Mental state decoding v. mental state reasoning as a mediator between cognitive and social function in psychosis

Abstract

Theory of mind deficits in schizophrenia have been parsed into mental state reasoning and mental state decoding components. We report that mental state decoding as measured by the ‘Eyes task’ better predicted social function than mental state reasoning as measured by the ‘Hinting task’ in 73 out-patients with chronic schizophrenia. Mental state decoding task performance also partly mediated the influence of basic neuropsychological performance on social function. We discuss these findings in terms of the accumulating evidence that mental state decoding has particular relevance for understanding deficits in social function in schizophrenia.

Social dysfunction in schizophrenia: An investigation of the GAF scale's sensitivity to deficits in social cognition

“…Social cognition has repeatedly been shown to predict real life social and occupational function, and indeed to mediate the effects of general cognitive function on outcome (Vauth et al, 2004;Brekke et al, 2005;Addington et al, 2006;Green et al, 2008;McGlade et al, 2008;Schmidt et al, 2011). Despite this, our study demonstrates that GAF scores are largely insensitive to variation in social cognition.…”

“…Social cognition -defined as the set of mental operations that underlie social interactions -has emerged in recent years as a key factor in explaining these functional impairments (Fett et al, 2011) both directly, and also by mediating the relationship between neurocognition and functional outcome (Vauth et al, 2004;Brekke et al, 2005;Addington et al, 2006;Green et al, 2008;McGlade et al, 2008;Schmidt et al, 2011). However, whether the current tools for assessing functional impairments in schizophrenia in clinical practice are sensitive enough to measure change in social cognition remains unclear.…”

“…Perhaps consequently, few social cognition studies have employed the GAF scale as an outcome measure (Fett et al, 2011). Furthermore, among the few studies that have used the GAF and found that social cognition is a mediator in the relationship between neurocognition and functioning, most did not account for variation in symptom severity (McGlade et al, 2008;Gard et al, 2009;Schmidt et al, 2011).…”

“…As social cognition encompasses a broad range of different domains we chose to focus solely on theory of mind for two reasons: 1) Fett et al's (2011) explained the largest amount of variance in functioning and 2) a previous study from our group demonstrated that theory of mind mediated the relationship between basic neuropsychological function and functional outcome using another measure of functional outcome, the Independent Living Scale (Revheim and Medalia, 2004;McGlade et al, 2008). We attempted to replicate this previous finding using the GAF scale as the outcome measure of global function.…”

What Is It like to Be a Person with Schizophrenia in the Social World? A First-Person Perspective Study on Schizophrenic Dissociality – Part 1: State of the Art

“…As mental states are inseparable from emotional processes and 'in many if not all cases, human social and emotional behaviors are highly intertwined' [ 113 , p. 48] any account of social impairments in persons with schizophrenia should include the role of emotions [104] . Emotion processing is a major determinant of social outcome in schizophrenia such as Emotion Recognition [83][84][85][86][87][88][89] , anhedonia [114,115] and particularly the anticipatory pleasure experience [116] , motivation [117,118] , recently regarded as the critical feature of negative syndrome [119] with respect to functional outcome. To note, persons with schizophrenia display relevant impairment in the integration of affective and cognitive ToM skills [120] , and affective ToM tasks have appeared to be more predictive of social functioning in people with schizophrenia [84] .…”