Previous studies in forensic patients with schizophrenia have shown that delinquent patients may outperform nondelinquent patients with regards to "theory of mind" (ToM). Findings were, however, confounded by a lack of control for executive functioning. We examined 33 forensic patients with schizophrenia regarding ToM, intelligence, executive functioning, and psychopathology. Results were compared with a nonforensic schizophrenia sample and a group of healthy controls. Both patient groups performed more poorly on most measures compared with controls. Forensic and nonforensic patients did not differ in task performance. In the forensic group ToM correlated inversely with "excitement" and cognitive symptoms. When "excitement" was covaried out, forensic patients outperformed nonforensic patients with regards to ToM. This study supports the hypothesis that schizophrenic patients with a criminal record are equally impaired in their ability to infer mental states compared with nonforensic patients, but for different reasons associated with a divergent psychopathological profile.
GERMANYABSTRACT -Background and Objectives: Abundant research has demonstrated that patients with schizophrenia have difficulties in recognizing the emotional content in facial expressions. However, there is a paucity of studies on emotion recognition in schizophrenia patients with a history of violent behavior compared to patients without a criminal record.Methods: Emotion recognition skills were examined in thirty-three forensic patients with schizophrenia. In addition, executive function and psychopathology was assessed.Results were compared to a group of 38 schizophrenia patients in regular psychiatric care and to a healthy control group.Results: Both patient groups performed more poorly on almost all tasks compared to controls. However, in the forensic group the recognition of the expression of disgust was preserved. When the excitement factor of the Positive and Negative Syndrome Scale was co-varied out, forensic patients outperformed the non-forensic patient group on emotion recognition across modalities.Conclusions: The superior recognition of disgust could be uniquely associated with delinquent behavior.
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