Deficits in Neurocognition, Theory of Mind, and Social Functioning in Patients With Schizophrenic Disorders

Bâ, Maryse Badan; Zanello, Adriano; Varnier, Marion; Koellner, Vanessa; Merlo, M.C.G.

doi:10.1097/nmd.0b013e318162aa08

Cited by 20 publications

(11 citation statements)

References 24 publications

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“…No association was found for ToM with specifically disorganization symptoms, as has been demonstrated for schizophrenia in meta-analysis (Sprong, et al, 2007), although this may be due to the low level of these symptoms in the CHR patients in our study. Finally, ToM performance was unrelated to the marked social impairment which characterizes this and other CHR cohorts (Ballon, et al, 2007; Cannon, et al, 2008; Corcoran, et al, 2010; Cornblatt, et al, 2007; Shim, et al, 2008; Velthorst, et al, 2009), which might be expected given the finding of lack of association of ToM with social function in patients with schizophrenia (Badan, et al, 2008). The presence of an association of ToM with IQ and not with social function suggests there may be other social cognitive impairments beyond mentalizing which underlie the marked social dysfunction seen in schizophrenia and its risk states.…”

Section: Discussionmentioning

confidence: 61%

Theory of Mind in patients at clinical high risk for psychosis

Stanford¹,

Messinger

Malaspina

et al. 2011

Schizophrenia Research

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Background Patients with schizophrenia have a decreased ability to interpret the intentions of other individuals, called Theory of Mind (ToM). As capacity for ToM normally advances with brain maturation, research on ToM in individuals at heightened clinical risk for psychosis may reveal developmental differences independent of disease based differences. Methods We examined ToM in at clinical high risk and schizophrenia patients as well as healthy controls: 1) 63 clinical high risk (CHR) patients and 24 normal youths ascertained by a CHR program; and 2) in 13 schizophrenia cases and 14 normal adults recruited through a schizophrenia program. ToM measures included first- and second-order false belief cartoon tasks (FBT) and two “higher order” tasks (“Strange Stories Task” (SST) and the “Reading the Mind in the Eyes” task). In the first study, CHR patients and normal youths were also assessed for cognition, “prodromal” symptoms and social function. Results Errors on first- and second-order false belief tasks were made primarily by patients. CHR patients and their young comparison group had equivalent performance on higher order ToM, which was not significantly different from the worse ToM performance of schizophrenia patients and the higher performance of normal adult controls. In the combined dataset from both studies, all levels of ToM were associated with IQ, controlling for age and sex. ToM bore no relation to explicit memory, prodromal symptoms, social function, or later transition to psychosis. Conclusions Higher order ToM capacity was equally undeveloped in high risk cases and younger controls, suggesting performance on these tasks is not fully achieved until adulthood. This study also replicates the association of IQ with ToM performance described in previous studies of schizophrenia.

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Section: Discussionmentioning

confidence: 61%

Theory of Mind in patients at clinical high risk for psychosis

Stanford¹,

Messinger

Malaspina

et al. 2011

Schizophrenia Research

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“…Accuracy on performance-based ToM tasks is partially dependent on general cognitive skills, such as executive function(40), and can be influenced by state effects, such as attention or effort. Furthermore, while some research shows that poor performance on ToM tasks predicts social functioning(6), other studies show no relationship(41). This suggests that while performance-based measures may assess cognitive capacity for ToM, they do not account for the motivation or success in using these skills to enhance social relationships, which may be better evaluated via self-report and interview-based functional assessments.…”

Section: Introductionmentioning

confidence: 99%

Theory of Mind Skills Are Related to Gray Matter Volume in the Ventromedial Prefrontal Cortex in Schizophrenia

Hooker

Bruce

Lincoln

et al. 2011

Biological Psychiatry

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Background Among individuals with schizophrenia, deficits in theory of mind (ToM) skills predict poor social functioning. Therefore, identifying the neural basis of ToM may assist the development of treatments that improve social outcomes. Despite growing evidence that the ventromedial prefrontal cortex (VMPFC) facilitates ToM skills among healthy individuals, methodological challenges, such as the influence of general cognitive deficits, have made it difficult to identify the relationship between ToM processing and VMPFC function in schizophrenia. Methods We used voxel-based morphometry (VBM) and a multi-method behavioral assessment of ToM processing, including performance-based (Recognition of Faux Pas Test), self-report (Interpersonal Reactivity Index, Perspective-Taking), and interview-rated (Quality of Life Scale–Empathy score) ToM assessments, to investigate whether ToM skills were related to VMPFC gray matter volume (GMV). Standardized neuropsychological measures were used to assess global cognition. 21 schizophrenia and 17 healthy control subjects participated. Results Between-group behavioral analyses showed that, as compared to healthy participants, schizophrenia participants had worse ToM performance and lower self-reported ToM processing in daily life. The between-group analysis of GMV showed that schizophrenia participants had less VMPFC GMV than healthy participants. Moreover, among schizophrenia participants, all three measures of ToM processing were associated with VMPFC GMV, such that worse ToM skills were related to less VMPFC GMV. This association remained strong for self-reported and interview-rated ToM skills even when controlling for the influence of global cognition. Conclusions The findings suggest that among individuals with schizophrenia, reduced VMPFC GMV is specifically associated with deficits using ToM skills to enhance social relationships.

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“…The isolation of these factors may direct effective therapeutic interventions, improving treatment outcome. While several studies have suggested that cognitive deficits in schizophrenia may account-at least partially-for patients' impaired social functioning (Addington & Addington, 2000;Green, 1996;Penn, Mueser, Spaulding, et al, 1995), others have failed to establish a robust relationship between neurocognition and social or community functioning in patients with schizophrenia (Bâ, Zanello, Varnier, Koellner, & Merlo, 2008;Bozikas, Kosmidis, Kafantari, et al, 2006;Dickinson & Coursey, 2002). The failure to explain adequately impaired social functioning in light of neurocognitive deficits has led researchers to expand their explorations into the domain of Theory of Mind (ToM) as a potential factor influencing social interactions.…”

Section: Introductionmentioning

confidence: 99%

The Impact of Impaired “Theory of Mind” on Social Interactions in Schizophrenia

Kosmidis

Giannakou

Garyfallos

et al. 2011

J Int Neuropsychol Soc

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Given the importance of social dysfunction in schizophrenia, many studies have explored how social cognition, and, particularly, Theory of Mind (ToM) may affect patients' social interactions. In the present study, we investigated the impact of ToM deficits on social interactions, taking into account overall neuropsychological functioning as well as clinical and demographic characteristics. We assessed 28 patients with schizophrenia and 30 healthy participants on a series of tasks including tests of ToM, neuropsychological tests focused on functions potentially relevant to ToM and role plays as an indicator of social interactions. Patients performed more poorly than healthy controls across most ToM and some of the neuropsychological tests. Correlations and hierarchical regression analyses indicated the impact of some, but not all, facets of ToM on patients' social interactions, over and above neuropsychological functioning, positive and negative symptom ratings, duration of illness and demographic characteristics. These findings suggest that remediation of ToM deficits in patients with schizophrenia may help to improve their social interactions.

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Deficits in Neurocognition, Theory of Mind, and Social Functioning in Patients With Schizophrenic Disorders

Cited by 20 publications

References 24 publications

Theory of Mind in patients at clinical high risk for psychosis

Theory of Mind in patients at clinical high risk for psychosis

Theory of Mind Skills Are Related to Gray Matter Volume in the Ventromedial Prefrontal Cortex in Schizophrenia

The Impact of Impaired “Theory of Mind” on Social Interactions in Schizophrenia

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