Theory of mind and social functioning in first episode psychosis

Sullivan, Sarah; Herzig, Daniela; Möhr, Christine; Corcoran, Rhiannon; Drake, Richard; Evans, Jonathan

doi:10.1080/13546805.2012.698239

Cited by 18 publications

(15 citation statements)

References 56 publications

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“…This is consistent with Sullivan et al’s [ 14 ] finding that ToM does not predict poor outcomes longitudinally in the early stages of psychosis. The findings, however, are in contrast to other cross-sectional research which has found that ToM deficits are associated with poor social functioning in both early [ 13 ] and chronic psychosis [ 10 ]. These divergent findings may reflect differences in methodology.…”

Section: Discussioncontrasting

confidence: 99%

“…To address these issues, Sullivan et al [ 13 ] recently examined the relations between ToM, general cognition, symptoms and social functioning in a sample of patients in their first psychotic episode. Sullivan et al found that social functioning in their sample was associated with ToM (as measured by the Hinting task) and verbal IQ, but not with other general cognitive measures or a measure of negative symptoms that excluded symptoms that overlapped with poor social functioning (e.g.…”

Section: Introductionmentioning

confidence: 99%

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Theory of mind and neurocognition in early psychosis: a quasi-experimental study

et al. 2014

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BackgroundPeople with chronic psychosis often display theory of mind impairments that are not fully accounted for by other, more general neurocognitive deficits. In these patients, both theory of mind and neurocognitive deficits contribute to poor functioning, independently of psychotic symptoms. In young people with recent-onset psychosis, however, it is unclear the extent to which theory of mind impairment is independent of neurocognitive deficits. The primary aim of this study was to examine the evidence for specific theory of mind impairments in early psychosis. A secondary aim was to explore the relations between theory of mind, neurocognition, symptom severity, and functional outcomes.MethodsTwenty-three patients who were within two years of their first psychotic episode and 19 healthy controls completed theory of mind and neurocognitive batteries. Social functioning, quality of life, and symptom severity were also assessed in patients.ResultsPatients demonstrated deficits in tasks assessing theory of mind and neurocognition relative to controls. Patients’ deficits in theory of mind were evident even after adjusting for their deficits in neurocognition. Neither theory of mind nor neurocognition predicted social functioning or quality of life in this early psychosis sample. Severity of negative symptoms, however, was a significant predictor of both outcomes.ConclusionsWhile a specific theory of mind impairment was evident in this early psychosis sample, severity of negative symptoms emerged as the best predictor of poor functional outcome. Further early psychosis research is needed to examine the longitudinal progression of theory of mind impairments – independent of neurocognitive deficits – and their impact on psychosocial function.

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Section: Discussioncontrasting

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Theory of mind and neurocognition in early psychosis: a quasi-experimental study

et al. 2014

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“…Contrarily, attributing overly complex mental states to others (Montag et al, 2011; Fretland et al, 2015), or overmentalizing, has been connected to positive symptoms of schizophrenia. Suspiciousness and delusions of persecution were found to be significant predictors of poor social functioning, and poor ToM performance (Hinting Test, Corcoran et al, 1995, Visual Cartoon Test, Corcoran et al, 1997) also plays a role in this relationship (Sullivan et al, 2013). However, other investigators using the Reading the Mind in the Eye Test (Baron-Cohen et al, 2001) found no connection between symptoms of schizophrenia and ToM (Kazemian et al, 2015).…”

Section: Introductionmentioning

confidence: 99%

Cognitive Correlates of Different Mentalizing Abilities in Individuals with High and Low Trait Schizotypy: Findings from an Extreme-Group Design

et al. 2017

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Mentalizing or Theory of Mind (ToM) deficits in schizophrenia have been studied to great extent, but studies involving samples of trait schizotypy yield ambiguous results. Executive functions like cognitive inhibition, cognitive flexibility, and agency are all prerequisites of mentalizing, and it is assumed that the impairment of these functions contributes to ToM deficits in schizophrenia. Whether these impairments influence the ToM performance of people with high trait schizotypy remains unclear. Although impaired self-agency has repeatedly been identified in people with schizotypy, its role in mentalizing is yet to be investigated. The main aim of this study was to explore whether deficits in cognitive and affective ToM can be found in high trait schizotypy, and to identify in what way these deficits are related to the positive and negative dimensions of schizotypy. The secondary aim was to examine whether these deficits correlate with executive functions. Based on the dimensional view of the schizophrenia spectrum, an extreme-group design was applied to non-clinical volunteers demonstrating high (N = 39) and low (N = 47) trait schizotypy. Affective and cognitive ToM were investigated using the Movie for Assessment of Social Cognition, a sensitive and video-based measurement. Cognitive inhibition was assessed using the Stroop Test, and cognitive flexibility was analyzed using the Trail-Making Test. Agency was measured using a computerized self-agency paradigm. Participants in the high-schizotypy group performed significantly worse in the affective ToM task (d = 0.79), and their overall ToM performance was significantly impaired (d = 0.60). No between-group differences were found with regards to cognitive ToM, executive functions, and self-agency. Cognitive flexibility correlated negatively with positive schizotypy, and contributed to a worse overall and affective ToM. Impaired cognitive inhibition contributed to undermentalizing-type errors. It was found that non-clinical participants with high trait (positive) schizotypy – especially those with slight executive-function deficits – may have difficulties in understanding the emotional state of others and consequently in functioning in social situations.

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“…Evidence has accumulated suggesting deficits in discrete metacognitive processes, such as Theory of Mind, are present in FEP [e.g. 14,15].…”

Section: Introductionmentioning

confidence: 99%

Metacognition, symptoms and premorbid functioning in a First Episode Psychosis sample

MacBeth

Gumley

Schwannauer

et al. 2014

Comprehensive Psychiatry

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Significant metacognitive impairments are observed in chronic psychosis samples but metacognition is less understood in first episode psychosis (FEP). The current study explored correlations between metacognition, symptoms and premorbid functioning in an FEP sample. In a cross-sectional cohort study, individuals in the first 12 months of treatment metacognition were assessed with the Metacognition Assessment Scale-Revised version (MAS-R). Psychotic symptomatology, premorbid adjustment, and clinician rated service engagement were also measured. Lower scores for metacognitive understanding of other's minds were significantly correlated with greater negative symptoms, poorer early adolescent social adjustment and poorer clinician rated help-seeking. Our findings suggest that FEP individuals with difficulties in understanding other's minds have more social deficits and may be less able to make effective use of treatment.

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Theory of mind and social functioning in first episode psychosis

Abstract: Theory of mind assessed by verbal stimuli is associated with social functioning in a population with first episode psychosis. These findings may be related to language disorders in psychosis.

Cited by 18 publications

References 56 publications

Theory of mind and neurocognition in early psychosis: a quasi-experimental study

Theory of mind and neurocognition in early psychosis: a quasi-experimental study

Cognitive Correlates of Different Mentalizing Abilities in Individuals with High and Low Trait Schizotypy: Findings from an Extreme-Group Design

Metacognition, symptoms and premorbid functioning in a First Episode Psychosis sample

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