento Salud Mental, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Sanitària Parc Taulí (I3PT), Universitat Autònoma de Barcelona, Sabadell, Spain; Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Departamento de Psiquiatría y Medicina Forense, Universitat Autònoma de Barcelona, International Excellence Campus Bellaterra, Barcelona, Spain
| | - Mercè Jodar Vicente
- Departamento de Psicología Clínica y de la Salud, Universitat Autònoma de Barcelona, International Excellence Campus Bellaterra, Barcerlona, Spain; Centro de Investigación Biomédica en Red en Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Departamento Neurología, Parc Taulí Hospital Universitari, Institut d'Investigació i Innovació Sanitària Parc Taulí (I3PT), Universitat Autònoma de Barcelona, Sabadell, Spain.
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8
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Sauvé G, Buck G, Lepage M, Corbière M. Minds@Work: A New Manualized Intervention to Improve Job Tenure in Psychosis Based on Scoping Review and Logic Model. JOURNAL OF OCCUPATIONAL REHABILITATION 2022; 32:515-528. [PMID: 34331191 DOI: 10.1007/s10926-021-09995-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 07/05/2021] [Indexed: 06/13/2023]
Abstract
Introduction A significant proportion of people experiencing psychosis are unemployed, despite a strong desire to work. Current supported employment programs appear effective in helping them obtain employment, yet job tenure remains an arduous challenge. The objective of this study was to review the literature and model the results to inform the development of a new manualized group psychosocial intervention-'Minds@Work'-aimed specifically at improving job tenure in psychosis. Methods The study was registered on the Open Science Framework platform ( https://osf.io/he68z ). The literature was searched in Medline, Embase, PsycInfo and Cochrane Library databases for studies examining predictors of job tenure in psychosis and existing occupational psychosocial interventions. Data were extracted using a pre-established form and synthesized using logic models. Results A total of 94 studies were included and their findings were modeled using different categories: intervention typologies, mechanisms of action, predictors of job tenure, outcomes and contextual factors. The 'Minds@Work' program was built based on these modeled findings and aimed to target specific predictors of job tenure while addressing some of the limitations of existing interventions. The program uses evidence-based techniques and is divided into 9 modules covering 4 themes: positive psychology (motivation, character strengths, self-compassion), neurocognitive remediation (attention, memory, problem-solving), cognitive biases training (jumping to conclusions, defeatists beliefs, theory of mind, attributional styles) and socioemotional coping skills (emotion regulation, communication). Conclusions Once validated, this new program is meant to be used either as a stand-alone intervention or integrated in supported employment initiatives, by employment specialists or healthcare workers.
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Affiliation(s)
- Geneviève Sauvé
- Department of Psychology, Université du Québec À Montréal, 100 Sherbrooke West, Montreal, QC, H2X 3P2, Canada
| | - Gabriella Buck
- Douglas Mental Health University Institute, 6875 LaSalle Blvd, Montreal, QC, H4H 1R3, Canada
| | - Martin Lepage
- Douglas Mental Health University Institute, 6875 LaSalle Blvd, Montreal, QC, H4H 1R3, Canada
- Department of Psychiatry, McGill University, 1033 Pine Avenue West, Montreal, QC, H3A 1A1, Canada
| | - Marc Corbière
- Centre de Recherche de L'Institut Universitaire en Santé Mentale de Montréal, 7331 Hochelaga, Montreal, QC, H1N 3V2, Canada.
- Department of Education - Career Counselling, Université du Québec À Montréal, Pavilion N, 1205 Saint-Denis, Montreal, QC, H2X 3R9, Canada.
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9
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Kubota R, Okubo R, Ikezawa S, Matsui M, Adachi L, Wada A, Fujimaki C, Yamada Y, Saeki K, Sumiyoshi C, Kikuchi A, Omachi Y, Takeda K, Hashimoto R, Sumiyoshi T, Yoshimura N. Sex Differences in Social Cognition and Association of Social Cognition and Neurocognition in Early Course Schizophrenia. Front Psychol 2022; 13:867468. [PMID: 35496257 PMCID: PMC9051335 DOI: 10.3389/fpsyg.2022.867468] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2022] [Accepted: 03/25/2022] [Indexed: 11/13/2022] Open
Abstract
Background Both impairment and sex differences in social cognition and neurocognition have been documented in schizophrenia. However, whether sex differences exist in the association between social cognition and neurocognition are not known. We aimed to investigate the contribution of areas of neurocognition to theory of mind (ToM) and hostility bias, representing social cognition, according to sex in early course schizophrenia. Methods In this cross-sectional study, we assessed neurocognition using the Japanese version of the Brief Assessment of Cognition in Schizophrenia (BACS) and assessed the ToM and hostility bias subdomains of social cognition using the Social Cognition Screening Questionnaire (SCSQ) in 131 participants (65 female, 66 male) diagnosed with schizophrenia within 5 years of onset. Sex differences were analyzed using t-tests. The associations of neurocognitive subdomains with ToM and hostility bias according to sex were analyzed using multiple regression analysis. Results were adjusted by age, estimated premorbid intelligence quotient, and symptomatology. Results No sex differences were found in ToM (p = 0.071) or hostility bias (p = 0.057). Higher verbal fluency was significantly associated with higher ToM in females (p < 0.01), whereas higher executive function was significantly associated with higher ToM in males (p < 0.05). Higher verbal fluency was significantly associated with lower hostility bias in females (p < 0.05), whereas neurocognition and hostility bias were not significantly associated in males. Conclusion The results suggest that neurocognition associated with social cognition differ according to sex. These differences should be considered for more effective treatment of social cognition.
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Affiliation(s)
- Ryotaro Kubota
- Department of Psychiatry, National Center of Neurology and Psychiatry Hospital, Tokyo, Japan
| | - Ryo Okubo
- Department of Psychiatry, National Center of Neurology and Psychiatry Hospital, Tokyo, Japan
- Clinical Research and Education Promotion Division, National Center of Neurology and Psychiatry, Tokyo, Japan
- *Correspondence: Ryo Okubo,
| | - Satoru Ikezawa
- Department of Psychiatry, National Center of Neurology and Psychiatry Hospital, Tokyo, Japan
- Endowed Institute for Empowering Gifted Minds, Graduate School of Arts and Sciences, The University of Tokyo, Tokyo, Japan
- Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
- Satoru Ikezawa,
| | - Makoto Matsui
- Department of Psychiatry, National Center of Neurology and Psychiatry Hospital, Tokyo, Japan
| | - Leona Adachi
- Department of Psychiatry, National Center of Neurology and Psychiatry Hospital, Tokyo, Japan
| | - Ayumu Wada
- Department of Psychiatry, National Center of Neurology and Psychiatry Hospital, Tokyo, Japan
- Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Chinatsu Fujimaki
- Department of Psychiatry, National Center of Neurology and Psychiatry Hospital, Tokyo, Japan
| | - Yuji Yamada
- Department of Psychiatry, National Center of Neurology and Psychiatry Hospital, Tokyo, Japan
| | - Koji Saeki
- Department of Psychiatry, National Center of Neurology and Psychiatry Hospital, Tokyo, Japan
| | - Chika Sumiyoshi
- Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
- Faculty of Human Development and Culture, Fukushima University, Fukushima, Japan
- Department of Pathology of Mental Diseases, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Akiko Kikuchi
- Department of Community Mental Health and Law, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Yoshie Omachi
- Department of Psychiatry, National Center of Neurology and Psychiatry Hospital, Tokyo, Japan
| | - Kazuyoshi Takeda
- Department of Psychiatry, National Center of Neurology and Psychiatry Hospital, Tokyo, Japan
- Clinical Research and Education Promotion Division, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Ryota Hashimoto
- Department of Pathology of Mental Diseases, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Tomiki Sumiyoshi
- Department of Psychiatry, National Center of Neurology and Psychiatry Hospital, Tokyo, Japan
- Department of Preventive Intervention for Psychiatric Disorders, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Naoki Yoshimura
- Department of Psychiatry, National Center of Neurology and Psychiatry Hospital, Tokyo, Japan
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10
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Kim NS, Lee TY, Hwang WJ, Kwak YB, Kim S, Moon SY, Lho SK, Oh S, Kwon JS. White Matter Correlates of Theory of Mind in Patients With First-Episode Psychosis. Front Psychiatry 2021; 12:617683. [PMID: 33746794 PMCID: PMC7973210 DOI: 10.3389/fpsyt.2021.617683] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/15/2020] [Accepted: 02/08/2021] [Indexed: 11/15/2022] Open
Abstract
Deficits in theory of mind (ToM) are considered as a distinctive feature of schizophrenia. Functional magnetic resonance imaging (fMRI) studies have suggested that aberrant activity among the regions comprising the mentalizing network is related to observed ToM deficits. However, the white matter structures underlying the ToM functional network in schizophrenia remain unclear. To investigate the relationship between white matter integrity and ToM impairment, 35 patients with first-episode psychosis (FEP) and 29 matched healthy controls (HCs) underwent diffusion tensor imaging (DTI). Using tract-based spatial statistics (TBSS), fractional anisotropy (FA) values of the two regions of interest (ROI)-the cingulum and superior longitudinal fasciculus (SLF)-were acquired, and correlational analysis with ToM task scores was performed. Among the patients with FEP, ToM strange story scores were positively correlated with the FA values of the left cingulum and left SLF. There was no significant correlation between FA and ToM task scores in HCs. These results suggest that the left cingulum and SLF constitute a possible neural basis for ToM deficits in schizophrenia. Our study is the first to demonstrate the white matter connectivity underlying the mentalizing network, as well as its relation to ToM ability in patients with FEP.
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Affiliation(s)
- Nahrie Suk Kim
- Department of Brain and Cognitive Sciences, Seoul National University College of Natural Science, Seoul, South Korea
- Biomedical Research Institute, Pusan National University Yangsan Hospital, Yangsan, South Korea
| | - Tae Young Lee
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, South Korea
- Department of Psychiatry, Pusan National University Yangsan Hospital, Yangsan, South Korea
| | - Wu Jeong Hwang
- Department of Brain and Cognitive Sciences, Seoul National University College of Natural Science, Seoul, South Korea
| | - Yoo Bin Kwak
- Department of Brain and Cognitive Sciences, Seoul National University College of Natural Science, Seoul, South Korea
| | - Seowoo Kim
- Department of Brain and Cognitive Sciences, Seoul National University College of Natural Science, Seoul, South Korea
| | - Sun-Young Moon
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, South Korea
| | - Silvia Kyungjin Lho
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, South Korea
| | - Sanghoon Oh
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, South Korea
| | - Jun Soo Kwon
- Department of Brain and Cognitive Sciences, Seoul National University College of Natural Science, Seoul, South Korea
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, South Korea
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11
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Ruiz-Castañeda P, Santiago-Molina E, Aguirre-Loaiza H, Daza González MT. " Cool" and " Hot" Executive Functions in Patients With a Predominance of Negative Schizophrenic Symptoms. Front Psychol 2020; 11:571271. [PMID: 33250814 PMCID: PMC7674804 DOI: 10.3389/fpsyg.2020.571271] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Accepted: 10/06/2020] [Indexed: 02/01/2023] Open
Abstract
Background Patients with psychosis often present significant neurocognitive deficits, with executive function deficits (EEFF) being one of the most relevant cognitive impairments with the greatest impact on the functioning of their daily lives. However, although various findings of executive involvement were reported, it is not entirely clear whether there is a differential pattern of involvement according to the clinical symptoms or the deficits occur in all or only in some subcomponents of EEFF. Objective The present study had a double objective: to study the specific deficits in the cool and hot EEFF in a group of psychotic patients with a predominance of negative symptoms; and determine the possible associations between the performance of the patients in the cool an hot EEFF tasks with the negative symptoms, and with the behavioral alterations associated with the dysexecutive syndrome. Method 66 participants, 33 psychotic patients with a predominance of negative symptoms and 33 healthy control subjects matched in gender, age and educational level participated. Both groups were administered 4 cool EEFF tasks (coding/maintenance and updating of information in working memory, ability to change the mental set and planning), and 3 hot EEFF tasks (decision making in situations of uncertainty, recognition of emotions through facial expressions and theory of mind). In the group of patients, the Negative symptoms were evaluated through the Scale for the Evaluation of Negative Symptoms (SANS), and the behavioral alterations associated with dysexecutive syndrome through the subscale of "Executive Dysfunction" of the Frontal Systems Behavior Scale. Results Patients performed worse on three cool EEFF tasks and on two of the hot EEFF tasks. Additionally, we found a correlation between the SANS score and the "executive dysfunction" subscale, with the cold EEFF task that measures planning. Conclusion Our findings showed that in psychotic patients with a predominance of negative symptoms, both, the cognitive (cool) and emotional (hot) components of executive functions are affected. The results reinforce the need for a cognitive rehabilitation treatment of the executive components of the working memory and of those more socio-emotional aspects.
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Affiliation(s)
- Pamela Ruiz-Castañeda
- Neuropsychological Evaluation and Rehabilitation Center, University of Almería, Almeria, Spain.,Department of Psychology, University of Almería, Almeria, Spain
| | | | | | - María Teresa Daza González
- Neuropsychological Evaluation and Rehabilitation Center, University of Almería, Almeria, Spain.,Department of Psychology, University of Almería, Almeria, Spain
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12
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Sjølie C, Meyn EK, Raudeberg R, Andreassen OA, Vaskinn A. Nonsocial cognitive underpinnings of theory of mind in schizophrenia. Psychiatry Res 2020; 289:113055. [PMID: 32446008 DOI: 10.1016/j.psychres.2020.113055] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 03/27/2020] [Accepted: 04/30/2020] [Indexed: 12/30/2022]
Abstract
Social cognition is a mediator between nonsocial cognition and functional outcome in schizophrenia. However, the relationship between specific nonsocial cognitive and social cognitive domains is less clear. The aim of this study was to investigate which specific nonsocial cognitive domains best predict theory of mind (ToM) performance in schizophrenia. We indexed ToM by a composite score of the video-based Movie for the Assessment of Social Cognition test (MASCtot) in a sample of 91 individuals with schizophrenia. Nonsocial cognition was measured with the nonsocial cognitive subtests of the MATRICS Consensus Cognitive Battery (MCCB) and the Wechsler Abbreviated Scale of Intelligence (WASI IQ). Bivariate and multiple regression analyses were applied. We found statistically significant bivariate associations between MASCtot and five nonsocial cognitive tests, measuring intelligence, speed of processing, verbal or visual memory, and non-verbal working memory. Together, they accounted for 17% of the variation in MASCtot, but none of the five tests made significant unique contributions to MASCtot in the regression analysis. Our results confirm that nonsocial cognition and ToM are associated, albeit distinct, constructs. The findings suggest that cognitive remediation must include social cognitive targets in order to achieve improved ToM and better functioning.
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Affiliation(s)
- Charlotte Sjølie
- Norwegian Centre for Mental Disorders Research, Oslo University Hospital, Oslo, Norway
| | - Emilie K Meyn
- Norwegian Centre for Mental Disorders Research, Oslo University Hospital, Oslo, Norway
| | - Rune Raudeberg
- Department of Biological and Medical Psychology, Faculty of Psychology, University of Bergen
| | - Ole A Andreassen
- Norwegian Centre for Mental Disorders Research, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Anja Vaskinn
- Norwegian Centre for Mental Disorders Research, Oslo University Hospital, Oslo, Norway; Institute of Clinical Medicine, Faculty of Medicine, University of Oslo, Oslo, Norway.
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13
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Eddy CM. What Do You Have in Mind? Measures to Assess Mental State Reasoning in Neuropsychiatric Populations. Front Psychiatry 2019; 10:425. [PMID: 31354534 PMCID: PMC6636467 DOI: 10.3389/fpsyt.2019.00425] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Accepted: 05/29/2019] [Indexed: 12/12/2022] Open
Abstract
Social interaction is closely associated with both functional capacity and well-being. Previous research has not only revealed evidence of social dysfunction in individuals with a wide range of psychiatric and neurological disorders but also generated an abundance of potential measures for assessing social cognition. This review explores the most popular measures used within neuropsychiatric populations to investigate the ability to recognize or reason about the mental states of others. Measures are also critically analyzed in terms of strengths and limitations to aid task selection in future clinical studies. The most frequently applied assessment tools use verbal, visual or audiovisual forms of presentation and assess recognition of mental states from facial features, self-rated empathy, the understanding of other's cognitive mental states such as beliefs and intentions, or the ability to combine knowledge of other's thoughts and emotions in order to understand subtle communications or socially inappropriate behavior. Key weaknesses of previous research include limited investigation of relationships with clinical symptoms, and underutilization of measures of everyday social functioning that offer a useful counterpart to traditional "lab" tasks. Future studies should aim to carefully select measures not only based on the range of skills to be assessed but also taking into account potential difficulties with interpretation and the need to gain insight into the application of social cognitive skills as well as ability per se. Some of the best measures include those with well-matched control trials (e.g., Yoni Task) or those that restrict the influence of verbal deficits (e.g., intentions comic strip task), elicit spontaneous mentalizing (e.g., Animations Task), and possess greater ecological validity (e.g., Movie for the Assessment of Social Cognition). Social cognitive research within psychiatric populations will be further enhanced through the development of more closely matched control tasks, and the exploration of relationships between task performance, medication, strategy use, and broader emotional and motor functions.
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Affiliation(s)
- Clare M. Eddy
- Research and Innovation, BSMHFT National Centre for Mental Health, Birmingham, United Kingdom
- Institute of Clinical Sciences, College of Medical and Dental Sciences, University of Birmingham, Birmingham, United Kingdom
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