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Bosco FM, Colle L, Salvini R, Gabbatore I. A machine-learning approach to investigating the complexity of theory of mind in individuals with schizophrenia. Heliyon 2024; 10:e30693. [PMID: 38756573 PMCID: PMC11096895 DOI: 10.1016/j.heliyon.2024.e30693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 04/23/2024] [Accepted: 05/02/2024] [Indexed: 05/18/2024] Open
Abstract
Individuals with schizophrenia have difficulty attributing mental states to themselves and to others - Theory of Mind (ToM). ToM is a complex, multifaceted theoretical construct comprising first and second order, first and third person, egocentric and allocentric perspective, and cognitive and affective ToM. Most studies addressing ToM deficit in people with schizophrenia consider it an "all-or-nothing" ability and use a classical statistical methodology to test a null hypothesis. With the present study, we investigated ToM in individuals with schizophrenia, considering its complex nature and degrees of impairment. To do this, we used a machine-learning approach to detect patterns in heterogeneous and multivariate data. Our findings highlight the complex nature of ToM deficit in individuals with schizophrenia and reveal the relationship between various different aspects of ToM.
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Affiliation(s)
| | - Livia Colle
- University of Turin, Department of Psychology, GIPSI Research Group, Italy
- Terzo Centro di Psicoterapia Cognitiva, Roma
| | - Rogerio Salvini
- Instituto de Informática, Universidade Federal de Goiás, Goiânia, GO, Brazil
| | - Ilaria Gabbatore
- University of Turin, Department of Psychology, GIPSI Research Group, Italy
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2
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Fuchs C, Silveira S, Meindl T, Musil R, Austerschmidt KL, Eilert DW, Müller N, Möller HJ, Engel R, Reiser M, Driessen M, Beblo T, Hennig-Fast K. Two Sides of Theory of Mind: Mental State Attribution to Moving Shapes in Paranoid Schizophrenia Is Independent of the Severity of Positive Symptoms. Brain Sci 2024; 14:461. [PMID: 38790440 PMCID: PMC11119087 DOI: 10.3390/brainsci14050461] [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: 03/26/2024] [Revised: 04/24/2024] [Accepted: 04/26/2024] [Indexed: 05/26/2024] Open
Abstract
BACKGROUND Theory of Mind (ToM) impairment has repeatedly been found in paranoid schizophrenia. The current study aims at investigating whether this is related to a deficit in ToM (undermentalizing) or an increased ToM ability to hyperattribute others' mental states (overmentalizing). METHODS Mental state attribution was examined in 24 patients diagnosed with schizophrenia (12 acute paranoid (APS) and 12 post-acute paranoid (PPS)) with regard to positive symptoms as well as matched healthy persons using a moving shapes paradigm. We used 3-T-functional magnetic resonance imaging (fMRI) to provide insights into the neural underpinnings of ToM due to attributional processes in different states of paranoid schizophrenia. RESULTS In the condition that makes demands on theory of mind skills (ToM condition), in patients with diagnosed schizophrenia less appropriate mental state descriptions have been used, and they attributed mental states less often to the moving shapes than healthy persons. On a neural level, patients suffering from schizophrenia exhibited within the ToM network hypoactivity in the medial prefrontal cortex (MPFC) and hyperactivity in the temporo-parietal junction (TPJ) as compared to the healthy sample. CONCLUSIONS Our results indicate both undermentalizing and hypoactivity in the MPFC and increased overattribution related to hyperactivity in the TPJ in paranoid schizophrenia, providing new implications for understanding ToM in paranoid schizophrenia.
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Affiliation(s)
- Christina Fuchs
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, 80539 Munich, Germany
| | - Sarita Silveira
- Institute of Medcial Psychology, Ludwig-Maximilians-University, 80539 Munich, Germany
| | - Thomas Meindl
- Department of Clinical Radiology, Ludwig-Maximilians-University, 80539 Munich, Germany
| | - Richard Musil
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, 80539 Munich, Germany
| | - Kim Laura Austerschmidt
- Department of Psychiatry and Psychotherapy, Universitätsklinikum OWL, 33617 Bielefeld, Germany
| | - Dirk W. Eilert
- Department of Psychology, Leopold-Franzens-University, A-6020 Innsbruck, Austria
| | - Norbert Müller
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, 80539 Munich, Germany
| | - Hans-Jürgen Möller
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, 80539 Munich, Germany
| | - Rolf Engel
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, 80539 Munich, Germany
| | - Maximilian Reiser
- Department of Clinical Radiology, Ludwig-Maximilians-University, 80539 Munich, Germany
| | - Martin Driessen
- Department of Psychiatry and Psychotherapy, Universitätsklinikum OWL, 33617 Bielefeld, Germany
| | - Thomas Beblo
- Department of Psychiatry and Psychotherapy, Universitätsklinikum OWL, 33617 Bielefeld, Germany
| | - Kristina Hennig-Fast
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University, 80539 Munich, Germany
- Department of Psychiatry and Psychotherapy, Universitätsklinikum OWL, 33617 Bielefeld, Germany
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Aranas DR. Delusional disorder with depression and history of early trauma: A case report. World J Neurol 2023; 9:8-16. [DOI: 10.5316/wjn.v9.i2.8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2022] [Revised: 12/18/2022] [Accepted: 02/07/2023] [Indexed: 03/01/2023] Open
Abstract
BACKGROUND The case report supports the recent findings regarding the correlation of posttraumatic stress disorder (PTSD) and schizophrenia. The report accomplished the following objectives: (1) To present a case of an adult female manifesting with somatic type of delusion (foul body odor) and history of PTSD; (2) To discuss the biopsychosocial factors, psychodynamics and management of the patient; and (3) To differentiate delusional disorder from schizophrenia according to recent studies. Schizophrenia and delusional disorder have certain defining features that separate the two. However, at times it may be difficult to actually classify one from the other. A psychiatrist must be able to carefully examine and assess the history of the patient, helping them share early life experiences of past traumatic events. The early past traumatic experiences and life events greatly influence the predisposition of a patient to develop schizophrenia. However, people with schizophrenia were known to underreport their trauma experience.
CASE SUMMARY This is a case of a young adult female diagnosed with delusional disorder with a history of PTSD and associated depression. The patient manifested with somatic type of delusion with a fixed false belief that a foul body odor was coming from her underarms.
CONCLUSION Developing a therapeutic alliance is vital in achieving therapy goals through empathy, support and warmth between the patient and physician. History of PTSD predisposes patients with schizophrenia to develop depressive disorders as a comorbidity.
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Affiliation(s)
- Denmarc Romero Aranas
- Department of Psychiatry, Baguio General Hospital - Medical Center, Baguio 2600, Benguet, Philippines
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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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Gourlay C, Collin P, D'Auteuil C, Jacques M, Scherzer PB. A further study of the psychometric qualities of the Strange Stories-Revised across the three stages of aging. APPLIED NEUROPSYCHOLOGY. ADULT 2022:1-9. [PMID: 35940197 DOI: 10.1080/23279095.2022.2109419] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
INTRODUCTION Happé's Strange Stories task was developed in 1994 to assess theory of mind, the ability to infer mental states in oneself and others. Since then, it has undergone revisions, translations, and adaptations. A modified version of the task, the Strange Stories-Revised (SS-R), previously showed satisfactory qualities in a study aiming at identifying psychometrically acceptable social cognitive measures. OBJECTIVE The current study expands upon the psychometric evaluation study by examining the qualities of a short version of the SS-R in a sample of healthy adult subjects. METHODS One hundred and eighteen healthy adults completed the task along with neurocognitive measures. Mean scores of the long and short versions were compared. Associations between ToM as measured by performance on this abbreviated version of the SS-R, and potential confounders were explored. Internal consistency, dimensionality of the short version, and performance comparisons across three stages of aging (18-34; 35-59; 60-85 years old) were investigated, and standard measurement error was calculated to improve precision and data interpretation. RESULTS Reliability coefficients were comparable in the short and long versions. Principal component analysis showed that a one-factor structure best fits the data. Significant differences were observed in ToM performance across the three age groups, indicating a decline with time that was also captured by the long version, starting during midlife and increasing in significance with age. CONCLUSION The short version of the SS-R is a promising measure that can be profitably used in time-limited settings to assess theory of mind.
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Affiliation(s)
- Catherine Gourlay
- Département de psychologie, Université du Québec à Montréal, Montréal, Canada
| | - Pascal Collin
- Département de psychologie, Université du Québec à Montréal, Montréal, Canada
| | - Camille D'Auteuil
- Département de psychologie, Université du Québec à Montréal, Montréal, Canada
| | - Marie Jacques
- Département de psychologie, Université du Québec à Montréal, Montréal, Canada
| | - Peter B Scherzer
- Département de psychologie, Université du Québec à Montréal, Montréal, Canada
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Rolli NJ. Mentalizing in Clinical Practice: Working with Children Whose Mother is Suffering from Psychotic Symptoms. BRITISH JOURNAL OF PSYCHOTHERAPY 2021. [DOI: 10.1111/bjp.12655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Brar PS, Sass L, Beck D, Kalarchian MA. Metacognitive training for schizophrenia: a scoping review and phenomenological evaluation. PSYCHOSIS-PSYCHOLOGICAL SOCIAL AND INTEGRATIVE APPROACHES 2021. [DOI: 10.1080/17522439.2021.1918753] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Affiliation(s)
- Pavan S. Brar
- Department of Psychology, Duquesne University, Pittsburgh, PA, USA
| | - Louis Sass
- Graduate School of Applied and Professional Psychology, Rutgers University, Pittsburgh, PA, USA
| | - Donna Beck
- Gumberg Library, Duquesne University, Pittsburgh, PA, USA
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Mazza M, Pino MC, Keller R, Vagnetti R, Attanasio M, Filocamo A, Le Donne I, Masedu F, Valenti M. Qualitative Differences in Attribution of Mental States to Other People in Autism and Schizophrenia: What are the Tools for Differential Diagnosis? J Autism Dev Disord 2021; 52:1283-1298. [PMID: 33909212 PMCID: PMC8854268 DOI: 10.1007/s10803-021-05035-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/18/2021] [Indexed: 11/26/2022]
Abstract
The differential diagnosis between schizophrenia spectrum disorders (SSD) and autism spectrum disorders (ASD) remains an important clinical question, because they have overlap in clinical diagnosis. This study explored the differences between ASD (n = 44) and SSD patients (n = 59), compared to typically developing peers (n = 63), in completing an advanced Theory of Mind (ToM) task. The outcome found several differences between groups. The SSD patients showed greater difficulty in understanding social scenarios, while ASD individuals understood the stories, but did not correctly identify the protagonist’s intention. The interesting aspect of the results is that some ToM stories are more informative about the mentalistic reasoning of the two clinical groups, namely, the stories that investigate pretend, persuasion, double bluff and ironic joke constructs.
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Affiliation(s)
- Monica Mazza
- Department of Applied Clinical Sciences and Biotechnology, University of L’Aquila, Via Vetoio, Località Coppito, 67100 L’Aquila, Italy
- Reference Centre for Autism of the Abruzzo Region, Local Health Unit ASL 1, L’Aquila, Italy
| | - Maria Chiara Pino
- Department of Applied Clinical Sciences and Biotechnology, University of L’Aquila, Via Vetoio, Località Coppito, 67100 L’Aquila, Italy
- Reference Centre for Autism of the Abruzzo Region, Local Health Unit ASL 1, L’Aquila, Italy
| | - Roberto Keller
- Reference Centre for Adult Autism of the Piemonte Region, DSM Local Health Unit ASL Città di Torino, Turin, Italy
| | - Roberto Vagnetti
- Department of Applied Clinical Sciences and Biotechnology, University of L’Aquila, Via Vetoio, Località Coppito, 67100 L’Aquila, Italy
| | - Margherita Attanasio
- Department of Applied Clinical Sciences and Biotechnology, University of L’Aquila, Via Vetoio, Località Coppito, 67100 L’Aquila, Italy
- Reference Centre for Autism of the Abruzzo Region, Local Health Unit ASL 1, L’Aquila, Italy
| | - Angela Filocamo
- Reference Centre for Autism of the Abruzzo Region, Local Health Unit ASL 1, L’Aquila, Italy
| | - Ilenia Le Donne
- Reference Centre for Autism of the Abruzzo Region, Local Health Unit ASL 1, L’Aquila, Italy
| | - Francesco Masedu
- Department of Applied Clinical Sciences and Biotechnology, University of L’Aquila, Via Vetoio, Località Coppito, 67100 L’Aquila, Italy
| | - Marco Valenti
- Department of Applied Clinical Sciences and Biotechnology, University of L’Aquila, Via Vetoio, Località Coppito, 67100 L’Aquila, Italy
- Reference Centre for Autism of the Abruzzo Region, Local Health Unit ASL 1, L’Aquila, Italy
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d’Arma A, Isernia S, Di Tella S, Rovaris M, Valle A, Baglio F, Marchetti A. Social Cognition Training for Enhancing Affective and Cognitive Theory of Mind in Schizophrenia: A Systematic Review and a Meta-Analysis. THE JOURNAL OF PSYCHOLOGY 2020; 155:26-58. [DOI: 10.1080/00223980.2020.1818671] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Affiliation(s)
- Alessia d’Arma
- IRCCS Fondazione Don Carlo Gnocchi
- Università Cattolica del Sacro Cuore
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10
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Gourlay C, Collin P, Caron PO, D'Auteuil C, Scherzer PB. Psychometric assessment of social cognitive tasks. APPLIED NEUROPSYCHOLOGY-ADULT 2020; 29:731-749. [PMID: 32841055 DOI: 10.1080/23279095.2020.1807348] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Although there has been a marked increase in interest in social cognition (SC) in recent years, psychometric data relating to many tasks used to measure its components remain limited in healthy populations with only five articles published to date. It is accordingly premature to speak of a consensus concerning the specific components, or best tests of the components, and possible cultural differences. The present study sought to partially fill that gap, examining the psychometric properties of a battery of SC tasks in a sample of 100 healthy adults aged 18-85 years old. Initially, nine tasks assessing four SC components were selected: emotion recognition, theory of mind, attributional bias, and social judgment. Construct validity and criterion-related validity were assessed using factor and correlational analyses. Performance across age and sex groups was also investigated. Reliability was assessed through internal consistency, interrater and intercoder agreement. Results indicated satisfactory properties for the Ambiguous Intentions Hostility Questionnaire-blame score, the Social Judgment Task, the Facial Emotions Recognition Test, and a modified version of the Strange Stories Task. Statistically significant differences were found between the groups with regard to age and sex after accounting for demographic and cognitive factors. However, the correlations of these measures with relationship quality were mostly very low, raising questions about their concomitant validity. Other tasks showed sub-optimal properties, suggesting that some frequently used tests require further validation or modifications to ensure the quality of research findings. Based on the results, recommended measures for future studies and limitations are discussed.
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Affiliation(s)
- Catherine Gourlay
- Department of Psychology, Université du Québec à Montréal, Montréal, Canada
| | - Pascal Collin
- Department of Psychology, Université du Québec à Montréal, Montréal, Canada
| | | | - Camille D'Auteuil
- Department of Psychology, Université du Québec à Montréal, Montréal, Canada
| | - Peter B Scherzer
- Department of Psychology, Université du Québec à Montréal, Montréal, Canada
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Nijman SA, Veling W, Greaves-Lord K, Vos M, Zandee CER, Aan Het Rot M, Geraets CNW, Pijnenborg GHM. Dynamic Interactive Social Cognition Training in Virtual Reality (DiSCoVR) for People With a Psychotic Disorder: Single-Group Feasibility and Acceptability Study. JMIR Ment Health 2020; 7:e17808. [PMID: 32763880 PMCID: PMC7442939 DOI: 10.2196/17808] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2020] [Revised: 05/04/2020] [Accepted: 05/14/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND People with a psychotic disorder commonly experience problems in social cognition and functioning. Social cognition training (SCT) improves social cognition, but may inadequately simulate real-life social interactions. Virtual reality (VR) provides a realistic, interactive, customizable, and controllable training environment, which could facilitate the application of skills in daily life. OBJECTIVE We developed a 16-session immersive VR SCT (Dynamic Interactive Social Cognition Training in Virtual Reality [DiSCoVR]) and conducted a single-group feasibility pilot study. METHODS A total of 22 people with a psychotic disorder and reported problems in social cognition participated. Feasibility and acceptability were assessed using a survey for participants and therapists, and by examining relevant parameters (eg, dropouts). We analyzed preliminary treatment effects on social cognition, neurocognition, and psychiatric symptoms. RESULTS A total of 17 participants completed the study. Participants enjoyed DiSCoVR (mean 7.25, SD 2.05; range 3-10), thought it was useful for daily social activities (mean 7.00, SD 2.05; range 3-10), and enjoyed the combination of VR and a therapist (mean 7.85, SD 2.11; range 3-10). The most frequently mentioned strength of DiSCoVR was the opportunity to practice with personalized social situations (14/20, 70%). A significant improvement of emotion perception was observed (Ekman 60 Faces; t16=-4.79, P<.001, d=-0.67), but no significant change was found in other measures of social cognition, neurocognition, psychiatric symptoms, or self-esteem. CONCLUSIONS DiSCoVR was feasible and acceptable to participants and therapists, and may improve emotion perception.
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Affiliation(s)
- Saskia Anne Nijman
- Department of Psychotic Disorders, GGZ Drenthe, Assen, Netherlands.,University Center of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, Netherlands.,Department of Clinical and Developmental Neuropsychology, Faculty of Behavioral and Social Sciences, University of Groningen, Groningen, Netherlands
| | - Wim Veling
- University Center of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Kirstin Greaves-Lord
- Department of Child & Adolescent Psychiatry/Psychology, Erasmus MC-Sophia, Rotterdam, Netherlands.,Autism Team Northern-Netherlands of Jonx, Department of (Youth) Mental Health and Autism, Lentis Psychiatric Institute, Groningen, Netherlands.,Department of Yulius Autism, Yulius, Dordrecht, Netherlands.,Department of Clinical Psychology and Experimental Psychopathology, Faculty of Behavioral and Social Sciences, University of Groningen, Groningen, Netherlands
| | - Maarten Vos
- University Center of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | | | - Marije Aan Het Rot
- Department of Clinical Psychology and Experimental Psychopathology, Faculty of Behavioral and Social Sciences, University of Groningen, Groningen, Netherlands
| | - Chris Neeltje Wil Geraets
- University Center of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, Netherlands
| | - Gerdina Hendrika Maria Pijnenborg
- Department of Psychotic Disorders, GGZ Drenthe, Assen, Netherlands.,Department of Clinical and Developmental Neuropsychology, Faculty of Behavioral and Social Sciences, University of Groningen, Groningen, Netherlands
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Tikka DL, Singh AR, Tikka SK. Social cognitive endophenotypes in schizophrenia: A study comparing first episode schizophrenia patients and, individuals at clinical- and familial- 'at-risk' for psychosis. Schizophr Res 2020; 215:157-166. [PMID: 31761472 DOI: 10.1016/j.schres.2019.10.053] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2018] [Revised: 10/17/2019] [Accepted: 10/25/2019] [Indexed: 01/19/2023]
Abstract
Impairments in specific domains of social cognition have been suggested as possible endophenotypes for schizophrenia and clinical markers for accurate identification of 'at-risk' (AR) states. Aim of the present study was to find out whether performance on social cognition tasks will distinguish 'clinical at-risk (CAR)' and 'familial at-risk (FAR)' individuals from remitted first episode schizophrenia (FES) patients and healthy controls. Fifty in each of these four groups were included for analysis. Schizophrenia psychopathology in FES group was assessed using the Positive and Negative Syndrome Scale (PANSS). Theory of mind (ToM; first and second order (SOT and FOT), and faux pas composite (FPC)), attributional bias (AB) and social perception (SP) were assessed using the Social Cognition Rating Tool in Indian Setting (SOCRATIS). Facial emotion recognition task was used to assess emotional-expression recognition (ER). Significant differences in ToM, SP and ER between the four groups were found, even after controlling for performance on various neurocognitive tasks. ToM and SP were identified to follow an endophenotype pattern. While, both ToM and SP classified FES from healthy with large accuracy rates, SP, specifically, distinguished at-risk from disease groups. None of the social cognitive domains accurately classified familial at-risk from clinical at-risk groups. We conclude that social cognitive measures may be used as reliable endophenotype markers for schizophrenia and its sub-domains may be used for valid identification of AR individuals.
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Affiliation(s)
- Deyashini Lahiri Tikka
- Department of Clinical Psychology, Ranchi Institute of Neuro Psychiatry and Allied Sciences, Kanke, Ranchi, Jharkhand, 834006, India
| | - Amool Ranjan Singh
- Department of Clinical Psychology, Ranchi Institute of Neuro Psychiatry and Allied Sciences, Kanke, Ranchi, Jharkhand, 834006, India
| | - Sai Krishna Tikka
- Department of Psychiatry, All India Institute of Medical Sciences, Tatibandh, Raipur, Chhattisgarh, 492099, India.
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Karabanowicz E, Tyburski E, Karasiewicz K, Sokołowski A, Mak M, Folkierska-Żukowska M, Radziwiłłowicz W. Metaphor Processing Dysfunctions in Schizophrenia Patients With and Without Substance Use Disorders. Front Psychiatry 2020; 11:331. [PMID: 32390887 PMCID: PMC7193109 DOI: 10.3389/fpsyt.2020.00331] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2019] [Accepted: 04/02/2020] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Patients with schizophrenia have difficulties comprehending metaphors, which significantly impedes communication. However, this topic has not been thoroughly studied in people with a dual diagnosis. On this basis, we formulated two research aims: a) to compare the ability to comprehend metaphors in schizophrenia patients without (SZ) and with substance use disorder (SZ-SUD) and b) to determine the relationship between the processing of metaphorical content and the severity of psychopathological symptoms in both clinical groups. METHODS A total of 40 individuals with SZ and 40 individuals with SZ-SUD took part in the study. The control group was composed of 40 individuals without a psychiatric or neurological diagnosis. Four subtests from the Right Hemisphere Language Battery (Picture Metaphor Test, Written Metaphor Test, Picture Metaphor Explanation Test, Written Metaphor Explanation Test) were used to measure the ability to understand and explain metaphors. RESULTS Both groups of individuals with schizophrenia (SZ and SZ-SUD) scored lower than individuals from the control group on all tests of metaphor processing. However, no differences were observed between the two clinical groups. SZ-SUD patients had better results for Picture Metaphor Explanation than for Written Metaphor Explanation. Negative symptoms were found to be significant predictors of difficulties with understanding and explaining metaphors. CONCLUSION Individuals with schizophrenia, regardless of their substance use disorder (SUD) status, exhibit impaired metaphorical content processing. SUD in schizophrenia is not associated with significant impairments in understanding and explaining metaphorical content. Moreover, impairments in processing metaphorical content are associated with more severe negative symptoms of schizophrenia.
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Affiliation(s)
- Ewa Karabanowicz
- Institute of Psychology, University of Szczecin, Szczecin, Poland
| | - Ernest Tyburski
- Institute of Psychology, SWPS University of Social Sciences and Humanities, Poznan, Poland
| | | | - Andrzej Sokołowski
- Department of Neurology, Memory and Aging Center, UCSF Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, United States
| | - Monika Mak
- Independent Clinical Psychology Unit, Pomeranian Medical University, Szczecin, Poland
| | - Monika Folkierska-Żukowska
- Interdisciplinary Centre for Behavioural Genetics Research, Faculty of Psychology, University of Warsaw, Warsaw, Poland
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Gernsbacher MA, Yergeau M. Empirical Failures of the Claim That Autistic People Lack a Theory of Mind. ARCHIVES OF SCIENTIFIC PSYCHOLOGY 2019; 7:102-118. [PMID: 31938672 PMCID: PMC6959478 DOI: 10.1037/arc0000067] [Citation(s) in RCA: 57] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Abstract
The claim that autistic people lack a theory of mind—that they fail to understand that other people have a mind or that they themselves have a mind—pervades psychology. This article (a) reviews empirical evidence that fails to support the claim that autistic people are uniquely impaired, much less that all autistic people are universally impaired, on theory-of-mind tasks; (b) highlights original findings that have failed to replicate; (c) documents multiple instances in which the various theory-of-mind tasks fail to relate to each other and fail to account for autistic traits, social interaction, and empathy; (c) summarizes a large body of data, collected by researchers working outside the theory-of-mind rubric, that fails to support assertions made by researchers working inside the theory-of-mind rubric; and (d) concludes that the claim that autistic people lack a theory of mind is empirically questionable and societally harmful. The assertion that autistic people lack a theory of mind—that they fail to understand that other people have a mind or that they themselves have a mind—pervades psychology. In this article, we critically examine the empirical basis of this assertion. We review empirical evidence that fails to support the claim that autistic people are uniquely impaired, much less that all autistic people are universally impaired, on theory-of-mind tasks. We highlight seminal theory-of-mind findings that have failed to replicate. We document multiple instances in which the various theory-of-mind tasks fail to converge and fail to predict autistic traits, social interaction, and empathy. We summarize a large body of data, collected by researchers working outside the theory-of-mind rubric, that fails to support assertions made by researchers working inside the theory-of-mind rubric. We conclude that the claim that autistic people lack a theory of mind is empirically questionable and societally harmful.
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Kavanagh D, Barnes-Holmes Y, Barnes-Holmes D. The Study of Perspective-Taking: Contributions from Mainstream Psychology and Behavior Analysis. PSYCHOLOGICAL RECORD 2019. [DOI: 10.1007/s40732-019-00356-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
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16
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An investigation of associations between experience of childhood trauma and political violence and theory of mind impairments in schizophrenia. Psychiatry Res 2018; 270:293-297. [PMID: 30286366 DOI: 10.1016/j.psychres.2018.09.052] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2017] [Revised: 09/06/2018] [Accepted: 09/21/2018] [Indexed: 11/23/2022]
Abstract
There has been little examination of the association between trauma and cognitive deficits seen in individuals diagnosed with schizophrenia. Theory of Mind (ToM) impairments are a significant feature of schizophrenia but it remains unclear as to why these deficits are so prevalent in this population. This study aimed to explore associations between ToM deficits and specific forms of childhood adversities in a schizophrenia population. The study sample comprised of 66 adults with a confirmed diagnosis of schizophrenia, attending mental health services in Northern Ireland. Assessments were completed to ascertain if individuals had prior experience of sexual or physical abuse, emotional neglect or experience of the political violence of Northern Ireland's "Troubles", and the Gardner Hinting Test was applied to assess ToM ability. Backwards stepwise regression analyses demonstrated that emotional neglect, specifically during early childhood (0-6 years) predicted ToM impairments in this group. Conflict-related trauma was also associated with ToM but was not an independent significant predictor of ToM deficits. This is the first study to examine links between specific forms of childhood adversity and ToM impairments in individuals diagnosed with schizophrenia. Potential underpinning psychological mechanisms are considered and implications for clinical practice are discussed.
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Eddy CM. Social cognition and self-other distinctions in neuropsychiatry: Insights from schizophrenia and Tourette syndrome. Prog Neuropsychopharmacol Biol Psychiatry 2018; 82:69-85. [PMID: 29195921 DOI: 10.1016/j.pnpbp.2017.11.026] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2017] [Revised: 11/16/2017] [Accepted: 11/27/2017] [Indexed: 02/08/2023]
Abstract
Impairments in social cognition may reflect dysfunction of disorder specific or disorder general mechanisms. Although cross-disorder comparison may prove insightful, few studies have compared social cognition in different neuropsychiatric disorders. Parallel investigation of schizophrenia and Tourette syndrome (TS) is encouraged by similarities including the presence of problematic social behavior, echophenomena, emotional dysregulation and dopamine dysfunction. Focusing on tests of social cognition administered in both disorders, this review aims to summarize behavioral, neurophysiological and neuroimaging findings, before exploring how these may contribute to clinical symptoms. Studies investigating social cognition (imitation, emotion recognition, and understanding of beliefs or intentions) in patients with schizophrenia or TS were identified through Web of Science and PubMed searches. Although findings indicate that social cognitive deficits are more apparent in schizophrenia, adults with TS can exhibit similar task performance to patients with paranoia. In both disorders, behavioral and neuroimaging findings raise the possibility of increased internal simulation of others' actions and emotions, in combination with a relative under-application of mentalizing. More specifically, dysfunction in neurobiological substrates such as temporo-parietal junction and inferior frontal gyrus may underlie problems with self-other distinctions in both schizophrenia and TS. Difficulties in distinguishing between actions and mental states linked to the self and other may contribute to a range of psychiatric symptoms, including emotional dysregulation, paranoia, social anhedonia and socially disruptive urges. Comparing different patient populations could therefore reveal common neuro-cognitive risk factors for the development of problematic social behaviors, in addition to markers of resilience, coping strategies and potential neuro-compensation mechanisms.
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Affiliation(s)
- Clare M Eddy
- BSMHFT National Centre for Mental Health, Birmingham, and College of Medical and Dental Sciences, University of Birmingham, UK.
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18
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Abstract
Recent empirical findings from clinical and genetic studies suggest that mentalization, a key area of social cognition, is a distinct construct, although it is closely related to the neurocognitive deficits and symptoms of schizophrenia. Mentalization contributes a great deal to impaired social functioning. Current measures often display methodological problems, and many aspects should be taken into account when assessing mentalization. Moreover, advances in cognitive and affective neurosciences have led to the development of more advanced behavioral methods to assess the relationship between cognitive functions, symptoms, and social cognition based on their underlying neural mechanisms. The development of assessment tools that better examine the neural circuitry of such relationships may lead to the development of new psychosocial and pharmacological treatments.
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Béland S, Lepage M. The relative contributions of social cognition and self-reflectiveness to clinical insight in enduring schizophrenia. Psychiatry Res 2017; 258:116-123. [PMID: 28992548 DOI: 10.1016/j.psychres.2017.09.082] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/24/2017] [Revised: 08/06/2017] [Accepted: 09/27/2017] [Indexed: 10/18/2022]
Abstract
Poor clinical insight represents a major barrier to recovery in schizophrenia. Research suggests that higher-order social cognitive abilities such as theory of mind (TOM) and metacognition contribute to levels of clinical insight. However, few studies have examined whether social cognitive abilities other than TOM are related to clinical insight. Moreover, to date, no investigation has attempted to determine whether the contribution of metacognitive ability to clinical insight can be differentiated from the contribution of higher-order social cognition, despite their conceptual similarity. Therefore, the purpose of this study was to examine the relative contribution of different social cognitive abilities, as well as metacognition, to clinical insight in a large sample of 139 enduring schizophrenia patients, and controlling for established predictors of clinical insight. Hierarchical regression analyses were used to evaluate the portion of variance explained by 3 social cognitive abilities: emotion recognition, TOM, and affective empathy, and the metacognitive ability of self-reflectiveness. Clinical insight levels were assessed using the Schedule for the Assessment of Insight-Expanded version. Results indicated that affective empathy and self-reflectiveness are the strongest predictors of clinical insight. These results provide insights on the development of targeted interventions for improving clinical insight in this population.
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Affiliation(s)
- Sophie Béland
- Integrated Program in Neuroscience, McGill University, Montreal, Canada; Douglas Mental Health University Institute, Verdun, Canada
| | - Martin Lepage
- Integrated Program in Neuroscience, McGill University, Montreal, Canada; Douglas Mental Health University Institute, Verdun, Canada; Department of Psychiatry, McGill University, Montreal, Canada.
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Mier D, Eisenacher S, Rausch F, Englisch S, Gerchen MF, Zamoscik V, Meyer-Lindenberg A, Zink M, Kirsch P. Aberrant activity and connectivity of the posterior superior temporal sulcus during social cognition in schizophrenia. Eur Arch Psychiatry Clin Neurosci 2017; 267:597-610. [PMID: 27770284 DOI: 10.1007/s00406-016-0737-y] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/23/2016] [Accepted: 09/25/2016] [Indexed: 12/31/2022]
Abstract
Schizophrenia is associated with significant impairments in social cognition. These impairments have been shown to go along with altered activation of the posterior superior temporal sulcus (pSTS). However, studies that investigate connectivity of pSTS during social cognition in schizophrenia are sparse. Twenty-two patients with schizophrenia and 22 matched healthy controls completed a social-cognitive task for functional magnetic resonance imaging that allows the investigation of affective Theory of Mind (ToM), emotion recognition and the processing of neutral facial expressions. Moreover, a resting-state measurement was taken. Patients with schizophrenia performed worse in the social-cognitive task (main effect of group). In addition, a group by social-cognitive processing interaction was revealed for activity, as well as for connectivity during the social-cognitive task, i.e., patients with schizophrenia showed hyperactivity of right pSTS during neutral face processing, but hypoactivity during emotion recognition and affective ToM. In addition, hypoconnectivity between right and left pSTS was revealed for affective ToM, but not for neutral face processing or emotion recognition. No group differences in connectivity from right to left pSTS occurred during resting state. This pattern of aberrant activity and connectivity of the right pSTS during social cognition might form the basis of false-positive perceptions of emotions and intentions and could contribute to the emergence and sustainment of delusions.
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Affiliation(s)
- Daniela Mier
- Department of Clinical Psychology, Central Institute of Mental Health, University of Heidelberg/Medical Faculty Mannheim, J5, 68159, Mannheim, Germany.
| | - Sarah Eisenacher
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, University of Heidelberg/Medical Faculty Mannheim, J5, 68159, Mannheim, Germany
| | - Franziska Rausch
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, University of Heidelberg/Medical Faculty Mannheim, J5, 68159, Mannheim, Germany
| | - Susanne Englisch
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, University of Heidelberg/Medical Faculty Mannheim, J5, 68159, Mannheim, Germany
| | - Martin Fungisai Gerchen
- Department of Clinical Psychology, Central Institute of Mental Health, University of Heidelberg/Medical Faculty Mannheim, J5, 68159, Mannheim, Germany
| | - Vera Zamoscik
- Department of Clinical Psychology, Central Institute of Mental Health, University of Heidelberg/Medical Faculty Mannheim, J5, 68159, Mannheim, Germany
| | - Andreas Meyer-Lindenberg
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, University of Heidelberg/Medical Faculty Mannheim, J5, 68159, Mannheim, Germany
| | - Mathias Zink
- Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, University of Heidelberg/Medical Faculty Mannheim, J5, 68159, Mannheim, Germany
| | - Peter Kirsch
- Department of Clinical Psychology, Central Institute of Mental Health, University of Heidelberg/Medical Faculty Mannheim, J5, 68159, Mannheim, Germany
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Helle S, Løberg EM, Gjestad R, Schnakenberg Martin AM, Lysaker PH. The positive link between executive function and lifetime cannabis use in schizophrenia is not explained by current levels of superior social cognition. Psychiatry Res 2017; 250:92-98. [PMID: 28152399 DOI: 10.1016/j.psychres.2017.01.047] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2016] [Revised: 01/18/2017] [Accepted: 01/18/2017] [Indexed: 11/26/2022]
Abstract
There has been a growing link between a history of cannabis use and neurocognitive performance in patients with schizophrenia. Fewer neurocognitive deficits may be a marker of the superior social cognition needed to obtain illicit substances, or cannabis use may indicate a distinct path to schizophrenia with less neurocognitive vulnerability. This study sought to determine whether the relationship of cannabis use and executive function exists independently of social cognition. Eighty-seven patients with schizophrenia were administered measures of social cognition and executive function. Social cognition was assessed using the Bell-Lysaker Emotion Recognition Test to measure affect recognition, and the Eyes and Hinting Tests to measure theory of mind. Executive function was assessed by the Mental Flexibility component of the Delis-Kaplan Executive Functioning Scale. The relations between the variables were examined with structural equation modeling. Cannabis use positively related to executive function, negatively related to affect recognition, and had no relationship with theory of mind. There were no indirect effects of other illicit substances on amount of regular cannabis use. Alcohol use was related to worse affect recognition. The relationship between cannabis use and better executive function was supported and was not explained by superior social cognition.
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Affiliation(s)
- Siri Helle
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway; Department of Biological and Medical Psychology, University of Bergen, Norway
| | - Else-Marie Løberg
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway; Department of Addiction Medicine, Haukeland University Hospital, Bergen, Norway; Department of Clinical Psychology, University of Bergen, Norway
| | - Rolf Gjestad
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - Ashley M Schnakenberg Martin
- Roudebush Veteran Affairs Medical Center, Indianapolis, IN, USA; Indiana University - Bloomington, Bloomington, IN, USA
| | - Paul H Lysaker
- Roudebush Veteran Affairs Medical Center, Indianapolis, IN, USA; Indiana University School of Medicine, Indianapolis, IN, USA.
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A contextual behavioral approach to the study of (persecutory) delusions. JOURNAL OF CONTEXTUAL BEHAVIORAL SCIENCE 2016. [DOI: 10.1016/j.jcbs.2016.09.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
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Rominger C, Bleier A, Fitz W, Marksteiner J, Fink A, Papousek I, Weiss EM. Auditory top-down control and affective theory of mind in schizophrenia with and without hallucinations. Schizophr Res 2016; 174:192-196. [PMID: 27197903 DOI: 10.1016/j.schres.2016.05.006] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Revised: 04/24/2016] [Accepted: 05/06/2016] [Indexed: 12/19/2022]
Abstract
Social cognitive impairments may represent a core feature of schizophrenia and above all are a strong predictor of positive psychotic symptoms. Previous studies could show that reduced inhibitory top-down control contributes to deficits in theory of mind abilities and is involved in the genesis of hallucinations. The current study aimed to investigate the relationship between auditory inhibition, affective theory of mind and the experience of hallucinations in patients with schizophrenia. In the present study, 20 in-patients with schizophrenia and 20 healthy controls completed a social cognition task (the Reading the Mind in the Eyes Test) and an inhibitory top-down Dichotic Listening Test. Schizophrenia patients with greater severity of hallucinations showed impaired affective theory of mind as well as impaired inhibitory top-down control. More dysfunctional top-down inhibition was associated with poorer affective theory of mind performance, and seemed to mediate the association between impairment to affective theory of mind and severity of hallucinations. The findings support the idea of impaired theory of mind as a trait marker of schizophrenia. In addition, dysfunctional top-down inhibition may give rise to hallucinations and may further impair affective theory of mind skills in schizophrenia.
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Affiliation(s)
- Christian Rominger
- Department of Psychology, Biological Psychology Unit, University of Graz, Austria
| | - Angelika Bleier
- Department of Psychology, Biological Psychology Unit, University of Graz, Austria
| | - Werner Fitz
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Austria
| | | | - Andreas Fink
- Department of Psychology, Biological Psychology Unit, University of Graz, Austria
| | - Ilona Papousek
- Department of Psychology, Biological Psychology Unit, University of Graz, Austria
| | - Elisabeth M Weiss
- Department of Psychology, Biological Psychology Unit, University of Graz, Austria.
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Scherzer P, Achim A, Léveillé E, Boisseau E, Stip E. Evidence from paranoid schizophrenia for more than one component of theory of mind. Front Psychol 2015; 6:1643. [PMID: 26579026 PMCID: PMC4627475 DOI: 10.3389/fpsyg.2015.01643] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2015] [Accepted: 10/12/2015] [Indexed: 11/13/2022] Open
Abstract
We previously reported finding that performance was impaired on four out of five theory of mind (ToM) tests in a group of 21 individuals diagnosed with paranoid schizophrenia (pScz), relative to a non-clinical group of 29 individuals (Scherzer et al., 2012). Only the Reading the Mind in the Eyes Test did not distinguish between groups. A principal components analysis revealed that the results on the ToM battery could be explained by one general ToM factor with the possibility of a latent second factor. As well, the tests were not equally sensitive to the pathology. There was also overmentalization in some ToM tests and under-mentalisation in others. These results led us to postulate that there is more than one component to ToM. We hypothesized that correlations between the different EF measures and ToM tests would differ sufficiently within and between groups to support this hypothesis. We considered the relationship between the performance on eight EF tests and five ToM tests in the same diagnosed and non-clinical individuals as in the first study. The ToM tests shared few EF correlates and each had its own best EF predictor. These findings support the hypothesis of multiple ToM components.
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Affiliation(s)
- Peter Scherzer
- Département de Psychologie, Université du Québec à Montréal Montréal, QC, Canada ; Institut des sciences cognitives, Université du Québec à Montréal Montréal, QC, Canada
| | - André Achim
- Département de Psychologie, Université du Québec à Montréal Montréal, QC, Canada ; Institut des sciences cognitives, Université du Québec à Montréal Montréal, QC, Canada
| | - Edith Léveillé
- Département de Psychologie, Université du Québec à Montréal Montréal, QC, Canada ; Hôpital du Sacré-Coeur de Montréal et sa Fondation Montréal, QC, Canada
| | - Emilie Boisseau
- Département de Psychologie, Université du Québec à Montréal Montréal, QC, Canada ; Hôpital Rivière-des-Prairies Montréal, QC, Canada
| | - Emmanuel Stip
- Centre Hospitalier de l'Université de Montréal Montréal, QC, Canada
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Abstract
Although clinical diagnosis of delusions is usually not difficult, defining delusions is more complicated. This study analyzes the concept of delusions, in particular persecutory delusions. Patients with persecutory delusions are convinced of others’ malicious intentions and are impervious to counterevidence. Conventionally, expression of intention is accepted at face value unless contradictory evidence is available. First-person authority regarding intention is respected in human society. Contemporary philosophy tends to limit the scope of first-person authority, but it cannot be eliminated. Persecutory delusions contravene first-person authority as one of the fundamental principles of daily life, even in the absence of malicious intention on the part of the patients. Two ways of denying others’ first-person authority are investigated. This study adds new insight to Manfred Spitzer’s formal definition of delusions.
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Abstract
The aim of this study was to investigate the influence of neurocognition on affective and cognitive theory of mind (ToM) tasks in early phases of psychosis. In a cross-sectional study of 60 first-episode schizophrenia/schizoaffective disorder patients, the implication of neurocognition in first- and second-order ToM stories, Hinting Task, and Reading the Mind in the Eyes Test (RMET) was analyzed. Regression models were used, controlling for clinical symptoms and antipsychotic dose. Spatial span backward (odds ratio [OR], 0.34; p = 0.01) and intrusions in the Rey Auditory Verbal Learning Test (OR, 4.86; p = 0.04) were the best factors to predict second-order ToM failure. Trail Making Test B (B = 0.01; p = 0.04) and negative symptoms (B = 0.09; p = 0.01) predicted Hinting task performance while Block design (B = 0.1; p = 0.04) was related to RMET outcome. Executive functions and clinical symptoms were related to ToM performance in first-episode schizophrenia patients, although different patterns of relationship were observed in each ToM task.
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Li C, Wang XP, Zhang DK, Zhou JS, Guo M. An EEG study that may improve the violence risk assessment in male schizophrenic patients. AUST J FORENSIC SCI 2014. [DOI: 10.1080/00450618.2014.901415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Laghi F, Cotugno A, Cecere F, Sirolli A, Palazzoni D, Bosco FM. An exploratory assessment of theory of mind and psychological impairment in patients with bulimia nervosa. Br J Psychol 2013; 105:509-23. [PMID: 24117350 DOI: 10.1111/bjop.12054] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2012] [Revised: 07/18/2013] [Indexed: 11/29/2022]
Abstract
This study aimed to investigate psychosocial functioning and different dimensions of theory of mind (ToM) in people with bulimia nervosa (BN) and Eating Disorder Not Otherwise Specified-BN type (EDNOS-BN). Psychosocial functioning and ToM were assessed in a sample of young adult females, 16 BN and 16 EDNOS-BN outpatients and 16 healthy controls (HCs). They were assessed using the Eating Disorder Inventory-Symptom Checklist-2 (EDI-2 SC) for evaluating psychological traits associated with eating disorders; the Symptom Checklist-90-Revised (SCL-90-R) for evaluating psychopathological status; and the Theory of Mind Assessment Scale (Th.o.m.a.s.), a semi-structured interview aimed at assessing a person's different dimensions of ToM. The BN and EDNOS-BN groups exhibited worse performance than the control group on all dimensions of the SCL-90-R, and on all dimensions of the EDI-2 SC. The only difference for perfectionism was that BN obtained higher scores than EDNOS-BN group. Our results also revealed an impairment of third-person and second-order ToM in patients with bulimia (BN and EDNOS-BN) with respect to control subjects. These preliminary data have important implications for future empirical work, in that they provide valuable information regarding the importance of investigating the various facets of ToM ability separately, in order to provide a more detailed profile of ToM functioning in the clinical samples.
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Affiliation(s)
- Fiorenzo Laghi
- Department of Social and Developmental Psychology, Faculty of Medicine and Psychology, Sapienza, University of Rome, Italy
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Stonnington CM, Locke DEC, Hsu CH, Ritenbaugh C, Lane RD. Somatization is associated with deficits in affective Theory of Mind. J Psychosom Res 2013; 74:479-85. [PMID: 23731744 DOI: 10.1016/j.jpsychores.2013.04.004] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2012] [Revised: 04/10/2013] [Accepted: 04/12/2013] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To determine whether deficits in mental representation of emotion may constitute a mechanism for somatization. METHODS In this case-control study, we obtained measures of cognitive and affective Theory of Mind, emotional awareness, positive and negative affect, depression, anxiety, and physical symptoms and determined psychiatric diagnoses in consecutive outpatients, aged 19 to 60, with Conversion Disorder (n=29), Functional Somatic Syndromes (n=30), or "explained" Medical Disorders (Controls) (n=30). Main outcome measure was the Animations-L score, i.e., use of words describing emotional content while performing the Frith-Happé Animations (video) Task, an established Theory of Mind measure in which the emotional content of a story is conveyed through movement. RESULTS Groups were similar in number of physical symptoms, negative affect, and ability to describe emotional experiences on a written measure that specifically solicited such descriptions. Conversion Disorder and Functional Somatic Syndrome groups scored lower on Animations-L, endorsed significantly less positive affect, and had more anxiety than Medical Controls. Animations-L and positive affect scores were predictive of group membership, with lower scores predicting somatizing conditions. CONCLUSIONS Relative to Medical Controls, a deficit in the encoding and reporting of emotion when the emotional content of the stimulus is conveyed in action occurs equally in Conversion Disorder and Functional Somatic Syndrome patients and is consistent with previous findings in somatoform disorder inpatients. Difficulty with "conversion" from implicit (action, somatic) to explicit (representational) processing of emotions, exacerbated by anxiety, may constitute a mechanism for somatization.
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Dimaggio G, Popolo R, Salvatore G, Lysaker PH. Mentalizing in schizophrenia is more than just solving theory of mind tasks. Front Psychol 2013; 4:83. [PMID: 23450982 PMCID: PMC3582989 DOI: 10.3389/fpsyg.2013.00083] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2013] [Accepted: 02/06/2013] [Indexed: 11/21/2022] Open
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