Theory of mind and unawareness of illness in schizophrenia

Abstract

This study investigates the impact of theory of mind (ToM) deficits on poor insight in schizophrenia. The scale for unawareness of mental disorder (SUMD) was administered to 58 stable outpatients with schizophrenia. First and second order false belief tasks, the Eyes test and a battery of nonToM cognitive measures were administered. The Second order false belief task was the best predictor of each global insight and symptom attribution scores of the SUMD. ToM tasks explained the substantial amount of the variance (ranging from 22.5% to 29.9%) for the insight scores and classified the significant amount of the patients who were aware of the illness correctly. WCST perseveration scores did not contribute to insight scores beyond that contributed by second order false belief tasks. The Second order ToM tasks seems to have critical importance for the awareness of the disorder. Beyond more direct self-evaluation, the awareness of the disorder and its consequences may also require the ability to evaluate the self from the perspective of others. "Understanding the others' belief about another person" may be conceptually very similar to "understanding the others' belief about self" (instead of another person).

Neurocognition, Social Cognition and Symptoms in Schizophrenia

“…This findings proposed that false belief task more required cognitive effort and executive functions to perform. Consistent with these findings, other previous studies reported that ToM have strong correlated with working memory in stable schizophrenia [22] and executive function was related to concrete social cue recognition [23]. And any relation on ToM(hinting task and false belief task) with symptoms was not verified through this study.…”

“…Our results suggest that positive and negative symptoms may not contribute to deficits of ToM. This finding may not support other reports of previous studies [22,24]. Positive symptoms were related with dose of medication.…”

Exploratory study of the association between insight and Theory of Mind (ToM) in stable schizophrenia patients

“…Thus, both second order false belief tasks (Bora et al, 2007) and metacognitive scores of an adapted version of the WSCT have shown a stronger association with insight than conventional WCST scores. Besides this general relationship between insight and ToM measures, the distinction of the 5 different insight dimensions in our study allowed identifying more specific associations.…”

Exploratory Study of the Association Between Insight and Theory of Mind (Tom) in Stable Schizophrenia Patients

“…In this line, found that first episode schizophrenic patients' self assessment of performance on the WCST was more closely related to insight than conventional WCST scores. Similarly, Bora et al (2007) studied more directly the differential impact of ToM and executive functioning deficits on poor insight. They found that performance on second order false belief tasks was the best predictor of insight, and that WCST perseveration scores did not contribute to insight scores beyond that.…”