Comparing the ability of cognitive and affective Theory of Mind in adolescent onset schizophrenia

Abstract

BackgroundEvidence in the literature suggests that there is an impairment of social cognition in schizophrenia. Theory of Mind (ToM) is defined as one’s ability to understand others’ wishes, beliefs, intentions, and other psychological states and thereby to judge others’ behavior, as an essential component of social cognition. However, there have been limited studies on social cognition, especially ToM in adolescent onset schizophrenia (AOS). The current study aims to investigate ToM abilities in adolescent schizophrenia according to various ToM subcomponents (cognitive ToM and affective ToM) and various ToM orders (first order and second order).MethodsThis study examines ToM in 35 adolescent schizophrenic patients and 35 healthy adolescents using the “Yoni task” and “Faux Pas Recognition test” to assess their affective and cognitive ToM abilities.ResultsIn the Yoni task, patients with AOS showed differences in ToM abilities either on a different order or under different conditions. The Faux Pas Recognition task results revealed that AOS patients were not always able to recognize a faux pas or understand complicated emotions under the faux pas scenario. Furthermore, as indicated by the correlation analysis, neither cognitive ToM nor affective ToM was related to the patients’ symptoms, disease duration, dose of medication, or intelligence quotient (IQ).ConclusionOur findings showed AOS impairment in the performance of ToM tasks. It seemed that impairment in second-order-ToM is more serious. Moreover, these deficits are largely independent of symptom clusters, disease duration, dose of medication, and IQ. It can be speculated that ToM dysfunction may be a hallmark of adolescent schizophrenia.

What Do You Have in Mind? Measures to Assess Mental State Reasoning in Neuropsychiatric Populations

“…A wide range of patient groups have already been found to report impairment on at least some aspect of the Yoni Task, suggesting that this is a versatile and sensitive measure. They include samples with Parkinson’s disease (172, 173), mild cognitive impairment (173), schizophrenia (174, 175), first-episode psychosis (176), bipolar disorder (174), depression (174), obsessive–compulsive disorder (177), epilepsy (178), Huntington’s disease (179), and Tourette syndrome (100). The task has revealed selective deficits in some patient groups on ToM trials only with performance on control trials being spared [e.g., in Parkinson’s disease: Ref.…”

“…(197, 368)] and neurophysiological studies (369), and has been presented with illustrations to help control for working memory demand (370). Deficits in understanding faux pas can be found in epilepsy (especially temporal lobe epilepsy) (157, 159, 338, 371–376), substance misuse (377), Parkinson’s disease (378, 379), multiple sclerosis (380, 381), schizophrenia (175, 176, 382–388), bipolar disorder (389, 390), ASD (391), attention deficit-hyperactivity disorder (392, 393), Tourette syndrome (100, 303, 394), Huntington’s disease (351, 352), depression (174, 395), frontotemporal dementia (36, 396, 397), personality disorder (398), anorexia nervosa (399), temporal lobe damage (400), caudate lesion (401), brain tumor (402), myotonic dystonia (403), and frontal lobe damage [(168, 404, 405); but see Ref. (406)].…”

Effects of High-Frequency Transcranial Magnetic Stimulation for Cognitive Deficit in Schizophrenia: A Meta-Analysis

“…Multiple cognitive deficits in SZs include cognitive processes such as attention, working memory, and executive function are correlated with the dysfunctions of distinct brain regions (6). For example, several previous studies (7, 8) have shown that frontal lobe, temporal lobe, parietal lobe, and hippocampus were the core areas associated with cognitive deficits in SZs. Further functional magnetic resonance imaging (fMRI) study showed a decrease in the volume of the prefrontal cortex of SZs compared with that of healthy controls (HCs) (9).…”

Theory of mind performance and prefrontal connectivity in adolescents at clinical high risk for psychosis

“…However, the conceptualization of schizophrenia as a neurodevelopmental disorder ( Murray and Lewis, 1987 ) has raised the possibility that ToM impairments may start early on in the developmental pathway, during childhood and adolescence. In fact, an earlier onset of schizophrenia is associated with more pronounced social cognitive deficits in adults ( Linke et al, 2015 ); and impaired ToM performance in adolescents with early-onset-schizophrenia has been described in IQ-matched samples ( Li et al, 2017 ; Tin et al, 2018 ). We recently examined ToM using the "Reading-the-Mind-in-the-Eyes" test, and documented poorer performance in adolescent patients two years after psychosis onset compared to healthy peers ( Ilzarbe et al, 2019 ).…”