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Polner B, Jamalabadi H, van Kemenade BM, Billino J, Kircher T, Straube B. Speech-Gesture Matching and Schizotypal Traits: A Network Approach. Schizophr Bull 2024:sbae134. [PMID: 39046822 DOI: 10.1093/schbul/sbae134] [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] [Indexed: 07/27/2024]
Abstract
BACKGROUND AND HYPOTHESIS Impaired speech-gesture matching has repeatedly been shown in patients with schizophrenia spectrum disorders. Here, we tested the hypothesis that schizotypal traits in the general population are related to reduced speech-gesture matching performance and reduced self-reports about gesture perception. We further explored the relationships between facets of schizotypy and gesture processing in a network model. STUDY DESIGN Participants (1094 mainly healthy adults) were presented with concrete or abstract sentences accompanied with videos showing related or unrelated gestures. For each video, participants evaluated the alignment between speech and gesture. They also completed self-rating scales about the perception and production of gestures (Brief Assessment of Gesture scale) and schizotypal traits (Schizotypal Personality Questionnaire-Brief 22-item version). We analyzed bivariate associations and estimated a non-regularized partial Spearman correlation network. We characterized the network by analyzing bridge centrality and controllability metrics of nodes. STUDY RESULTS We found a negative relationship between both concrete and abstract gesture-speech matching performance and overall schizotypy. In the network, disorganization had the highest average controllability and it was negatively related to abstract speech-gesture matching. Bridge centralities indicated that self-reported production of gestures to enhance communication in social interactions connects self-reported gesture perception, schizotypal traits, and gesture processing task performance. CONCLUSION The association between impaired abstract speech-gesture matching and disorganization supports a continuum between schizophrenia and schizotypy. Using gestures to facilitate communication connects subjective and objective aspects of gesture processing and schizotypal traits. Future interventional studies in patients should test the potential causal pathways implied by this network model.
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Affiliation(s)
- Bertalan Polner
- Institute of Psychology, ELTE, Eötvös Loránd University, Budapest, Hungary
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
| | - Hamidreza Jamalabadi
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
| | - Bianca M van Kemenade
- Center for Psychiatry, Justus Liebig University Giessen, Giessen, Germany
- Center for Mind, Brain, and Behavior (CMBB), University of Marburg, Marburg, Germany, and Justus Liebig University Giessen, Giessen, Germany
| | - Jutta Billino
- Center for Mind, Brain, and Behavior (CMBB), University of Marburg, Marburg, Germany, and Justus Liebig University Giessen, Giessen, Germany
- Experimental Psychology, Lifespan Neuropsychology, Justus Liebig University Giessen, Giessen, Germany
| | - Tilo Kircher
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
- Center for Mind, Brain, and Behavior (CMBB), University of Marburg, Marburg, Germany, and Justus Liebig University Giessen, Giessen, Germany
| | - Benjamin Straube
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany
- Center for Mind, Brain, and Behavior (CMBB), University of Marburg, Marburg, Germany, and Justus Liebig University Giessen, Giessen, Germany
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DeBats CC, Abel DB, Sullivan MM, Koesterer SC, Linton IS, Mickens JL, Russell MT, Hammer LA, Minor KS. Social Activity in Schizotypy: Measuring Frequency and Enjoyment of Social Events. Behav Sci (Basel) 2024; 14:474. [PMID: 38920806 PMCID: PMC11201023 DOI: 10.3390/bs14060474] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2024] [Accepted: 06/03/2024] [Indexed: 06/27/2024] Open
Abstract
Improving social functioning deficits-a core characteristic of schizophrenia-spectrum disorders-is often listed by patients as a key recovery goal. Evidence suggests that social deficits also extend to people with schizotypy, a group at heightened risk for psychotic and other psychopathological disorders. One challenge of social functioning research in schizotypy is understanding whether social deficits arise from receiving less pleasure from social activities or from participating less in high-pleasure activities. However, limited information exists on what constitutes highly pleasurable, common social activities. In this study, 357 college students rated the frequency and enjoyment of 38 social activities. Our aims were to categorize activities based on their frequency and enjoyment, and whether these correlated with validated social functioning and schizotypy measures. We found that social activities could be characterized based on their frequency and enjoyment and created a frequency-enjoyment matrix that could be useful for future studies. Activities were correlated with social functioning, generally reaching a small effect size level, with increasing frequency and enjoyment showing associations with greater social functioning. Further, negative and disorganized-but not positive-traits were associated with less engagement and pleasure. Although follow-up studies in community samples are needed, our findings have the potential to help researchers and clinicians better understand which activities participants are more likely to engage in and derive pleasure from. The findings may also illustrate the extent to which social deficits may be due to less engagement or less pleasure from social activities, as well as which aspects of schizophrenia-spectrum disorders are associated with these facets of social functioning.
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Affiliation(s)
- Candice C. DeBats
- Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, IN 46202, USA; (C.C.D.); (D.B.A.); (M.M.S.); (S.C.K.); (I.S.L.); (J.L.M.); (M.T.R.)
| | - Danielle B. Abel
- Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, IN 46202, USA; (C.C.D.); (D.B.A.); (M.M.S.); (S.C.K.); (I.S.L.); (J.L.M.); (M.T.R.)
- West Haven VA Medical Center, West Haven, CT 06516, USA
| | - Morgan M. Sullivan
- Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, IN 46202, USA; (C.C.D.); (D.B.A.); (M.M.S.); (S.C.K.); (I.S.L.); (J.L.M.); (M.T.R.)
- Department of Psychology, University of Indianapolis, Indianapolis, IN 46227, USA
| | - Sophia C. Koesterer
- Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, IN 46202, USA; (C.C.D.); (D.B.A.); (M.M.S.); (S.C.K.); (I.S.L.); (J.L.M.); (M.T.R.)
- Department of Psychology, University of Iowa, Iowa City, IA 52242, USA
| | - Imani S. Linton
- Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, IN 46202, USA; (C.C.D.); (D.B.A.); (M.M.S.); (S.C.K.); (I.S.L.); (J.L.M.); (M.T.R.)
| | - Jessica L. Mickens
- Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, IN 46202, USA; (C.C.D.); (D.B.A.); (M.M.S.); (S.C.K.); (I.S.L.); (J.L.M.); (M.T.R.)
| | - Madisen T. Russell
- Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, IN 46202, USA; (C.C.D.); (D.B.A.); (M.M.S.); (S.C.K.); (I.S.L.); (J.L.M.); (M.T.R.)
| | - Lillian A. Hammer
- Department of Psychology, University of Southern Mississippi, Hattiesburg, MS 39406, USA;
| | - Kyle S. Minor
- Department of Psychology, Indiana University-Purdue University Indianapolis, Indianapolis, IN 46202, USA; (C.C.D.); (D.B.A.); (M.M.S.); (S.C.K.); (I.S.L.); (J.L.M.); (M.T.R.)
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Hu DD, Guo XD, Zheng H, Yan C, Lui SSY, Wang YY, Wang Y, Chan RCK. Empathic accuracy in individuals with schizotypal personality traits. Psych J 2024. [PMID: 38530878 DOI: 10.1002/pchj.743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2023] [Accepted: 01/31/2024] [Indexed: 03/28/2024]
Abstract
Empirical research using the Empathic Accuracy Task (EAT) has suggested that schizophrenia patients and people with schizotypal personality disorder exhibit lower empathic accuracy than healthy people. However, empathic accuracy in a subclinical sample with high levels of schizotypy has seldom been studied. Our study aimed to investigate empathy in a subclinical sample using the Chinese version of the EAT and a self-report empathy measure. Forty participants with high levels of schizotypy (HS participants) and 40 with low levels of schizotypy (LS participants), as measured by the Schizotypal Personality Questionnaire (SPQ), were recruited. All participants completed the Chinese version of the EAT and the self-report Questionnaire of Cognitive and Affective Empathy. Empathic accuracy (EA) scores and the intra-individual variability of EA scores were calculated. Independent samples t tests and Pearson correlation analyses were performed to examine group differences in empathy and the relationship between empathy and schizotypy respectively. HS participants exhibited reduced EA for both positive and negative videos, and larger intra-individual variability of EA for negative videos than LS participants. However, HS and LS participants did not differ in self-report cognitive empathy. Moreover, the interpersonal dimension of the SPQ was negatively correlated with EAT performance and self-report cognitive empathy in LS participants. Individuals with HS show poorer performance-based EA but relatively intact self-report cognitive empathy. This study provides empirical evidence for the ontogeny of empathy deficits in subclinical populations at risk of developing schizophrenia, supporting early interventions for social cognitive deficits.
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Affiliation(s)
- Ding-Ding Hu
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Xiao-Dong Guo
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Hong Zheng
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Chao Yan
- Key Laboratory of Brain Functional Genomics (MOES & STCSM), School of Psychology and Cognitive Science, East China Normal University, Shanghai, China
| | - Simon S Y Lui
- Department of Psychiatry, School of Clinical Medicine, The University of Hong Kong, Hong Kong Special Administrative Region, Hong Kong, China
| | - Yan-Yu Wang
- School of Psychology, Weifang Medical University, Weifang, China
| | - Yi Wang
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
| | - Raymond C K Chan
- Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
- Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
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Karamaouna P, Zouraraki C, Economou E, Kafetsios K, Bitsios P, Giakoumaki SG. Cold executive function processes and their hot analogs in schizotypy. J Int Neuropsychol Soc 2024; 30:285-294. [PMID: 37750805 DOI: 10.1017/s1355617723000590] [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] [Indexed: 09/27/2023]
Abstract
OBJECTIVE To examine cold (based on logical reasoning) versus hot (having emotional components) executive function processes in groups with high individual schizotypal traits. METHOD Two-hundred and forty-seven participants were administered the Schizotypal Personality Questionnaire and were allocated into schizotypal (cognitive-perceptual, paranoid, negative, disorganized) or control groups according to pre-specified criteria. Participants were also administered a battery of tasks examining working memory, complex selective attention, response inhibition, decision-making and fluid intelligence and their affective counterparts. The outcome measures of each task were reduced to one composite variable thus formulating five cold and five hot cognitive domains. Between-group differences in the cognitive domains were examined with repeated measures analyses of covariance. RESULTS For working memory, the control and the cognitive-perceptual groups outperformed negative schizotypes, while for affective working memory controls outperformed the disorganized group. Controls also scored higher compared with the disorganized group in complex selective attention, while both the control and the cognitive-perceptual groups outperformed negative schizotypes in complex affective selective attention. Negative schizotypes also had striking difficulties in response inhibition, as they scored lower compared with all other groups. Despite the lack of differences in fluid intelligence, controls scored higher compared with all schizotypal groups (except from cognitive-perceptual schizotypes) in emotional intelligence; the latter group reported higher emotional intelligence compared with negative schizotypes. CONCLUSION Results indicate that there is no categorical association between the different schizotypal dimensions with solely cold or hot executive function processes and support impoverished emotional intelligence as a core feature of schizotypy.
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Affiliation(s)
- Penny Karamaouna
- Laboratory of Neuropsychology, Department of Psychology, School of Social Sciences, University of Crete, Rethymno, Crete, Greece
- University of Crete Research Center for the Humanities, the Social and Education Sciences (UCRC), University of Crete, Rethymno, Crete, Greece
| | - Chrysoula Zouraraki
- Laboratory of Neuropsychology, Department of Psychology, School of Social Sciences, University of Crete, Rethymno, Crete, Greece
- University of Crete Research Center for the Humanities, the Social and Education Sciences (UCRC), University of Crete, Rethymno, Crete, Greece
| | - Elias Economou
- Laboratory of Experimental Psychology, Department of Psychology, School of Social Sciences, University of Crete, Rethymno, Crete, Greece
| | | | - Panos Bitsios
- Department of Psychiatry and Behavioural Sciences, Faculty of Medicine, University of Crete, Heraklion, Crete, Greece
| | - Stella G Giakoumaki
- Laboratory of Neuropsychology, Department of Psychology, School of Social Sciences, University of Crete, Rethymno, Crete, Greece
- University of Crete Research Center for the Humanities, the Social and Education Sciences (UCRC), University of Crete, Rethymno, Crete, Greece
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Alfimova M, Plakunova V, Kaleda V, Lezheiko T, Golimbet V. A comparative study of theory of mind in taxon-like clusters of psychometric schizotypes and individuals at genetic risk for schizophrenia. Cogn Neuropsychiatry 2023; 28:36-51. [PMID: 36382910 DOI: 10.1080/13546805.2022.2147814] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Introduction: Clinical and family studies suggest that alterations of theory of mind (ToM) represent a marker of genetic liability to schizophrenia. Findings regarding ToM in schizotypy are less consistent. The study aimed to explore whether this might be due to an insufficient account of the heterogeneity of schizotypy in prior research and/or the fact that in psychometric schizotypy ToM alterations could manifest as subtle peculiarities rather than overt errors of mentalising.Methods: Individuals without a family history of psychosis (n = 150) were assigned to low, positive, negative, and high mixed schizotypy classes based on a cluster analysis of 1322 subjects who completed the Schizotypal Personality Questionnaire. The classes were compared on their performance of faux pas tasks with 77 adult first-degree relatives of schizophrenia patients, who represent individuals at genetic risk for schizophrenia. Besides overt errors, subtle alterations in ToM were analysed using expert judgment.Results: The relatives tended to make overt errors and demonstrated specific features of intentional reasoning. None of the schizotypal classes showed similar trends.Conclusions: The results complement the literature on the subjective-objective disjunction in psychometric schizotypes and did not provide evidence that ToM anomalies are a marker of genetic liability to schizophrenia in this cohort.
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Affiliation(s)
| | | | - Vasily Kaleda
- Mental Health Research Center, Moscow, Russian Federation
| | | | - Vera Golimbet
- Mental Health Research Center, Moscow, Russian Federation
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Ruiz-Castañeda P, Santiago Molina E, Aguirre Loaiza H, Daza González MT. Positive symptoms of schizophrenia and their relationship with cognitive and emotional executive functions. Cogn Res Princ Implic 2022; 7:78. [PMID: 35960384 PMCID: PMC9374871 DOI: 10.1186/s41235-022-00428-z] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Accepted: 07/27/2022] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Positive symptoms of schizophrenia are associated with significant difficulties in daily functioning, and these difficulties have been associated with impaired executive functions (EEFF). However, specific cognitive and socio-emotional executive deficits have not been fully established. OBJECTIVE The present study has several objectives. First, we aimed to examine the specific deficits in cognitive and socio-emotional EEFF in a group of patients with schizophrenia with a predominance of positive symptoms, as well as to determine if these patients present clinically significant scores in any of the three fronto-subcortical behavioral syndromes: Dorsolateral, Orbitofrontal, or Anterior Cingulate. METHOD The sample consisted of 54 patients, 27 with a predominance of positive symptoms, and 27 healthy controls matched for gender, age, and education. The two groups completed four cognitive and three socio-emotional EEFF tasks. In the group of patients, positive symptoms were evaluated using the scale for the Evaluation of Positive Symptoms (SANS), while the behavioral alterations associated with the three fronto-subcortical syndromes were evaluated using the Frontal System Behavior Scale (FrSBe). RESULTS The patients, in comparison with a control group, presented specific deficits in cognitive and socio-emotional EEFF. In addition, a high percentage of patients presented clinically significant scores on the three fronto-subcortical syndromes. CONCLUSION The affectation that these patients present, in terms of both cognitive and emotional components, highlights the importance of developing a neuropsychological EEFF intervention that promotes the recovery of the affected cognitive capacities and improves the social and emotional functioning of the affected patients.
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Affiliation(s)
- Pamela Ruiz-Castañeda
- Neuropsychological Evaluation and Rehabilitation Center (CERNEP), University of Almeria, Carretera de Sacramento, s / n. La Cañada de San Urbano. 04120, Almeria, Spain
- Department of Psychology, University of Almeria Spain, Carretera de Sacramento, s /n. La Cañada de San Urbano. 04120, Almeria, Spain
| | - Encarnación Santiago Molina
- Mental Health Hospitalization Unit of Torrecárdenas University Hospital, Calle Hermandad de Donantes de Sangre, s/n, 04009, Almería, Spain
| | - Haney Aguirre Loaiza
- Department of Psychology, Catholic University of Pereira, Avenida Sur/Las Americas Cra 21 # 49-95, Pereira, Colombia
| | - María Teresa Daza González
- Neuropsychological Evaluation and Rehabilitation Center (CERNEP), University of Almeria, Carretera de Sacramento, s / n. La Cañada de San Urbano. 04120, Almeria, Spain.
- Department of Psychology, University of Almeria Spain, Carretera de Sacramento, s /n. La Cañada de San Urbano. 04120, Almeria, Spain.
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Seitz KI, Ehler N, Schmitz M, Schmitz SE, Dziobek I, Herpertz SC, Bertsch K. Affective and cognitive theory of mind in posttraumatic stress, major depressive, and somatic symptom disorders: Association with childhood trauma. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2022; 61:680-700. [PMID: 35102575 DOI: 10.1111/bjc.12357] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 01/12/2022] [Indexed: 11/28/2022]
Abstract
OBJECTIVES Childhood trauma constitutes a major risk factor for adult psychopathology, including posttraumatic stress disorder (PTSD), major depressive disorder (MDD), and somatic symptom disorder (SSD). One potential mechanism linking childhood trauma to adult psychopathology may be alterations in theory of mind (ToM). Given the lack of transdiagnostic studies on the association between childhood trauma and ToM, further research is needed to elucidate whether and how childhood trauma relates to ToM impairments across and within diagnostic boundaries. DESIGN A cross-sectional study design was applied. METHODS A total of 137 individuals with varying levels of childhood trauma took part in this study, encompassing individuals with PTSD (n = 33), MDD (n = 33), SSD (n = 36), and healthy volunteers (HVs; n = 35). To assess ToM performance and childhood trauma, the Movie for the Assessment of Social Cognition was administered along with the Childhood Trauma Questionnaire. RESULTS Only individuals with PTSD, but not individuals with MDD or SSD, showed a worse ToM performance compared to HVs. In the whole sample, childhood trauma correlated negatively with ToM performance. Exploratory group-specific analyses revealed higher levels of childhood trauma to be associated with more excessive ToM errors in individuals with SSD, and notably with an enhanced ToM performance in individuals with MDD. CONCLUSIONS Our results indicate associations between childhood trauma and ToM impairments in a large, transdiagnostic sample. Provided replication in future studies, our findings suggest ToM capacities as a promising treatment target for individuals exposed to severe childhood trauma, at least or particularly with a diagnosis of PTSD. PRACTITIONER POINTS Our results suggest that individuals with a history of severe childhood trauma, at least or particularly with a clinical diagnosis of posttraumatic stress disorder, may benefit from therapeutic approaches targeting theory of mind capacities. Our findings indicate that higher levels of childhood trauma may be linked to a specific 'hypermentalizing' bias in somatic symptom disorder. Our findings further point towards an association between higher levels of childhood trauma and a heightened - rather than a diminished - sensitivity towards interpersonal cues in major depressive disorder. Provided further confirmatory evidence, our findings may support diagnosis-specific approaches in ameliorating theory of mind abilities in individuals with different mental disorders and a history of severe childhood trauma.
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Affiliation(s)
- Katja I Seitz
- Department of General Psychiatry, Center for Psychosocial Medicine, Medical Faculty, Heidelberg University, Germany
| | - Nicola Ehler
- Department of General Psychiatry, Center for Psychosocial Medicine, Medical Faculty, Heidelberg University, Germany
| | - Marius Schmitz
- Department of General Psychiatry, Center for Psychosocial Medicine, Medical Faculty, Heidelberg University, Germany.,Department of Psychology, Ludwig-Maximilians-University Munich, Germany
| | - Sara E Schmitz
- Department of Psychosomatic Medicine and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Germany
| | - Isabel Dziobek
- Berlin School of Mind and Brain, Humboldt Universität zu Berlin, Germany.,Department of Psychology, Humboldt Universität zu Berlin, Germany
| | - Sabine C Herpertz
- Department of General Psychiatry, Center for Psychosocial Medicine, Medical Faculty, Heidelberg University, Germany
| | - Katja Bertsch
- Department of General Psychiatry, Center for Psychosocial Medicine, Medical Faculty, Heidelberg University, Germany.,Department of Psychology, Ludwig-Maximilians-University Munich, Germany
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[Theory of mind and schizotypy: A review]. Encephale 2021; 47:254-262. [PMID: 33648750 DOI: 10.1016/j.encep.2020.10.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2020] [Revised: 10/01/2020] [Accepted: 10/19/2020] [Indexed: 11/21/2022]
Abstract
OBJECTIVES Schizophrenia spectrum disorders are associated with incapacitating social impairments, mostly due to Theory of Mind (ToM) deficits. Theory of mind difficulties often precede the beginning of schizophrenia spectrum disorders and contribute highly to the social withdrawal of patients. They also predict bad outcome for individuals suffering from this condition. The use of samples of individuals presenting subclinical forms of schizophrenia spectrum disorders constitute an opportunity to study theory of mind capacities. Notably, the study of theory of mind deficits in schizotypy allows a better understanding of predictive markers of schizophrenia spectrum disorders. They also contribute to the identification of primary processes involved in social difficulties associated with these disorders. METHODS We searched PubMed, Science Direct and Google Scholar databases for peer-reviewed articles studying the association between theory of mind performance and schizotypal traits up to the 1 April 2020. The following syntax was used: schizotypy AND ("theory of mind" OR "social cognition" OR "irony" OR "false belief" OR "social inference" OR "hinting task"). We also checked the references from these articles for additional papers. Only English and French written articles were considered. RESULTS Twenty-three articles were included in the review. The majority of these studies (n=20) used behavioral measures of theory of mind (i.e. percentages of correct responses on a theory of mind task). Only a few (n=3) recent studies used brain imaging to study theory of mind in psychometric schizotypy. In those 23 studies, 18 report theory of mind difficulties in individuals with high schizotypal traits. Ten out of these 19 studies report an association between positive schizotypy and theory of mind deficits/hypomentalizing. The positive dimension was the most associated with theory of mind difficulties. The negative dimension was associated with theory of mind deficits in six studies out of 19 (33 %). The association between disorganization and theory of mind deficits was weak, mostly because of a lack of studies measuring this dimension (only one study out of 13 measured this particular trait). The association between hypermentalizing and schizotypy was poorly characterized, due to high heterogeneity in how this feature was conceptualized and measured. In summary, some authors consider good performance on a theory of mind task as a sign of hypermentalizing, while other authors consider that this feature relates to the production of erroneous interpretations of mental states. We advocate in favor of the second definition, and more studies using this framework should be conducted. Interestingly, the three studies using fMRI showed no significant behavioral differences between high and low schizotypal groups on theory of mind performance, while the patterns of brain activation differed. This shows that in individuals with schizotypy, theory of mind anomalies are not always captured just by behavioral performance. Brain imagery should be included in more studies to better understand theory of mind in schizotypy. In general, high heterogeneity in ways of assessing schizotypy, and in the tasks used to evaluate theory of mind, were found. Notably, some tasks require shallower theory of mind processing than others. It is a priority to design theory of mind tasks that allow for manipulating the difficulty of the items within one task, as well as the level of help that can be given, in order to allow for a better assessment of the impact of theory of mind difficulties and the ways to compensate for them. CONCLUSIONS The studies included in this review confirm the association between psychometric schizotypy and theory of mind. But the high heterogeneity in methods used in these studies, and notably the diversity in ways of assessing schizotypal traits and theory of mind, hinder a precise description of such an association. Additional studies are required. In particular, fMRI studies using tasks allowing for a precise description of altered and preserved theory of mind processes could be of great use in characterizing theory of mind difficulties associated with schizotypy.
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