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Bosco FM, Colle L, Salvini R, Gabbatore I. A machine-learning approach to investigating the complexity of theory of mind in individuals with schizophrenia. Heliyon 2024; 10:e30693. [PMID: 38756573 PMCID: PMC11096895 DOI: 10.1016/j.heliyon.2024.e30693] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 04/23/2024] [Accepted: 05/02/2024] [Indexed: 05/18/2024] Open
Abstract
Individuals with schizophrenia have difficulty attributing mental states to themselves and to others - Theory of Mind (ToM). ToM is a complex, multifaceted theoretical construct comprising first and second order, first and third person, egocentric and allocentric perspective, and cognitive and affective ToM. Most studies addressing ToM deficit in people with schizophrenia consider it an "all-or-nothing" ability and use a classical statistical methodology to test a null hypothesis. With the present study, we investigated ToM in individuals with schizophrenia, considering its complex nature and degrees of impairment. To do this, we used a machine-learning approach to detect patterns in heterogeneous and multivariate data. Our findings highlight the complex nature of ToM deficit in individuals with schizophrenia and reveal the relationship between various different aspects of ToM.
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Affiliation(s)
| | - Livia Colle
- University of Turin, Department of Psychology, GIPSI Research Group, Italy
- Terzo Centro di Psicoterapia Cognitiva, Roma
| | - Rogerio Salvini
- Instituto de Informática, Universidade Federal de Goiás, Goiânia, GO, Brazil
| | - Ilaria Gabbatore
- University of Turin, Department of Psychology, GIPSI Research Group, Italy
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Zhang Y, Lai S, Zhang J, Wang Y, Zhao H, He J, Huang D, Chen G, Qi Z, Chen P, Yan S, Huang X, Lu X, Zhong S, Jia Y. The effectiveness of vortioxetine on neurobiochemical metabolites and cognitive of major depressive disorders patients: A 8-week follow-up study. J Affect Disord 2024; 351:799-807. [PMID: 38311073 DOI: 10.1016/j.jad.2024.01.272] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Revised: 01/22/2024] [Accepted: 01/31/2024] [Indexed: 02/06/2024]
Abstract
OBJECTIVE Vortioxetine has been shown to improve cognitive performance in people with depression. This study will look at the changes in neurobiochemical metabolites that occur when vortioxetine improves cognitive performance in MDD patients, with the goal of determining the neuroimaging mechanism through which vortioxetine improves cognitive function. METHODS 30 depressed patients and 30 demographically matched healthy controls (HC) underwent MCCB cognitive assessment and 1H-MRS. After 8 weeks of vortioxetine medication, MCCB and 1H-MRS tests were retested in the MDD group. Before and after therapy, changes in cognitive performance, NAA/Cr, and Cho/Cr were examined in the MDD group. RESULTS Compared with the HC group, the MDD group had significant reduced in verbal learning, social cognition, and total cognition (all p < 0.05). And the MDD group had lower NAA/Cr in Right thalamus and Left PFC; the Cho/Cr in Right thalamus was lower than HC; the Cho/Cr in Left ACC had significantly increase (all p < 0.05). The MDD group showed significant improvements in the areas of verbal learning, attention/alertness, and total cognitive function before and after Vortioxetine treatment (all p < 0.05). The NAA/Cr ratio of the right PFC before and after treatment (t = 2.338, p = 0.026) showed significant changes. CONCLUSIONS Vortioxetine can enhance not just the depression symptoms of MDD patients in the initial period, but also their verbal learning, social cognition, and general cognitive capacities after 8 weeks of treatment. Furthermore, vortioxetine has been shown to enhance cognitive function in MDD patients by altering NAA/Cr and Cho/Cr levels in the frontal-thalamic-ACC.
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Affiliation(s)
- Yiliang Zhang
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Shunkai Lai
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Jianzhao Zhang
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Ying Wang
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Hui Zhao
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Jiali He
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Dong Huang
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Guanmao Chen
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Zhangzhang Qi
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Pan Chen
- Medical Imaging Center, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Shuya Yan
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Xiaosi Huang
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Xiaodan Lu
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China
| | - Shuming Zhong
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China.
| | - Yanbin Jia
- Department of Psychiatry, First Affiliated Hospital of Jinan University, Guangzhou 510630, China.
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Sander AM, Pappadis MR, Bushnik T, Chiaravalloti ND, Driver S, Hanks R, Lercher K, Neumann D, Rabinowitz A, Seel RT, Weber E, Ralston RK, Corrigan J, Kroenke K, Hammond FM. An Umbrella Review of Self-Management Interventions for Health Conditions With Symptom Overlap With Traumatic Brain Injury. J Head Trauma Rehabil 2024; 39:140-151. [PMID: 37294622 DOI: 10.1097/htr.0000000000000863] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
OBJECTIVE To synthesize evidence for the effectiveness of self-management interventions for chronic health conditions that have symptom overlap with traumatic brain injury (TBI) in order to extract recommendations for self-management intervention in persons with TBI. DESIGN An umbrella review of existing systematic reviews and/or meta-analyses of randomized controlled trials or nonrandomized studies targeting self-management of chronic conditions and specific outcomes relevant to persons with TBI. METHOD A comprehensive literature search of 5 databases was conducted using PRISMA guidelines. Two independent reviewers conducted screening and data extraction using the Covidence web-based review platform. Quality assessment was conducted using criteria adapted from the Assessing the Methodological Quality of Systematic Reviews-2 (AMSTAR-2). RESULTS A total of 26 reviews met the inclusion criteria, covering a range of chronic conditions and a range of outcomes. Seven reviews were of moderate or high quality and focused on self-management in persons with stroke, chronic pain, and psychiatric disorders with psychotic features. Self-management interventions were found to have positive effects on quality of life, self-efficacy, hope, reduction of disability, pain, relapse and rehospitalization rates, psychiatric symptoms, and occupational and social functioning. CONCLUSIONS Findings are encouraging with regard to the effectiveness of self-management interventions in patients with symptoms similar to those of TBI. However, reviews did not address adaptation of self-management interventions for those with cognitive deficits or for populations with greater vulnerabilities, such as low education and older adults. Adaptations for TBI and its intersection with these special groups may be needed.
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Affiliation(s)
- Angelle M Sander
- Author Affiliations: H. Ben Taub Department of Physical Medicine & Rehabilitation, Baylor College of Medicine and Harris Health System, Houston, Texas (Dr Sander); Brain Injury Research Center, TIRR Memorial Herman, Houston, Texas (Drs Sander and Pappadis); Department of Population Health and Health Disparities, School of Public and Population Health, and Sealy Center on Aging, The University of Texas Medical Branch (UTMB) (Dr Pappadis); Rusk Rehabilitation and NYU Langone Health, New York City, New York (Dr Bushnik); Kessler Foundation, East Hanover, New Jersey (Drs Chiaravalloti, Weber, and Lercher); Department of Physical Medicine and Rehabilitation, Rutgers-New Jersey Medical School, Newark (Drs Chiaravalloti, Weber, and Lercher); Department of Physical Medicine and Rehabilitation, Baylor Scott and White Institute for Rehabilitation, Dallas, Texas (Dr Driver); Baylor Scott and White Research Institute, Dallas, Texas (Dr Driver); Department of Physical Medicine and Rehabilitation, Wayne State University, Detroit, Michigan (Dr Hanks); Department of Physical Medicine and Rehabilitation (Drs Neumann and Hammond), Ruth Lilly Medical Library (Mr Ralston), and Department of Medicine (Dr Kroenke), Indiana University School of Medicine, Indianapolis; Rehabilitation Hospital of Indiana, Indianapolis (Drs Neumann and Hammond); Moss Rehabilitation Research Institute, Elkins, Pennsylvania (Dr Rabinowitz); Department of Physical Medicine and Rehabilitation, Thomas Jefferson University Philadelphia, Pennsylvania (Dr Rabinowitz); Department of Physical Medicine and Rehabilitation, Virginia Commonwealth University, Richmond (Dr Seel); Department of Physical Medicine & Rehabilitation, The Ohio State University, Columbus (Dr Corrigan); and Regenstrief Institute, Indianapolis, Indiana (Dr Kroenke)
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Altuntaş Ö, Yıldırım EA, Yılmaz G, Cesur E. Comparison of theory of mind and neurocognition in siblings and offspring of female schizophrenia patients. APPLIED NEUROPSYCHOLOGY. ADULT 2023:1-9. [PMID: 36652595 DOI: 10.1080/23279095.2023.2168544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
This study aims to compare the Theory of Mind (ToM) functions in the siblings and offspring of female Schizophrenia patients in an evaluation of the association between neurocognitive functions and ToM. A battery of ToM tests (Reading the Mind in the Eyes Test, Hinting Test and Faux Pas Test) and neurocognitive tests (Digit Span Test, Corsi Block Test, Digit Symbol Substitution Test, Rey's Auditory Verbal Learning Test, Trail Making Test, The Stroop Test, Wisconsin Card Sorting Test) were used to assess 31 offspring, 29 siblings of female schizophrenia patients and 28 healthy controls (HC). When the ToM functions of the offspring, siblings and HC groups in the present study are compared, no significant difference is identified between the offspring and sibling groups in Hinting, Faux Pas and Eyes tests, while Hinting test performance of the sibling group was significantly lower than those of the HCs. Neurocognitive functions are more affected both in offspring and siblings than HC. Although it was determined that ToM deficits of the patients' relatives were not as prominent as their neurocognitive functions, ToM is an endophenotype candidate in schizophrenia.
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Affiliation(s)
| | - Ejder Akgun Yıldırım
- Bakirkoy Research and Training Hospital for Psychiatry, Neurology, and Neurosurgery, Istanbul, Turkey
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Varela LF, Wong KHT, Shergill SS, Fett AKJ. Attachment styles moderate Theory of Mind differences between persons with schizophrenia, first-degree relatives and controls. BRITISH JOURNAL OF CLINICAL PSYCHOLOGY 2021; 60:339-356. [PMID: 34036577 DOI: 10.1111/bjc.12308] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2020] [Revised: 05/04/2021] [Indexed: 11/29/2022]
Abstract
OBJECTIVES Theory of Mind (ToM) plays a role in social functioning and is impaired in patients with schizophrenia and to a lesser degree in first-degree relatives, compared to healthy controls. This study investigates whether attachment styles moderate these observed group differences in ToM. METHODS This cross-sectional study included a sample of 51 patients, 23 first-degree relatives, and 49 controls who completed assessments of anxious and avoidant attachment (Psychosis Attachment Measure), ToM (Reading the Mind in the Eyes Test), and estimated cognitive ability. Patients' symptoms were assessed with the Positive and Negative Syndrome Scale. RESULTS Patients differed from controls and relatives in ToM performance but not in attachment avoidance or attachment anxiety. Attachment anxiety showed an interaction with group over ToM. The interaction was significant only between patients and controls but not between patients and relatives or relatives and controls. Post-hoc analysis showed that patients and controls showed differential ToM performance at average and high attachment anxiety. In patients, symptom levels did not moderate the association between attachment and ToM. CONCLUSIONS Attachment anxiety is related to poorer levels of ToM in patients, suggesting this may have a contributory role in schizophrenia. The findings stress the need for longitudinal research into the directionality of the relationship between ToM and attachment anxiety. PRACTITIONER POINTS Relationships with significant others might be a factor that influences the way in which social information is processed by persons with a diagnosis of a psychotic disorder. In patients, higher levels of attachment anxiety - that is, low self-worth, fear of abandonment and rejection, continuous vigilance of threat-related cues - were associated with a lower ability to understand the mental states of others. However, at lower levels of attachment anxiety, their ToM performance was comparable to that of relatives and controls. This effect was not influenced by symptom severity. Further research is required to confirm the potential influence of attachment insecurity on ToM ability as the latter is strongly related to patient's functional outcomes.
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Affiliation(s)
- Luis F Varela
- Unidad de Psiquiatría, Escuela de Medicina, Facultad de Medicina, Universidad Andres Bello, Santiago, Chile.,Servicio de Psiquiatría y Salud Mental, Hospital CRS El Pino, Servicio de Salud Metropolitano Sur, Santiago, Chile.,Cognition, Schizophrenia and Imaging Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Katie H T Wong
- Cognition, Schizophrenia and Imaging Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Sukhi S Shergill
- Cognition, Schizophrenia and Imaging Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK
| | - Anne-K J Fett
- Cognition, Schizophrenia and Imaging Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, UK.,Department of Psychology, School of Arts and Social Sciences, City, University of London, UK
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Theory of Mind in Borderline Personality Disorder: A Possible Endophenotypic Factor? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18063193. [PMID: 33808735 PMCID: PMC8003401 DOI: 10.3390/ijerph18063193] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Revised: 03/10/2021] [Accepted: 03/16/2021] [Indexed: 11/17/2022]
Abstract
The purpose of this study is to examine whether theory of mind (ToM) is an endophenotypic marker of borderline personality disorder (BPD), thus constituting an etiopathogenic factor of the disease. This would suggest familial vulnerability to BPD. This was a case-control study involving 146 individuals with 57 BPD patients, 32 first-degree relatives, and 57 controls (median age of BPD and control = 33.4 years; relatives = 52.9 years; BPD females and controls = 91.2%; female relatives = 62.5%). All the participants completed the Spanish version of the Movie for the Assessment of Social Cognition test to evaluate the ToM subclassification: interpretation of emotions, thoughts and intentions. BPD patients and their healthy first-degree relatives exhibited significant deficits in the correct interpretation of emotions and intentions compared to healthy controls. Both patients with BPD and their healthy first-degree relatives exhibited significant deficits in ToM, which suggests that it may be an etiopathogenic factor of BPD, and ToM (interpretation of emotions, thoughts and intentions) is a possible endophenotypic marker of BPD, suggesting a genetic predisposition to the disorder. Therefore, ToM could be considered as an indicator for the early detection of the disorder of and intervention for BPD.
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Del Sette P, Bambini V, Bischetti L, Lecce S. Longitudinal associations between theory of mind and metaphor understanding during middle childhood. COGNITIVE DEVELOPMENT 2020. [DOI: 10.1016/j.cogdev.2020.100958] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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The Influence of Premorbid Adjustment and Autistic Traits on Social Cognitive Dysfunction in Schizophrenia. J Int Neuropsychol Soc 2020; 26:276-285. [PMID: 31507263 DOI: 10.1017/s1355617719000961] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
OBJECTIVES Premorbid dysfunction during childhood and adolescence is well documented in patients with schizophrenia. Literature pointed out multiple premorbid trajectories leading to different patients' cognitive status, symptomatology, and global functioning after disease onset. This study aimed at identifying groups of premorbid trajectories and disentangling between group differences in clinical and cognitive measures, focusing on theory of mind (ToM) and autistic traits (ATs). METHODS Ninety-seven patients with schizophrenia were recruited and assessed for cognitive and ToM abilities, psychopathology, and ATs. A two-step cluster analysis identified three different groups of patients based on premorbid adjustment during childhood, adolescence, and late adolescence (i.e., stable-good, stable-poor, and "deteriorating"). RESULTS Compared to 66 healthy controls, results showed a widespread impairment in cognitive and ToM abilities among all groups of patients, except for affective ToM and executive functions in the stable-good group. Moreover, the stable-poor group exhibited more pronounced ATs and a more severe ToM impairment, compared to the other two groups of patients. CONCLUSIONS Our findings highlight the existence of a group of patients with poor premorbid adjustment since childhood, more pronounced ATs and a severe ToM impairment affecting those basic mentalizing skills that are usually preserved in schizophrenia. Results might have intriguing implications in identifying underpinning endophenotypes and implementing cutting-edge rehabilitation programs.
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Knight MJ, Baune BT. Social cognitive abilities predict psychosocial dysfunction in major depressive disorder. Depress Anxiety 2019; 36:54-62. [PMID: 30211966 DOI: 10.1002/da.22844] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2018] [Revised: 08/21/2018] [Accepted: 09/02/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Major depressive disorder (MDD) is associated with social cognitive deficits (e.g., poor affect recognition and impaired theory of mind). However, the contribution of social cognitive issues to psychosocial dysfunction in MDD (e.g., occupational functioning and interpersonal relationships) has not been investigated. The current study evaluated the relationship between specific social cognitive domains (e.g., prosody interpretation) and psychosocial dysfunction in subjects with lifetime MDD, as well as currently depressed, remitted, and healthy controls (HCs) subjects. METHOD Data were obtained from 213 participants in the Cognitive Function and mood study (CoFaMS), a cross-sectional study of mood, social cognition, cold cognition, and psychosocial functioning in mood disorders. Participants' (current MDD n = 42, remitted MDD n = 69, and HCs n = 102) social cognitive abilities were assessed using the Social Perception subtest of the Wechsler Adult Intelligence Scale, and psychosocial dysfunction was clinically evaluated with the Functioning Assessment Short Test (FAST). RESULTS The results indicated that prosody interpretation, but not facial affect or meaning interpretation, was associated with psychosocial dysfunction in subjects with lifetime MDD, as well as remitted MDD subjects relative to HCs. In contrast, social cognition was not associated with functioning in participants with current MDD or in HCs. CONCLUSIONS These results suggest that the relationship between social cognition and psychosocial functioning differs between the acute and remitted stage of illness in MDD, and that prosody interpretation should be considered a treatment target in patients with residual psychosocial issues.
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Affiliation(s)
- Matthew J Knight
- Discipline of Psychiatry, Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia
| | - Bernhard T Baune
- Department of Psychiatry, Melbourne Medical School, University of Melbourne, Melbourne, VIC, Australia
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Knight MJ, Baune BT. The Direct and Indirect Relationship Between Social Cognition and Psychosocial Dysfunction in Major Depressive Disorder. Front Psychiatry 2019; 10:347. [PMID: 31156485 PMCID: PMC6533355 DOI: 10.3389/fpsyt.2019.00347] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2019] [Accepted: 05/02/2019] [Indexed: 11/13/2022] Open
Abstract
Background: Recent evidence suggests that depressed patients experience social cognitive deficits (e.g., poor affect recognition). However, very little is known regarding the contribution of social cognitive deficits to psychosocial dysfunction (e.g., occupational functioning). In particular, the mechanistic roles of depression severity and cognitive deficits (e.g., memory) in this domain have not been explored. The current study evaluated the extent to which mood symptoms and cognitive deficits provide a mechanistic explanation for the relationship between social cognitive and psychosocial deficits in major depressive disorder (MDD). Methods: Data were obtained from 111 participants with MDD (75 Female, mean age = 35, 84% Caucasian, 12% Asian, 4% Other) in the Cognitive Function and Mood Study (CoFaM-S), a cross-sectional study of mood, social cognition, cognition, and psychosocial functioning in mood disorders. Social cognitive abilities were assessed using the Social Perception subtest of the Wechsler Adult Intelligence Scale, and psychosocial dysfunction was clinically evaluated with the Functioning Assessment Short Test (FAST). Results: Cognitive deficits and mood symptoms did not significantly mediate relationships between social cognitive ability and psychosocial dysfunction. The exception was executive function, which mediated an indirect relationship between meaning interpretation (i.e., theory of mind) and self-perceived cognitive dysfunction. Conclusion: The results suggest that the relationship between social cognitive deficits and psychosocial dysfunction is not mechanistically explained by mood symptoms or nonsocial cognition. Development of treatment strategies targeting social cognitive deficits in patients with MDD is warranted.
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Affiliation(s)
- Matthew J Knight
- Discipline of Psychiatry, Adelaide Medical School, University of Adelaide, Adelaide, Australia
| | - Bernhard T Baune
- Department of Psychiatry and Psychotherapy, University Hospital Münster, University of Münster, Münster, Germany
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Aykan S, Nalçacı E. Assessing Theory of Mind by Humor: The Humor Comprehension and Appreciation Test (ToM-HCAT). Front Psychol 2018; 9:1470. [PMID: 30150962 PMCID: PMC6099116 DOI: 10.3389/fpsyg.2018.01470] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Accepted: 07/26/2018] [Indexed: 01/10/2023] Open
Abstract
Theory of Mind (ToM) may be defined as the ability to understand the mental states, such as beliefs, desires, intentions, and emotions, of others. Impairment of ToM ability leads to disorders with pathologies in social skills, such as autism spectrum disorder and schizophrenia. In addition to differences in ToM ability among patient populations, there is variation between neurotypical individuals. Unfortunately, ToM tasks are usually developed for children or patients with cognitive disorders and cannot detect variations in healthy adults. As an alternative tool, humor may be used. Humor plays a role in social communication and requires many different cognitive functions. Humor is believed to represent complex high-order cognitive processes. There are numerous types of humor; the most complex type is considered ToM humor, where an understanding of social/emotional content is necessary. Given the need for a ToM assessment test suitable for healthy adult populations, we developed a test for measuring humor comprehension and appreciation, with and without ToM content (ToM-HCAT). The present ToM-HCAT test is a performance test consisting of cartoons. The test measures perceived funniness, reaction time to perceived funniness decision, and meaning inference. Cartoons were selected after pilot studies involving 44 participants. Subscales were constituted according to expert views and confirmed by confirmatory factor analysis (N = 135). Goodness of fit values for the final 35-item test were acceptable to excellent: GFI = 0.97; AGFI = 0.97; NFI = 0.97; RFI = 0.97, and SRMR = 0.067. Both categories were internally consistent (α1 = 0.84, α2 = 0.94). External validity was assessed against autistic traits. One hundred and three participants completed the Autism Spectrum Quotient and were grouped by +0.5 standard deviations from the mean as high in autistic traits. The meaning-inference scores of the subscale with the ToM cartoons were significantly lower (p = 0.034) for the high autistic traits group, providing evidence of external validity. In conclusion, we developed and validated a test for assessment of ToM by humor comprehension and appreciation. We believe that the present test will be useful for the detection of variations in ToM ability in the healthy adult population.
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Affiliation(s)
- Simge Aykan
- Department of Physiology, Ankara University School of Medicine, Ankara, Turkey
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Förster K, Jörgens S, Air TM, Bürger C, Enneking V, Redlich R, Zaremba D, Grotegerd D, Dohm K, Meinert S, Leehr EJ, Böhnlein J, Repple J, Opel N, Kavakbasi E, Arolt V, Zwitserlood P, Dannlowski U, Baune BT. The relationship between social cognition and executive function in Major Depressive Disorder in high-functioning adolescents and young adults. Psychiatry Res 2018; 263:139-146. [PMID: 29550719 DOI: 10.1016/j.psychres.2018.02.046] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2017] [Revised: 02/21/2018] [Accepted: 02/21/2018] [Indexed: 10/18/2022]
Abstract
To understand how cognitive dysfunction contributes to social cognitive deficits in depression, we investigated the relationship between executive function and social cognitive performance in adolescents and young adults during current and remitted depression, compared to healthy controls. Social cognition and executive function were measured in 179 students (61 healthy controls and 118 patients with depression; Mage = 20.60 years; SDage = 3.82 years). Hierarchical regression models were employed within each group (healthy controls, remitted depression, current depression) to examine the nature of associations between cognitive measures. Social cognitive and executive function did not significantly differ overall between depressed patients and healthy controls. There was no association between executive function and social cognitive function in healthy controls or in remitted patients. However, in patients with a current state of depression, lower cognitive flexibility was associated with lower performance in facial-affect recognition, theory-of-mind tasks and overall affect recognition. In this group, better planning abilities were associated with decreased performance in facial affect recognition and overall social cognitive performance. While we infer that less cognitive flexibility might lead to a more rigid interpretation of ambiguous social stimuli, we interpret the counterintuitive negative correlation of planning ability and social cognition as a compensatory mechanism.
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Affiliation(s)
- Katharina Förster
- Department of Psychiatry, University of Münster, Germany; Institute of Psychiatric Phenomics and Genomics, Ludwig-Maximillians-University, Munich, Germany
| | - Silke Jörgens
- Department of Psychiatry, University of Münster, Germany
| | - Tracy M Air
- Discipline of Psychiatry, Adelaide Medical School, The University of Adelaide, Australia
| | | | | | - Ronny Redlich
- Department of Psychiatry, University of Münster, Germany
| | - Dario Zaremba
- Department of Psychiatry, University of Münster, Germany
| | | | - Katharina Dohm
- Department of Psychiatry, University of Münster, Germany
| | | | | | | | | | - Nils Opel
- Department of Psychiatry, University of Münster, Germany
| | | | - Volker Arolt
- Department of Psychiatry, University of Münster, Germany
| | | | - Udo Dannlowski
- Department of Psychiatry, University of Münster, Germany
| | - Bernhard T Baune
- Discipline of Psychiatry, Adelaide Medical School, The University of Adelaide, Australia.
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Tadmor H, Levin M, Dadon T, Meiman ME, Ajameeh A, Mazzawi H, Rigbi A, Kremer I, Golani I, Shamir A. Decoding emotion of the other differs among schizophrenia patients and schizoaffective patients: A pilot study. SCHIZOPHRENIA RESEARCH-COGNITION 2017; 5:13-20. [PMID: 28740812 PMCID: PMC5514298 DOI: 10.1016/j.scog.2016.06.001] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/27/2015] [Revised: 02/02/2016] [Accepted: 06/02/2016] [Indexed: 12/19/2022]
Abstract
The deficit in ability to attribute mental states such as thoughts, beliefs, and intentions of another person is a key component in the functional impairment of social cognition in schizophrenia. In the current study, we compared the ability of persons with first episode schizophrenia (FE-SZ) and individuals with schizophrenia displaying symptomatic remission (SZ-CR) to decode the mental state of others with healthy individuals and schizoaffective patients. In addition, we analyzed the effect of dopamine-related genes polymorphism on the ability to decode the mental state of another, and searched for different genetic signatures. Our results show that overall, individuals with schizophrenia performed worse in the "Reading the Mind in the Eyes" (eyes) test, a simple well-defined task to infer the mental state of others than healthy individuals. Within the schizophrenia group, schizoaffective scored significantly higher than FE-SZ, SZ-CR, and healthy individuals. No difference was observed in performance between FE-SZ and SZ-CR subjects. Interestingly, FE-SZ and SZ-CR, but not schizoaffective individuals, performed worse in decoding negative and neutral emotional valance than the healthy control group. At the genetic level, we observed a significant effect of the DAT genotype, but not D4R genotype, on the eyes test performance. Our data suggest that understanding the mental state of another person is a trait marker of the illness, and might serve as an intermediate phenotype in the diagnostic process of schizophrenia disorders, and raise the possibility that DA-related DAT gene might have a role in decoding the mental state of another person.
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Affiliation(s)
- Hagar Tadmor
- Psychobiology Research Laboratory, Mazor Mental Health Center, Akko, Israel.,Faculty of Medicine in the Galilee, Bar-Ilan University, Zefat, Israel
| | - Maya Levin
- Faculty of Medicine in the Galilee, Bar-Ilan University, Zefat, Israel
| | - Tzameret Dadon
- Psychobiology Research Laboratory, Mazor Mental Health Center, Akko, Israel
| | - Meital E Meiman
- Psychobiology Research Laboratory, Mazor Mental Health Center, Akko, Israel
| | - Alaa Ajameeh
- Psychobiology Research Laboratory, Mazor Mental Health Center, Akko, Israel
| | - Hosam Mazzawi
- Psychobiology Research Laboratory, Mazor Mental Health Center, Akko, Israel
| | - Amihai Rigbi
- Department of Behavioral Science, Kinneret Academic Collage on the Sea of Galilee, Israel.,Research Authority Unit, Beit Berl Academic College, Kfar Sava, Israel
| | - Ilana Kremer
- Psychobiology Research Laboratory, Mazor Mental Health Center, Akko, Israel.,The Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
| | - Idit Golani
- Department of Biotechnology, Ort Braude College, Karmiel, Israel
| | - Alon Shamir
- Psychobiology Research Laboratory, Mazor Mental Health Center, Akko, Israel.,The Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel
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Ay R, Böke Ö, Pazvantoğlu O, Şahin AR, Sarisoy G, Arik AC, Güz H. Social Cognition in Schizophrenia Patients and Their First-Degree Relatives. Noro Psikiyatr Ars 2017; 53:338-343. [PMID: 28360809 DOI: 10.5152/npa.2016.10223] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Accepted: 08/27/2015] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Social cognition is a person's ability to configure the designs of relationships between themselves and others and to use these designs to guide social behaviors in a flexible manner. The models that are the most studied and describe social cognition are the theory of mind (ToM) and emotion recognition. This study was aimed to detect ToM and emotion recognition disorders in schizophrenia patients and their first-degree relatives. METHODS Thirty schizophrenia patients in remission, the first-degree relatives of schizophrenia patients (n=30), and 30 healthy volunteers who were paired with the patients in terms of age and duration of education were included in the study. The Positive and Negative Symptom Scale (PANSS), Dokuz-Eylül Theory of Mind Scale (DEToMS), Reading the Mind in the Eyes test, Facial Emotion Identification Test (FEIT), and Facial Emotion Discrimination Test (FEDT) were performed by the patients participating in this study. RESULTS ToM and emotion recognition were found to be defective in the schizophrenia patients and their relatives. The performances of ToM and emotion recognition were ranked as the schizophrenia group, family group, and control group, from the worst to the best. The schizophrenia group showed poor performance in all sub-components except irony. In the family group, the empathy subcomponent showed similar performance with the control group, whereas the subcomponents of the second-order false belief, metaphor, and faux pas tests showed similar performance with the patient group. There were differences among the three groups in the first-order false belief subscale as well as the total DEToMS. The patient and family groups showed the poorest performances, whereas the control group showed the best performance. CONCLUSION The detection of ToM and emotion recognition disorders in the remission period, regardless of the attack period and asymptomatic first-degree relatives, may support the view that the period of schizophrenia is an independent continuous variable.
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Affiliation(s)
- Rukiye Ay
- Departmen of Psychiatry, Ondokuz Mayıs University School of Medicine, Samsun, Turkey
| | - Ömer Böke
- Departmen of Psychiatry, Ondokuz Mayıs University School of Medicine, Samsun, Turkey
| | - Ozan Pazvantoğlu
- Department of Psychiatry, Sokrates Psychiatry Center, İzmir, Turkey
| | - Ahmet Rıfat Şahin
- Departmen of Psychiatry, Ondokuz Mayıs University School of Medicine, Samsun, Turkey
| | - Gökhan Sarisoy
- Departmen of Psychiatry, Ondokuz Mayıs University School of Medicine, Samsun, Turkey
| | - Ali Cezmi Arik
- Departmen of Psychiatry, Ondokuz Mayıs University School of Medicine, Samsun, Turkey
| | - Hatice Güz
- Departmen of Psychiatry, Ondokuz Mayıs University School of Medicine, Samsun, Turkey
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Bambini V, Arcara G, Bechi M, Buonocore M, Cavallaro R, Bosia M. The communicative impairment as a core feature of schizophrenia: Frequency of pragmatic deficit, cognitive substrates, and relation with quality of life. Compr Psychiatry 2016; 71:106-120. [PMID: 27653782 DOI: 10.1016/j.comppsych.2016.08.012] [Citation(s) in RCA: 79] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/02/2016] [Revised: 08/01/2016] [Accepted: 08/21/2016] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Impairments in specific aspects of pragmatic competence, supporting the use of language in context, are largely documented in schizophrenia and might represent an indicator of poor outcome. Yet pragmatics is rarely included in clinical settings. This paper aims to promote a clinical consideration of pragmatics as a target of assessment and intervention. We investigated the frequency of the pragmatic deficit, its cognitive substrates, and the relation with quality of life. METHODS Pragmatic abilities were compared in a sample of patients with schizophrenia and healthy controls based on a comprehensive pragmatic test (APACS). We assessed also for psychopathology, cognition, social cognition, and quality of life. We explored the co-occurrence of deficits in different domains, and we used multiple regressions to investigate the effect of cognition and social cognition on pragmatics, and of pragmatics on quality of life. RESULTS Pragmatic abilities, especially comprehending discourse and non-literal meanings, were compromised in schizophrenia, with 77% of patients falling below cutoff. Pragmatic deficit co-occurred with cognitive or socio-cognitive deficits in approximately 30% of cases. Multiple regression analysis confirmed the interplay of cognition and social cognition in pragmatic behavior. Quality of life was predicted by symptoms and by pragmatic abilities. CONCLUSIONS The high frequency of impairment suggests that the pragmatic deficit is a core feature of schizophrenia, associated with quality of life. Cognitive and socio-cognitive abilities might represent necessary though not sufficient building blocks for the acquisition of pragmatic abilities throughout development. Therefore, a more precise incorporation of pragmatics in the description of the pathology is of high clinical and translational relevance.
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Affiliation(s)
- Valentina Bambini
- Center for Neurocognition, Epistemology and theoretical Syntax, Scuola Universitaria Superiore IUSS Pavia, Piazza della Vittoria 15, 27100, Pavia, Italy.
| | - Giorgio Arcara
- IRCCS Fondazione Ospedale San Camillo, Via Alberoni 70, Lido di Venezia (Venezia), Italy.
| | - Margherita Bechi
- Department of Clinical Neurosciences, IRCSS San Raffaele Scientific Institute, Via Stamira d'Ancona 20, 20127, Milano, Italy.
| | - Mariachiara Buonocore
- Department of Clinical Neurosciences, IRCSS San Raffaele Scientific Institute, Via Stamira d'Ancona 20, 20127, Milano, Italy.
| | - Roberto Cavallaro
- Department of Clinical Neurosciences, IRCSS San Raffaele Scientific Institute, Via Stamira d'Ancona 20, 20127, Milano, Italy.
| | - Marta Bosia
- Department of Clinical Neurosciences, IRCSS San Raffaele Scientific Institute, Via Stamira d'Ancona 20, 20127, Milano, Italy; Vita Salute San Raffaele University, Via Olgettina, 58, 20132, Milano, Italy.
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Roux P, Brunet-Gouet E, Passerieux C, Ramus F. Eye-tracking reveals a slowdown of social context processing during intention attribution in patients with schizophrenia. J Psychiatry Neurosci 2016; 41:E13-21. [PMID: 26836621 PMCID: PMC4764486 DOI: 10.1503/jpn.150045] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Schizophrenia is associated with poor theory of mind (ToM), particularly in the attribution of intentions to others. It is also associated with abnormal gaze behaviours and contextual processing. This study investigated to what extent impaired ToM in patients with schizophrenia is related to abnormal processing of social context. METHODS We evaluated ToM using a nonverbal intention attribution task based on comic strips depicting social/nonsocial and contextual/noncontextual events while eye movements were recorded. Eye-tracking was used to assess processing time dedicated to visual cues contained in regions of interest identified in a pilot study. We measured cognitive contextual control on a separate task. RESULTS We tested 29 patients with schizophrenia and 29 controls. Compared with controls, patients were slower in intention attribution but not in physical reasoning. They looked longer than controls at contextual cues displayed in the first 2 context pictures of the comic strips, and this difference was greater for intention attribution than for physical reasoning. We found no group difference in time spent looking at noncontextual cues. Patients' impairment in contextual control did not explain their increased reaction time and gaze duration on contextual cues during intention attribution. LIMITATIONS Difficulty may not have been equivalent between intention attribution and physical reasoning conditions. CONCLUSION Overall, schizophrenia was characterized by a delay in intention attribution related to a slowdown of social context processing that was not explained by worse executive contextual control.
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Affiliation(s)
- Paul Roux
- Correspondence to: P. Roux, Service Universitaire de Psychiatrie d’adultes, Centre Hospitalier de Versailles, 177 rue de Versailles, 78157 Le Chesnay, France;
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Cella M, Hamid S, Butt K, Wykes T. Cognition and Social Cognition in non-psychotic siblings of patients with schizophrenia. Cogn Neuropsychiatry 2015; 20:232-42. [PMID: 25720746 DOI: 10.1080/13546805.2015.1014032] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
INTRODUCTION Deficits in Social Cognition are common in people with schizophrenia. However, it is not clear if these deficits are a vulnerability marker and whether they are independent to cognitive difficulties. This study investigates these two issues in individuals with a genetic liability to psychosis. METHODS Twenty-one healthy siblings of patients with schizophrenia were compared with 21 healthy individuals on a range of cognitive and social cognitive measures. Significant differences in cognitive domains were controlled for when comparing the two groups on measures of social cognition. RESULTS Siblings of people with schizophrenia performed significantly worst on tests of theory of mind and social perception but not on affect recognition. Scores on tests of executive function, processing speed and general IQ were also lower in the sibling group. When controlled for differences in cognitive tests, the two groups still retained significant differences in theory of mind and social perception. However, executive function significantly contributed to theory of mind and processing speed to social perception differences. CONCLUSIONS These results further suggest that difficulties in some domains of social cognition are associated with a genetic vulnerability for schizophrenia. In these areas, cognitive difficulties account only partially for social cognition problems suggesting that these two domains may represent relatively independent liability factors.
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Affiliation(s)
- Matteo Cella
- a Department of Psychology , Institute of Psychiatry, King's College London , De Crespigny Park, SE5 8AF London , UK
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20
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Mohnke S, Erk S, Schnell K, Romanczuk-Seiferth N, Schmierer P, Romund L, Garbusow M, Wackerhagen C, Ripke S, Grimm O, Haller L, Witt SH, Degenhardt F, Tost H, Heinz A, Meyer-Lindenberg A, Walter H. Theory of mind network activity is altered in subjects with familial liability for schizophrenia. Soc Cogn Affect Neurosci 2015; 11:299-307. [PMID: 26341902 DOI: 10.1093/scan/nsv111] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2015] [Accepted: 08/31/2015] [Indexed: 12/19/2022] Open
Abstract
As evidenced by a multitude of studies, abnormalities in Theory of Mind (ToM) and its neural processing might constitute an intermediate phenotype of schizophrenia. If so, neural alterations during ToM should be observable in unaffected relatives of patients as well, since they share a considerable amount of genetic risk. While behaviorally, impaired ToM function is confirmed meta-analytically in relatives, evidence on aberrant function of the neural ToM network is sparse and inconclusive. The present study therefore aimed to further explore the neural correlates of ToM in relatives of schizophrenia. About 297 controls and 63 unaffected first-degree relatives of patients with schizophrenia performed a ToM task during functional magnetic resonance imaging. Consistent with the literature relatives exhibited decreased activity of the medial prefrontal cortex. Additionally, increased recruitment of the right middle temporal gyrus and posterior cingulate cortex was found, which was related to subclinical paranoid symptoms in relatives. These results further support decreased medial prefrontal activation during ToM as an intermediate phenotype of genetic risk for schizophrenia. Enhanced recruitment of posterior ToM areas in relatives might indicate inefficiency mechanisms in the presence of genetic risk.
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Affiliation(s)
- Sebastian Mohnke
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany,
| | - Susanne Erk
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany
| | - Knut Schnell
- Department of Psychiatry, University of Heidelberg, Heidelberg, Germany
| | - Nina Romanczuk-Seiferth
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany
| | - Phöbe Schmierer
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany
| | - Lydia Romund
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany
| | - Maria Garbusow
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany
| | - Carolin Wackerhagen
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany
| | - Stephan Ripke
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany, Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Oliver Grimm
- Department of Psychiatry, Central Institute of Mental Health, Mannheim/University of Heidelberg; Germany, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zürich, Zürich, Switzerland
| | - Leila Haller
- Department of Psychiatry, Central Institute of Mental Health, Mannheim/University of Heidelberg; Germany
| | - Stephanie H Witt
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Mannheim/University of Heidelberg, Germany, and
| | - Franziska Degenhardt
- Department of Genomics, Institute of Human Genetics, Life and Brain Center, University of Bonn, Bonn, Germany
| | - Heike Tost
- Department of Psychiatry, Central Institute of Mental Health, Mannheim/University of Heidelberg; Germany
| | - Andreas Heinz
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany
| | - Andreas Meyer-Lindenberg
- Department of Psychiatry, Central Institute of Mental Health, Mannheim/University of Heidelberg; Germany
| | - Henrik Walter
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany
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Air T, Weightman MJ, Baune BT. Symptom severity of depressive symptoms impacts on social cognition performance in current but not remitted major depressive disorder. Front Psychol 2015; 6:1118. [PMID: 26300814 PMCID: PMC4523699 DOI: 10.3389/fpsyg.2015.01118] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2015] [Accepted: 07/20/2015] [Indexed: 11/13/2022] Open
Abstract
The aim of the present study was to investigate the social cognitive functioning of participants with depression when compared with healthy controls, and to assess the impact of symptom severity. One hundred and eight patients with depression (66 remitted and 42 current) and 52 healthy controls were assessed using the Wechsler Advanced Clinical Solutions: Social Perception Subtest, measuring facial affect recognition in isolation and in combination with prosody and body language interpretation. When healthy controls, remitted depression and currently depressed groups were compared, no associations were found on any of the social cognition subscales. Severity of depressive and anxious symptoms predicted performance on all social cognition subscales in currently depressed participants, controlling for age, gender, education and psychotropic medication. Affective depressive symptoms were inversely related to ACS Pairs and Prosody subscales, while somatic symptoms were inversely related to the ACS Affect Recognition and Total scores. There was no association between severity and the WAIS ACS in remitted depression participants. People with MDD exhibiting more severe depressive and anxious symptoms and a cluster of affective symptoms have greater difficulty undertaking complex social cognitive tasks. Given the state like nature to these deficits, these impairments may cause problems with day to day functioning and have implications in targeted therapeutic interventions.
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Affiliation(s)
- Tracy Air
- Discipline of Psychiatry, School of Medicine, The University of Adelaide Adelaide, SA, Australia
| | - Michael J Weightman
- Discipline of Psychiatry, School of Medicine, The University of Adelaide Adelaide, SA, Australia
| | - Bernhard T Baune
- Discipline of Psychiatry, School of Medicine, The University of Adelaide Adelaide, SA, Australia
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Haas MH, Chance SA, Cram DF, Crow TJ, Luc A, Hage S. Evidence of Pragmatic Impairments in Speech and Proverb Interpretation in Schizophrenia. JOURNAL OF PSYCHOLINGUISTIC RESEARCH 2015; 44:469-483. [PMID: 24756919 DOI: 10.1007/s10936-014-9298-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Schizophrenia has been suggested to involve linguistic pragmatic deficits. In this study, two aspects of pragmatic ability were assessed; comprehension and production. Drawing on relevance theory and Gricean implicatures to assess shared attention and interpretation in a linguistic context, discourse samples and proverb interpretation were transcribed from recorded interviews with patients with schizophrenia and control subjects. The productive aspect of implicatures was assessed by quantifying the use of 'connectors' in discourse. Receptive aspects were assessed by scoring interpretations of four common proverbs. Statistically significant effects were found: patients with schizophrenia used connectors less than controls as well as performing worse in proverb comprehension. Positive correlations between connectors and proverb interpretation in all subjects suggested an underlying pragmatic root for both productive and receptive aspects. The relative number of connectors (as a percentage of words used) provided a better index of pragmatic ability than total number because total output appeared to be influenced by additional factors such as IQ. Deficits were found in the use of connectors and in proverb interpretation even when controlling for verbal IQ, suggesting that pragmatic aspects of language are particularly vulnerable in schizophrenia compared with other verbal abilities.
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Affiliation(s)
- Marc H Haas
- Department of Linguistics, University of Oxford, Oxford, UK,
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Hinzen W, Rosselló J. The linguistics of schizophrenia: thought disturbance as language pathology across positive symptoms. Front Psychol 2015; 6:971. [PMID: 26236257 PMCID: PMC4503928 DOI: 10.3389/fpsyg.2015.00971] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2014] [Accepted: 06/28/2015] [Indexed: 11/13/2022] Open
Abstract
We hypothesize that linguistic (dis-)organization in the schizophrenic brain plays a more central role in the pathogenesis of this disease than commonly supposed. Against the standard view, that schizophrenia is a disturbance of thought or selfhood, we argue that the origins of the relevant forms of thought and selfhood at least partially depend on language. The view that they do not is premised by a theoretical conception of language that we here identify as 'Cartesian' and contrast with a recent 'un-Cartesian' model. This linguistic model empirically argues for both (i) a one-to-one correlation between human-specific thought or meaning and forms of grammatical organization, and (ii) an integrative and co-dependent view of linguistic cognition and its sensory-motor dimensions. Core dimensions of meaning mediated by grammar on this model specifically concern forms of referential and propositional meaning. A breakdown of these is virtually definitional of core symptoms. Within this model the three main positive symptoms of schizophrenia fall into place as failures in language-mediated forms of meaning, manifest either as a disorder of speech perception (Auditory Verbal Hallucinations), abnormal speech production running without feedback control (Formal Thought Disorder), or production of abnormal linguistic content (Delusions). Our hypothesis makes testable predictions for the language profile of schizophrenia across symptoms; it simplifies the cognitive neuropsychology of schizophrenia while not being inconsistent with a pattern of neurocognitive deficits and their correlations with symptoms; and it predicts persistent findings on disturbances of language-related circuitry in the schizophrenic brain.
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Affiliation(s)
- Wolfram Hinzen
- Institució Catalana de Recerca i Estudis AvançatsBarcelona, Spain
- Department of Philosophy, University of DurhamDurham, UK
- Department of Linguistics, Grammar & Cognition Lab, Universitat de BarcelonaBarcelona, Spain
| | - Joana Rosselló
- Department of Linguistics, Grammar & Cognition Lab, Universitat de BarcelonaBarcelona, Spain
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von Maffei C, Görges F, Kissling W, Schreiber W, Rummel-Kluge C. Using films as a psychoeducation tool for patients with schizophrenia: a pilot study using a quasi-experimental pre-post design. BMC Psychiatry 2015; 15:93. [PMID: 25924784 PMCID: PMC4422602 DOI: 10.1186/s12888-015-0481-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/20/2014] [Accepted: 04/23/2015] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND Relapses and, subsequently, readmissions are common in patients with schizophrenia. Psychoeducation has been shown to reduce the number and duration of readmissions. Yet, only little more than 20% of psychiatric patients in German speaking countries receive psychoeducation. Among other reasons, costs may be considered too high by hospitals. The objective of the present study was to test the feasibility of a new cost-efficient approach in the psychoeducation of patients with schizophrenia. In this study, films were used to impart knowledge about the illness to inpatients. METHODS A total of 113 participants were initially included in the study, eleven of which were not included in the final analyses. Six films about the symptoms, diagnosis, causes, warning signs, treatment of schizophrenia and about the influence of family members and friends were shown in a group setting in the presence of nursing staff. All films combined facts, expert opinions, and personal experiences of peers. As the main outcome criterion of this feasibility pilot study, we measured the effects on knowledge. Secondary outcome measures included compliance, insight into illness, side effects, and quality of life. Data were collected directly after the intervention and about half a year afterwards. The number and the duration of readmissions to the hospital were recorded and compared to the number and duration of prior admissions. Patients were also asked to state their subjective opinion about the films. Main data analyses were done using paired t-tests and Wilcoxon signed-rank tests. Secondary analyses also involved ANOVAs and ANCOVAs. RESULTS One hundred and two inpatients were included in the data analyses. Showing the films in the tested setting was shown to be feasible. Knowledge about schizophrenia (p < .001), compliance (ps < .01), insight into illness (p < .01), and quality of life (p < .001) all increased significantly after patients had watched the films and remained stable for at least half a year. A vast majority (84.9%) of the patients found the films to be interesting and informative. CONCLUSIONS Using films to educate inpatients about schizophrenia is a feasible method that is cost- and time-efficient and well received by the patients.
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Affiliation(s)
- Christian von Maffei
- Department of Psychiatry and Psychotherapy, University of Leipzig, Semmelweisstr. 10, D-04103, Leipzig, Germany.
| | - Frauke Görges
- Department of Psychiatry and Psychotherapy, University of Leipzig, Semmelweisstr. 10, D-04103, Leipzig, Germany.
| | - Werner Kissling
- Department of Psychiatry and Psychotherapy, Technische Universität München, Möhlstr. 26, 81675, München, Germany.
| | | | - Christine Rummel-Kluge
- Department of Psychiatry and Psychotherapy, University of Leipzig, Semmelweisstr. 10, D-04103, Leipzig, Germany. .,Forschungszentrum Depression der Stiftung Deutsche Depressionshilfe, Semmelweisstr. 10, 04103, Leipzig, Germany.
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Lavoie MA, Plana I, Jackson PL, Godmaire-Duhaime F, Bédard Lacroix J, Achim AM. Performance in multiple domains of social cognition in parents of patients with schizophrenia. Psychiatry Res 2014; 220:118-24. [PMID: 25216560 DOI: 10.1016/j.psychres.2014.07.055] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2013] [Revised: 06/10/2014] [Accepted: 07/24/2014] [Indexed: 10/25/2022]
Abstract
Social cognition refers to a set of cognitive abilities that allow us to perceive and interpret social stimuli. Social cognition is affected in schizophrenia and impairments have also been documented in unaffected relatives, suggesting that social cognition may be related to a genetic vulnerability to the disease. This study aims to investigate potential impairments in four domains of social cognition (mentalizing, emotion recognition, social knowledge and empathy) in the same group of relatives in order to gather a more complete picture of social cognition difficulties in this population. The Batterie Intégrée de Cognition Sociale (BICS) (mentalizing, emotion recognition, and social knowledge) and the Interpersonal Reactivity Index (IRI) (empathy) were administered to 31 parents of patients with a psychotic disorder and 38 healthy controls. Parents of patients performed significantly worse than controls on the mentalizing test but significantly better on the social knowledge test. No significant between-group differences were observed for emotion recognition and empathy. This study is the first to evaluate four social cognition domains in this population. The results precise which social cognition processes may be impaired or preserved in unaffected relatives of patients and lead us to propose an hypothesis about a mechanism that could underlie the mentalizing difficulties observed in this population.
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Affiliation(s)
- Marie-Audrey Lavoie
- École de psychologie, Université Laval, Quebec city, Québec, Canada; Centre de recherche de l׳Institut universitaire en santé mentale de Québec, Quebec city, Québec, Canada; Centre interdisciplinaire de recherche en réadaptation et réintégration sociale, Quebec city, Québec, Canada
| | - India Plana
- Centre de recherche de l׳Institut universitaire en santé mentale de Québec, Quebec city, Québec, Canada; Faculté de médecine, Université Laval, Quebec city, Québec, Canada
| | - Philip L Jackson
- École de psychologie, Université Laval, Quebec city, Québec, Canada; Centre de recherche de l׳Institut universitaire en santé mentale de Québec, Quebec city, Québec, Canada; Centre interdisciplinaire de recherche en réadaptation et réintégration sociale, Quebec city, Québec, Canada
| | | | | | - Amélie M Achim
- Centre de recherche de l׳Institut universitaire en santé mentale de Québec, Quebec city, Québec, Canada; Faculté de médecine, Université Laval, Quebec city, Québec, Canada.
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Gromann PM, Shergill SS, de Haan L, Meewis DGJ, Fett AKJ, Korver-Nieberg N, Krabbendam L. Reduced brain reward response during cooperation in first-degree relatives of patients with psychosis: an fMRI study. Psychol Med 2014; 44:3445-3454. [PMID: 25065732 DOI: 10.1017/s0033291714000737] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Psychosis is characterized by a profound lack of trust and disturbed social interactions. Investigating the neural basis of these deficits is difficult because of medication effects but first-degree relatives show qualitatively similar abnormalities to patients with psychosis on various tasks. This study aimed to investigate neural activation in siblings of patients in response to an interactive task. We hypothesized that, compared to controls, siblings would show (i) less basic trust at the beginning of the task and (ii) reduced activation of the brain reward and mentalizing systems. METHOD Functional magnetic resonance imaging (fMRI) data were acquired on 50 healthy siblings of patients with psychosis and 33 healthy controls during a multi-round trust game with a cooperative counterpart. An a priori region-of-interest (ROI) analysis of the caudate, temporoparietal junction (TPJ), superior temporal sulcus (STS), insula and medial prefrontal cortex (mPFC) was performed focusing on the investment and repayment phases. An exploratory whole-brain analysis was run to test for group-wise differences outside these ROIs. RESULTS The siblings' behaviour during the trust game did not differ significantly from that of the controls. At the neural level, siblings showed reduced activation of the right caudate during investments, and the left insula during repayments. In addition, the whole-brain analysis revealed reduced putamen activation in siblings during investments. CONCLUSIONS The findings suggest that siblings show aberrant functioning of regions traditionally involved in reward processing in response to cooperation, which may be associated with the social reward deficits observed in psychosis.
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Affiliation(s)
- P M Gromann
- Department of Educational Neuroscience, Faculty of Psychology and Education,VU University Amsterdam,The Netherlands
| | - S S Shergill
- CSI Laboratory, Department of Psychosis Studies, Institute of Psychiatry,King's College London,UK
| | - L de Haan
- Department of Early Psychosis, AMC, Academic Psychiatric Centre, Amsterdam,The Netherlands
| | - D G J Meewis
- Department of Educational Neuroscience, Faculty of Psychology and Education,VU University Amsterdam,The Netherlands
| | - A-K J Fett
- Department of Educational Neuroscience, Faculty of Psychology and Education,VU University Amsterdam,The Netherlands
| | - N Korver-Nieberg
- Department of Early Psychosis, AMC, Academic Psychiatric Centre, Amsterdam,The Netherlands
| | - L Krabbendam
- Department of Educational Neuroscience, Faculty of Psychology and Education,VU University Amsterdam,The Netherlands
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Cassetta B, Goghari V. Theory of mind reasoning in schizophrenia patients and non-psychotic relatives. Psychiatry Res 2014; 218:12-9. [PMID: 24745472 DOI: 10.1016/j.psychres.2014.03.043] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/11/2013] [Revised: 03/19/2014] [Accepted: 03/28/2014] [Indexed: 10/25/2022]
Abstract
Research consistently demonstrates that schizophrenia patients have theory of mind (ToM) impairments. Additionally, there is some evidence that family members of schizophrenia patients also demonstrate impairments in ToM, suggesting a genetic vulnerability for the disorder. This study assessed ToM abilities (i.e., sarcasm comprehension) in schizophrenia patients and their first-degree biological relatives during video-taped social interactions, to be representative of real-world interactions and to assess for disease-specific and/or genetic liability effects. Additionally, we assessed whether ToM abilities predicted social and global functioning in schizophrenia patients, and whether symptoms were associated with ToM deficits. Schizophrenia patients demonstrated impairments in sarcasm comprehension compared to controls and relatives, whereas relatives showed intact comprehension. Symptoms of schizophrenia significantly predicted worse ToM abilities. Furthermore, in schizophrenia patients, impaired ToM reasoning predicted worse social and global functioning. Given schizophrenia patients demonstrated impairments in ToM reasoning in a task that resembles real-life interactions, this might be a key area for remediation.
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Affiliation(s)
- Briana Cassetta
- Clinical Neuroscience of Schizophrenia Laboratory, Department of Psychology, 2500 University Drive NW, University of Calgary, Calgary, AB, Canada T2N 1N4
| | - Vina Goghari
- Clinical Neuroscience of Schizophrenia Laboratory, Department of Psychology, 2500 University Drive NW, University of Calgary, Calgary, AB, Canada T2N 1N4.
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Tomlinson E, Onwumere J, Kuipers E. Distress and negative experiences of the caregiving relationship in early psychosis: does social cognition play a role? Early Interv Psychiatry 2014; 8:253-60. [PMID: 23489370 DOI: 10.1111/eip.12040] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2012] [Accepted: 12/28/2012] [Indexed: 12/01/2022]
Abstract
AIM This study explored the relationship between individuals with early psychosis and first-degree relatives who were carers, to see whether negative and distressing experiences of the patient-carer relationship were associated with social cognition difficulties in both groups. METHOD The study had a cross-sectional correlational design. A total of 33 patients with early psychosis (within 3 years of first psychotic episode) and 24 first-degree relative carers (all parents) completed measures of mood, expressed emotion and negative experiences of caregiving. Social cognition measures of theory of mind and emotion recognition were also collected. RESULTS Patient perceptions of carer criticism were related to increased anxiety and depression. Carer negative experiences of caregiving were related to higher levels of expressed emotion, anxiety and depression. Both patients and carers showed impaired performance on social cognition tasks. However, patient social cognition was not related to perceptions of carer criticism or symptoms. Carer social cognition was not related to expressed emotion or carer burden. CONCLUSION Even in the early stages of psychosis, both patients and carers were reporting negative experiences of the caregiving relationship. These were related to higher levels of anxiety and depression. Social cognition difficulties were found in both early psychosis patients and first-degree relatives, but did not relate to caregiving relationships. The findings underscore the importance of providing targeted family interventions to individuals with early psychosis and their carers that address appraisals of the relationship and low mood.
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Affiliation(s)
- Eleanor Tomlinson
- Institute of Psychiatry, Kings College Hospital, London, UK; South London and Maudsley NHS Foundation Trust, London, UK
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29
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Dodell-Feder D, DeLisi LE, Hooker CI. Neural disruption to theory of mind predicts daily social functioning in individuals at familial high-risk for schizophrenia. Soc Cogn Affect Neurosci 2014; 9:1914-25. [PMID: 24396009 DOI: 10.1093/scan/nst186] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Theory-of-mind (ToM) ability is foundational for successful social relationships, and dependent on a neurocognitive system, which includes temporoparietal junction and medial prefrontal cortex. Schizophrenia is associated with ToM impairments, and initial studies demonstrate similar, though more subtle deficits, in unaffected first-degree relatives, indicating that ToM deficits are a potential biomarker for the disorder. Importantly, the social consequences of ToM deficits could create an additional vulnerability factor for individuals at familial high risk (FHR). However, behavioral studies of ToM are inconsistent and virtually nothing is known about the neural basis of ToM in FHR or the relationship between ToM and social functioning. Here, FHR and non-FHR control participants underwent functional MRI scanning while reasoning about a story character's thoughts, emotions or physical appearance. Afterwards, participants completed a 28-day online 'daily-diary' questionnaire in which they reported daily social interactions and degree of ToM reasoning. FHR participants demonstrated less neural activity in bilateral temporoparietal junction when reasoning about thoughts and emotions. Moreover, across all participants, the degree of neural activity during ToM reasoning predicted several aspects of daily social behavior. Results suggest that vulnerability for schizophrenia is associated with neurocognitive deficits in ToM and the degree of deficit is related to day-to-day social functioning.
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Affiliation(s)
- David Dodell-Feder
- Department of Psychology, Harvard University, Cambridge, MA 02138, USA, Boston VA Medical Center, Brockton, MA 02301, USA and Department of Psychiatry, Harvard Medical School, Boston, MA 02215, USA
| | - Lynn E DeLisi
- Department of Psychology, Harvard University, Cambridge, MA 02138, USA, Boston VA Medical Center, Brockton, MA 02301, USA and Department of Psychiatry, Harvard Medical School, Boston, MA 02215, USA Department of Psychology, Harvard University, Cambridge, MA 02138, USA, Boston VA Medical Center, Brockton, MA 02301, USA and Department of Psychiatry, Harvard Medical School, Boston, MA 02215, USA
| | - Christine I Hooker
- Department of Psychology, Harvard University, Cambridge, MA 02138, USA, Boston VA Medical Center, Brockton, MA 02301, USA and Department of Psychiatry, Harvard Medical School, Boston, MA 02215, USA
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30
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Dodell-Feder D, Lincoln SH, Coulson JP, Hooker CI. Using fiction to assess mental state understanding: a new task for assessing theory of mind in adults. PLoS One 2013; 8:e81279. [PMID: 24244736 PMCID: PMC3820595 DOI: 10.1371/journal.pone.0081279] [Citation(s) in RCA: 55] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2013] [Accepted: 10/18/2013] [Indexed: 11/18/2022] Open
Abstract
Social functioning depends on the ability to attribute and reason about the mental states of others – an ability known as theory of mind (ToM). Research in this field is limited by the use of tasks in which ceiling effects are ubiquitous, rendering them insensitive to individual differences in ToM ability and instances of subtle ToM impairment. Here, we present data from a new ToM task – the Short Story Task (SST) - intended to improve upon many aspects of existing ToM measures. More specifically, the SST was designed to: (a) assess the full range of individual differences in ToM ability without suffering from ceiling effects; (b) incorporate a range of mental states of differing complexity, including epistemic states, affective states, and intentions to be inferred from a first- and second-order level; (c) use ToM stimuli representative of real-world social interactions; (d) require participants to utilize social context when making mental state inferences; (e) exhibit adequate psychometric properties; and (f) be quick and easy to administer and score. In the task, participants read a short story and were asked questions that assessed explicit mental state reasoning, spontaneous mental state inference, and comprehension of the non-mental aspects of the story. Responses were scored according to a rubric that assigned greater points for accurate mental state attributions that included multiple characters’ mental states. Results demonstrate that the SST is sensitive to variation in ToM ability, can be accurately scored by multiple raters, and exhibits concurrent validity with other social cognitive tasks. The results support the effectiveness of this new measure of ToM in the study of social cognition. The findings are also consistent with studies demonstrating significant relationships among narrative transportation, ToM, and the reading of fiction. Together, the data indicate that reading fiction may be an avenue for improving ToM ability.
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Affiliation(s)
- David Dodell-Feder
- Department of Psychology, Harvard University, Cambridge, Massachusetts, United States of America
- * E-mail:
| | - Sarah Hope Lincoln
- Department of Psychology, Harvard University, Cambridge, Massachusetts, United States of America
| | | | - Christine I. Hooker
- Department of Psychology, Harvard University, Cambridge, Massachusetts, United States of America
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Lavoie MA, Plana I, Bédard Lacroix J, Godmaire-Duhaime F, Jackson PL, Achim AM. Social cognition in first-degree relatives of people with schizophrenia: a meta-analysis. Psychiatry Res 2013; 209:129-35. [PMID: 23375626 DOI: 10.1016/j.psychres.2012.11.037] [Citation(s) in RCA: 91] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/23/2012] [Revised: 10/12/2012] [Accepted: 11/28/2012] [Indexed: 12/14/2022]
Abstract
Social cognition is affected in people with schizophrenia, but whether this is the case for healthy relatives of these patients is less clear. The presence of social cognition impairments in relatives would suggest a potential genetic role of social cognition in schizophrenia. To determine whether social cognition is affected in first-degree relatives of people with schizophrenia and examine the impact of potential moderator variables, a meta-analysis of studies investigating at least one domain of social cognition (mentalizing, emotional processing, social perception, social knowledge and/or attributional style) in adult first-degree relatives of patients with schizophrenia was performed. Our inclusion criteria were satisfied by 29 studies, of which 11 evaluated mentalizing, 20 emotional processing, and two social perception. Moderate mean effect sizes were obtained for these three components. Across all studies, effect sizes were significantly correlated with IQ and age differences between groups, calling for careful group matching for future studies. Overall, the results from this meta-analysis highlight that social cognition is globally affected in first-degree relatives of people with schizophrenia, suggesting that social cognition deficits in schizophrenia may be related to a genetic vulnerability for the disorder.
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Tucker R, Farhall J, Thomas N, Groot C, Rossell SL. An examination of auditory processing and affective prosody in relatives of patients with auditory hallucinations. Front Hum Neurosci 2013; 7:531. [PMID: 24046737 PMCID: PMC3764330 DOI: 10.3389/fnhum.2013.00531] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2013] [Accepted: 08/15/2013] [Indexed: 11/13/2022] Open
Abstract
Research on auditory verbal hallucinations (AVHs) indicates that AVH schizophrenia patients show greater abnormalities on tasks requiring recognition of affective prosody (AP) than non-AVH patients. Detecting AP requires accurate perception of manipulations in pitch, amplitude and duration. Schizophrenia patients with AVHs also experience difficulty detecting these acoustic manipulations; with a number of theorists speculating that difficulties in pitch, amplitude and duration discrimination underlie AP abnormalities. This study examined whether both AP and these aspects of auditory processing are also impaired in first degree relatives of persons with AVHs. It also examined whether pitch, amplitude and duration discrimination were related to AP, and to hallucination proneness. Unaffected relatives of AVH schizophrenia patients (N = 19) and matched healthy controls (N = 33) were compared using tone discrimination tasks, an AP task, and clinical measures. Relatives were slower at identifying emotions on the AP task (p = 0.002), with secondary analysis showing this was especially so for happy (p = 0.014) and neutral (p = 0.001) sentences. There was a significant interaction effect for pitch between tone deviation level and group (p = 0.019), and relatives performed worse than controls on amplitude discrimination and duration discrimination. AP performance for happy and neutral sentences was significantly correlated with amplitude perception. Lastly, AVH proneness in the entire sample was significantly correlated with pitch discrimination (r = 0.44) and pitch perception was shown to predict AVH proneness in the sample (p = 0.005). These results suggest basic impairments in auditory processing are present in relatives of AVH patients; they potentially underlie processing speed in AP tasks, and predict AVH proneness. This indicates auditory processing deficits may be a core feature of AVHs in schizophrenia, and are worthy of further study as a potential endophenotype for AVHs.
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Affiliation(s)
- Rachel Tucker
- School of Psychological Sciences, La Trobe University Melbourne, VIC, Australia
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Martin AK, Robinson G, Dzafic I, Reutens D, Mowry B. Theory of mind and the social brain: implications for understanding the genetic basis of schizophrenia. GENES BRAIN AND BEHAVIOR 2013; 13:104-17. [DOI: 10.1111/gbb.12066] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2013] [Revised: 07/22/2013] [Accepted: 07/28/2013] [Indexed: 02/03/2023]
Affiliation(s)
- A. K. Martin
- Queensland Brain Institute; University of Queensland; Brisbane QLD Australia
| | - G. Robinson
- School of Psychology; University of Queensland; Brisbane QLD Australia
| | - I. Dzafic
- Queensland Brain Institute; University of Queensland; Brisbane QLD Australia
| | - D. Reutens
- Centre for Advanced Imaging; University of Queensland; Brisbane QLD Australia
| | - B. Mowry
- Queensland Brain Institute; University of Queensland; Brisbane QLD Australia
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34
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Mehta UM, Thirthalli J, Naveen Kumar C, Keshav Kumar J, Keshavan MS, Gangadhar BN. Schizophrenia patients experience substantial social cognition deficits across multiple domains in remission. Asian J Psychiatr 2013; 6:324-9. [PMID: 23810141 DOI: 10.1016/j.ajp.2013.02.001] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2012] [Revised: 01/31/2013] [Accepted: 02/06/2013] [Indexed: 10/27/2022]
Abstract
Knowledge about SC (social cognition) during remission would inform us whether such deficits are trait- or state-markers of the disorder, as well as highlight its relevance for rehabilitation. We aimed to compare SC deficits and their relative independence from NC (neuro-cognition) deficits in remitted schizophrenia patients and matched health controls using comprehensive, culturally sensitive standardized tools. 60 schizophrenia patients meeting modified standardized criteria for remission and 60 age, gender and education matched healthy controls were compared on culturally validated tests of SC-Social Cognition Rating Tool in Indian Setting (SOCRATIS) & Tool for Recognition of Emotions in Neuropsychiatric Disorders (TRENDS) to assess theory of mind, attributional bias, social perception and emotion recognition and NC-(attention/vigilance, speed of processing, visual and verbal learning, working memory and executive functions). Patients had deficits in both SC and NC compared to healthy controls. Deficits in SC were largely independent of NC performance, and SC deficits persisted after adjusting for deficits in NC function. The effect sizes (Cohen's d) for SC deficits ranged from 0.37 to 2.23. All patients scored below a defined cut-off in at least one SC domain. SC deficits are likely to be state-independent in schizophrenia, as they are present in remission phase of the illness. This supports their status as a possible composite-endophenotype in schizophrenia.
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Affiliation(s)
- Urvakhsh M Mehta
- Department of Psychiatry, National Institute of Mental Health & Neurosciences (NIMHANS), Bangalore 560029, India.
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35
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Wang YG, Roberts DL, Xu BH. Dissociation of understanding from applying others' false beliefs in remitted schizophrenia: evidence from a computerized referential communication task. BMC Psychiatry 2013; 13:141. [PMID: 23683146 PMCID: PMC3680038 DOI: 10.1186/1471-244x-13-141] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2013] [Accepted: 05/15/2013] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND In research on theory of mind (ToM), false belief paradigms are commonly used. Previous studies have reported that there is heterogeneity in the magnitude of impairment on false belief tasks. Moreover, intact ability to attribute others' false beliefs has been widely reported in patients with remitted schizophrenia. Increasingly, evidence suggests that there may be different cognitive mechanisms underlying the understanding others' false beliefs versus applying one's knowledge of others' false beliefs. Since the role of psychotic symptoms in ToM impairments is an important issue in the study of ToM deficits in schizophrenia, we examined both remitted schizophrenia and non-remitted schizophrenia, with the aim to investigate whether psychotic symptoms in schizophrenia are associated with deficits in understanding others' mental states or difficulties in applying this understanding. METHODS The present study investigated 29 patients with non-remitted schizophrenia, 19 patients with remitted schizophrenia, and 22 healthy controls with a revised computerized referential communication task. The ability to understand others' false beliefs and the ability to apply others' false beliefs were measured separately. RESULTS Patients with non-remitted schizophrenia performed significantly worse than patients with remitted schizophrenia and healthy controls on a task of understanding others' false beliefs, whereas no significant difference was found between the patients with remitted schizophrenia and healthy controls. Both the patients with non-remitted schizophrenia and patients with remitted schizophrenia performed significantly worse than healthy controls on a task of applying others' false beliefs. CONCLUSIONS Our findings suggested a dissociation of understanding others' false beliefs from applying others' false beliefs in remitted schizophrenia. We preliminarily conclude that deficits in the ToM ability of applying knowledge of others' mental states might be state-dependent.
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Affiliation(s)
- Yong-guang Wang
- Department of Psychology and Behavioral Sciences, Zhejiang University, 148 Tianmushan Road, Hangzhou, Zhejiang Province 310028, China,Department of Mental Health, Hangzhou Center for Disease Control and Prevention, Hangzhou, Zhejiang Province, China
| | - David L Roberts
- Department of Psychiatry, University of Texas Health Science Center, San Antonio, USA
| | - Bai-hua Xu
- Department of Psychology and Behavioral Sciences, Zhejiang University, 148 Tianmushan Road, Hangzhou, Zhejiang Province 310028, China
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Ibáñez A, Aguado J, Baez S, Huepe D, Lopez V, Ortega R, Sigman M, Mikulan E, Lischinsky A, Torrente F, Cetkovich M, Torralva T, Bekinschtein T, Manes F. From neural signatures of emotional modulation to social cognition: individual differences in healthy volunteers and psychiatric participants. Soc Cogn Affect Neurosci 2013; 9:939-50. [PMID: 23685775 DOI: 10.1093/scan/nst067] [Citation(s) in RCA: 57] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
It is commonly assumed that early emotional signals provide relevant information for social cognition tasks. The goal of this study was to test the association between (a) cortical markers of face emotional processing and (b) social-cognitive measures, and also to build a model which can predict this association (a and b) in healthy volunteers as well as in different groups of psychiatric patients. Thus, we investigated the early cortical processing of emotional stimuli (N170, using a face and word valence task) and their relationship with the social-cognitive profiles (SCPs, indexed by measures of theory of mind, fluid intelligence, speed processing and executive functions). Group comparisons and individual differences were assessed among schizophrenia (SCZ) patients and their relatives, individuals with attention deficit hyperactivity disorder (ADHD), individuals with euthymic bipolar disorder (BD) and healthy participants (educational level, handedness, age and gender matched). Our results provide evidence of emotional N170 impairments in the affected groups (SCZ and relatives, ADHD and BD) as well as subtle group differences. Importantly, cortical processing of emotional stimuli predicted the SCP, as evidenced by a structural equation model analysis. This is the first study to report an association model of brain markers of emotional processing and SCP.
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Affiliation(s)
- Agustín Ibáñez
- Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive Neurology (INECO), Favaloro University, Buenos Aires, Argentina, Laboratory of Cognitive and Social Neuroscience (LANCYS), UDP-INECO Foundation Core on Neuroscience (NUFIN), Universidad Diego Portales, Santiago, Chile, National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina, Parc Sanitari Joan de Deu-SSM, CIBERSAM, Universitat de Barcelona, Sant Boi, Barcelona, Spain, Escuela de Psicología, Facultad de Ciencias Sociales, Pontificia Universidad Católica de Chile, Santiago, Chile, Laboratorio de Neurociencia Cognitiva, Departamento de Psiquiatría, Facultad de Medicina, y Centro Interdisciplinario de Neurociencia, Pontificia Universidad Católica de Chile, Santiago, Chile, Programa de Doctorado en Psicología, Departamento de Psicología, Facultad de Ciencias Sociales, Universidad de Chile, Santiago, Chile, Departamento de Física, FCEN, UBA and IFIBA, Conicet, Pabellón 1, Ciudad Universitaria, 1428 Buenos Aires, Argentina, Universidad Torcuato Di Tella, Alte. Juan Saenz Valiente 1010, Buenos Aires C1428BIJ, Argentina, and MRC Cognition and Brain Sciences Unit, Cambridge, UKLaboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive Neurology (INECO), Favaloro University, Buenos Aires, Argentina, Laboratory of Cognitive and Social Neuroscience (LANCYS), UDP-INECO Foundation Core on Neuroscience (NUFIN), Universidad Diego Portales, Santiago, Chile, National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina, Parc Sanitari Joan de Deu-SSM, CIBERSAM, Universitat de Barcelona, Sant Boi, Barcelona, Spain, Escuela de Psicología, Facultad de Ciencias Sociales, Pontificia Universidad Católica de Chile, Santiago, Chile, Laboratorio de Neurociencia Cognitiva, Departamento de Psiquiatría, Facultad de Medicina, y Centro Interdisciplinario de Neurociencia, Pontificia Universidad Católica de Chile, Santiago, C
| | - Jaume Aguado
- Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive Neurology (INECO), Favaloro University, Buenos Aires, Argentina, Laboratory of Cognitive and Social Neuroscience (LANCYS), UDP-INECO Foundation Core on Neuroscience (NUFIN), Universidad Diego Portales, Santiago, Chile, National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina, Parc Sanitari Joan de Deu-SSM, CIBERSAM, Universitat de Barcelona, Sant Boi, Barcelona, Spain, Escuela de Psicología, Facultad de Ciencias Sociales, Pontificia Universidad Católica de Chile, Santiago, Chile, Laboratorio de Neurociencia Cognitiva, Departamento de Psiquiatría, Facultad de Medicina, y Centro Interdisciplinario de Neurociencia, Pontificia Universidad Católica de Chile, Santiago, Chile, Programa de Doctorado en Psicología, Departamento de Psicología, Facultad de Ciencias Sociales, Universidad de Chile, Santiago, Chile, Departamento de Física, FCEN, UBA and IFIBA, Conicet, Pabellón 1, Ciudad Universitaria, 1428 Buenos Aires, Argentina, Universidad Torcuato Di Tella, Alte. Juan Saenz Valiente 1010, Buenos Aires C1428BIJ, Argentina, and MRC Cognition and Brain Sciences Unit, Cambridge, UK
| | - Sandra Baez
- Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive Neurology (INECO), Favaloro University, Buenos Aires, Argentina, Laboratory of Cognitive and Social Neuroscience (LANCYS), UDP-INECO Foundation Core on Neuroscience (NUFIN), Universidad Diego Portales, Santiago, Chile, National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina, Parc Sanitari Joan de Deu-SSM, CIBERSAM, Universitat de Barcelona, Sant Boi, Barcelona, Spain, Escuela de Psicología, Facultad de Ciencias Sociales, Pontificia Universidad Católica de Chile, Santiago, Chile, Laboratorio de Neurociencia Cognitiva, Departamento de Psiquiatría, Facultad de Medicina, y Centro Interdisciplinario de Neurociencia, Pontificia Universidad Católica de Chile, Santiago, Chile, Programa de Doctorado en Psicología, Departamento de Psicología, Facultad de Ciencias Sociales, Universidad de Chile, Santiago, Chile, Departamento de Física, FCEN, UBA and IFIBA, Conicet, Pabellón 1, Ciudad Universitaria, 1428 Buenos Aires, Argentina, Universidad Torcuato Di Tella, Alte. Juan Saenz Valiente 1010, Buenos Aires C1428BIJ, Argentina, and MRC Cognition and Brain Sciences Unit, Cambridge, UK
| | - David Huepe
- Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive Neurology (INECO), Favaloro University, Buenos Aires, Argentina, Laboratory of Cognitive and Social Neuroscience (LANCYS), UDP-INECO Foundation Core on Neuroscience (NUFIN), Universidad Diego Portales, Santiago, Chile, National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina, Parc Sanitari Joan de Deu-SSM, CIBERSAM, Universitat de Barcelona, Sant Boi, Barcelona, Spain, Escuela de Psicología, Facultad de Ciencias Sociales, Pontificia Universidad Católica de Chile, Santiago, Chile, Laboratorio de Neurociencia Cognitiva, Departamento de Psiquiatría, Facultad de Medicina, y Centro Interdisciplinario de Neurociencia, Pontificia Universidad Católica de Chile, Santiago, Chile, Programa de Doctorado en Psicología, Departamento de Psicología, Facultad de Ciencias Sociales, Universidad de Chile, Santiago, Chile, Departamento de Física, FCEN, UBA and IFIBA, Conicet, Pabellón 1, Ciudad Universitaria, 1428 Buenos Aires, Argentina, Universidad Torcuato Di Tella, Alte. Juan Saenz Valiente 1010, Buenos Aires C1428BIJ, Argentina, and MRC Cognition and Brain Sciences Unit, Cambridge, UK
| | - Vladimir Lopez
- Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive Neurology (INECO), Favaloro University, Buenos Aires, Argentina, Laboratory of Cognitive and Social Neuroscience (LANCYS), UDP-INECO Foundation Core on Neuroscience (NUFIN), Universidad Diego Portales, Santiago, Chile, National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina, Parc Sanitari Joan de Deu-SSM, CIBERSAM, Universitat de Barcelona, Sant Boi, Barcelona, Spain, Escuela de Psicología, Facultad de Ciencias Sociales, Pontificia Universidad Católica de Chile, Santiago, Chile, Laboratorio de Neurociencia Cognitiva, Departamento de Psiquiatría, Facultad de Medicina, y Centro Interdisciplinario de Neurociencia, Pontificia Universidad Católica de Chile, Santiago, Chile, Programa de Doctorado en Psicología, Departamento de Psicología, Facultad de Ciencias Sociales, Universidad de Chile, Santiago, Chile, Departamento de Física, FCEN, UBA and IFIBA, Conicet, Pabellón 1, Ciudad Universitaria, 1428 Buenos Aires, Argentina, Universidad Torcuato Di Tella, Alte. Juan Saenz Valiente 1010, Buenos Aires C1428BIJ, Argentina, and MRC Cognition and Brain Sciences Unit, Cambridge, UK
| | - Rodrigo Ortega
- Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive Neurology (INECO), Favaloro University, Buenos Aires, Argentina, Laboratory of Cognitive and Social Neuroscience (LANCYS), UDP-INECO Foundation Core on Neuroscience (NUFIN), Universidad Diego Portales, Santiago, Chile, National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina, Parc Sanitari Joan de Deu-SSM, CIBERSAM, Universitat de Barcelona, Sant Boi, Barcelona, Spain, Escuela de Psicología, Facultad de Ciencias Sociales, Pontificia Universidad Católica de Chile, Santiago, Chile, Laboratorio de Neurociencia Cognitiva, Departamento de Psiquiatría, Facultad de Medicina, y Centro Interdisciplinario de Neurociencia, Pontificia Universidad Católica de Chile, Santiago, Chile, Programa de Doctorado en Psicología, Departamento de Psicología, Facultad de Ciencias Sociales, Universidad de Chile, Santiago, Chile, Departamento de Física, FCEN, UBA and IFIBA, Conicet, Pabellón 1, Ciudad Universitaria, 1428 Buenos Aires, Argentina, Universidad Torcuato Di Tella, Alte. Juan Saenz Valiente 1010, Buenos Aires C1428BIJ, Argentina, and MRC Cognition and Brain Sciences Unit, Cambridge, UKLaboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive Neurology (INECO), Favaloro University, Buenos Aires, Argentina, Laboratory of Cognitive and Social Neuroscience (LANCYS), UDP-INECO Foundation Core on Neuroscience (NUFIN), Universidad Diego Portales, Santiago, Chile, National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina, Parc Sanitari Joan de Deu-SSM, CIBERSAM, Universitat de Barcelona, Sant Boi, Barcelona, Spain, Escuela de Psicología, Facultad de Ciencias Sociales, Pontificia Universidad Católica de Chile, Santiago, Chile, Laboratorio de Neurociencia Cognitiva, Departamento de Psiquiatría, Facultad de Medicina, y Centro Interdisciplinario de Neurociencia, Pontificia Universidad Católica de Chile, Santiago, C
| | - Mariano Sigman
- Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive Neurology (INECO), Favaloro University, Buenos Aires, Argentina, Laboratory of Cognitive and Social Neuroscience (LANCYS), UDP-INECO Foundation Core on Neuroscience (NUFIN), Universidad Diego Portales, Santiago, Chile, National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina, Parc Sanitari Joan de Deu-SSM, CIBERSAM, Universitat de Barcelona, Sant Boi, Barcelona, Spain, Escuela de Psicología, Facultad de Ciencias Sociales, Pontificia Universidad Católica de Chile, Santiago, Chile, Laboratorio de Neurociencia Cognitiva, Departamento de Psiquiatría, Facultad de Medicina, y Centro Interdisciplinario de Neurociencia, Pontificia Universidad Católica de Chile, Santiago, Chile, Programa de Doctorado en Psicología, Departamento de Psicología, Facultad de Ciencias Sociales, Universidad de Chile, Santiago, Chile, Departamento de Física, FCEN, UBA and IFIBA, Conicet, Pabellón 1, Ciudad Universitaria, 1428 Buenos Aires, Argentina, Universidad Torcuato Di Tella, Alte. Juan Saenz Valiente 1010, Buenos Aires C1428BIJ, Argentina, and MRC Cognition and Brain Sciences Unit, Cambridge, UKLaboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive Neurology (INECO), Favaloro University, Buenos Aires, Argentina, Laboratory of Cognitive and Social Neuroscience (LANCYS), UDP-INECO Foundation Core on Neuroscience (NUFIN), Universidad Diego Portales, Santiago, Chile, National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina, Parc Sanitari Joan de Deu-SSM, CIBERSAM, Universitat de Barcelona, Sant Boi, Barcelona, Spain, Escuela de Psicología, Facultad de Ciencias Sociales, Pontificia Universidad Católica de Chile, Santiago, Chile, Laboratorio de Neurociencia Cognitiva, Departamento de Psiquiatría, Facultad de Medicina, y Centro Interdisciplinario de Neurociencia, Pontificia Universidad Católica de Chile, Santiago, C
| | - Ezequiel Mikulan
- Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive Neurology (INECO), Favaloro University, Buenos Aires, Argentina, Laboratory of Cognitive and Social Neuroscience (LANCYS), UDP-INECO Foundation Core on Neuroscience (NUFIN), Universidad Diego Portales, Santiago, Chile, National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina, Parc Sanitari Joan de Deu-SSM, CIBERSAM, Universitat de Barcelona, Sant Boi, Barcelona, Spain, Escuela de Psicología, Facultad de Ciencias Sociales, Pontificia Universidad Católica de Chile, Santiago, Chile, Laboratorio de Neurociencia Cognitiva, Departamento de Psiquiatría, Facultad de Medicina, y Centro Interdisciplinario de Neurociencia, Pontificia Universidad Católica de Chile, Santiago, Chile, Programa de Doctorado en Psicología, Departamento de Psicología, Facultad de Ciencias Sociales, Universidad de Chile, Santiago, Chile, Departamento de Física, FCEN, UBA and IFIBA, Conicet, Pabellón 1, Ciudad Universitaria, 1428 Buenos Aires, Argentina, Universidad Torcuato Di Tella, Alte. Juan Saenz Valiente 1010, Buenos Aires C1428BIJ, Argentina, and MRC Cognition and Brain Sciences Unit, Cambridge, UK
| | - Alicia Lischinsky
- Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive Neurology (INECO), Favaloro University, Buenos Aires, Argentina, Laboratory of Cognitive and Social Neuroscience (LANCYS), UDP-INECO Foundation Core on Neuroscience (NUFIN), Universidad Diego Portales, Santiago, Chile, National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina, Parc Sanitari Joan de Deu-SSM, CIBERSAM, Universitat de Barcelona, Sant Boi, Barcelona, Spain, Escuela de Psicología, Facultad de Ciencias Sociales, Pontificia Universidad Católica de Chile, Santiago, Chile, Laboratorio de Neurociencia Cognitiva, Departamento de Psiquiatría, Facultad de Medicina, y Centro Interdisciplinario de Neurociencia, Pontificia Universidad Católica de Chile, Santiago, Chile, Programa de Doctorado en Psicología, Departamento de Psicología, Facultad de Ciencias Sociales, Universidad de Chile, Santiago, Chile, Departamento de Física, FCEN, UBA and IFIBA, Conicet, Pabellón 1, Ciudad Universitaria, 1428 Buenos Aires, Argentina, Universidad Torcuato Di Tella, Alte. Juan Saenz Valiente 1010, Buenos Aires C1428BIJ, Argentina, and MRC Cognition and Brain Sciences Unit, Cambridge, UK
| | - Fernando Torrente
- Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive Neurology (INECO), Favaloro University, Buenos Aires, Argentina, Laboratory of Cognitive and Social Neuroscience (LANCYS), UDP-INECO Foundation Core on Neuroscience (NUFIN), Universidad Diego Portales, Santiago, Chile, National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina, Parc Sanitari Joan de Deu-SSM, CIBERSAM, Universitat de Barcelona, Sant Boi, Barcelona, Spain, Escuela de Psicología, Facultad de Ciencias Sociales, Pontificia Universidad Católica de Chile, Santiago, Chile, Laboratorio de Neurociencia Cognitiva, Departamento de Psiquiatría, Facultad de Medicina, y Centro Interdisciplinario de Neurociencia, Pontificia Universidad Católica de Chile, Santiago, Chile, Programa de Doctorado en Psicología, Departamento de Psicología, Facultad de Ciencias Sociales, Universidad de Chile, Santiago, Chile, Departamento de Física, FCEN, UBA and IFIBA, Conicet, Pabellón 1, Ciudad Universitaria, 1428 Buenos Aires, Argentina, Universidad Torcuato Di Tella, Alte. Juan Saenz Valiente 1010, Buenos Aires C1428BIJ, Argentina, and MRC Cognition and Brain Sciences Unit, Cambridge, UK
| | - Marcelo Cetkovich
- Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive Neurology (INECO), Favaloro University, Buenos Aires, Argentina, Laboratory of Cognitive and Social Neuroscience (LANCYS), UDP-INECO Foundation Core on Neuroscience (NUFIN), Universidad Diego Portales, Santiago, Chile, National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina, Parc Sanitari Joan de Deu-SSM, CIBERSAM, Universitat de Barcelona, Sant Boi, Barcelona, Spain, Escuela de Psicología, Facultad de Ciencias Sociales, Pontificia Universidad Católica de Chile, Santiago, Chile, Laboratorio de Neurociencia Cognitiva, Departamento de Psiquiatría, Facultad de Medicina, y Centro Interdisciplinario de Neurociencia, Pontificia Universidad Católica de Chile, Santiago, Chile, Programa de Doctorado en Psicología, Departamento de Psicología, Facultad de Ciencias Sociales, Universidad de Chile, Santiago, Chile, Departamento de Física, FCEN, UBA and IFIBA, Conicet, Pabellón 1, Ciudad Universitaria, 1428 Buenos Aires, Argentina, Universidad Torcuato Di Tella, Alte. Juan Saenz Valiente 1010, Buenos Aires C1428BIJ, Argentina, and MRC Cognition and Brain Sciences Unit, Cambridge, UK
| | - Teresa Torralva
- Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive Neurology (INECO), Favaloro University, Buenos Aires, Argentina, Laboratory of Cognitive and Social Neuroscience (LANCYS), UDP-INECO Foundation Core on Neuroscience (NUFIN), Universidad Diego Portales, Santiago, Chile, National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina, Parc Sanitari Joan de Deu-SSM, CIBERSAM, Universitat de Barcelona, Sant Boi, Barcelona, Spain, Escuela de Psicología, Facultad de Ciencias Sociales, Pontificia Universidad Católica de Chile, Santiago, Chile, Laboratorio de Neurociencia Cognitiva, Departamento de Psiquiatría, Facultad de Medicina, y Centro Interdisciplinario de Neurociencia, Pontificia Universidad Católica de Chile, Santiago, Chile, Programa de Doctorado en Psicología, Departamento de Psicología, Facultad de Ciencias Sociales, Universidad de Chile, Santiago, Chile, Departamento de Física, FCEN, UBA and IFIBA, Conicet, Pabellón 1, Ciudad Universitaria, 1428 Buenos Aires, Argentina, Universidad Torcuato Di Tella, Alte. Juan Saenz Valiente 1010, Buenos Aires C1428BIJ, Argentina, and MRC Cognition and Brain Sciences Unit, Cambridge, UK
| | - Tristan Bekinschtein
- Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive Neurology (INECO), Favaloro University, Buenos Aires, Argentina, Laboratory of Cognitive and Social Neuroscience (LANCYS), UDP-INECO Foundation Core on Neuroscience (NUFIN), Universidad Diego Portales, Santiago, Chile, National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina, Parc Sanitari Joan de Deu-SSM, CIBERSAM, Universitat de Barcelona, Sant Boi, Barcelona, Spain, Escuela de Psicología, Facultad de Ciencias Sociales, Pontificia Universidad Católica de Chile, Santiago, Chile, Laboratorio de Neurociencia Cognitiva, Departamento de Psiquiatría, Facultad de Medicina, y Centro Interdisciplinario de Neurociencia, Pontificia Universidad Católica de Chile, Santiago, Chile, Programa de Doctorado en Psicología, Departamento de Psicología, Facultad de Ciencias Sociales, Universidad de Chile, Santiago, Chile, Departamento de Física, FCEN, UBA and IFIBA, Conicet, Pabellón 1, Ciudad Universitaria, 1428 Buenos Aires, Argentina, Universidad Torcuato Di Tella, Alte. Juan Saenz Valiente 1010, Buenos Aires C1428BIJ, Argentina, and MRC Cognition and Brain Sciences Unit, Cambridge, UK
| | - Facundo Manes
- Laboratory of Experimental Psychology and Neuroscience (LPEN), Institute of Cognitive Neurology (INECO), Favaloro University, Buenos Aires, Argentina, Laboratory of Cognitive and Social Neuroscience (LANCYS), UDP-INECO Foundation Core on Neuroscience (NUFIN), Universidad Diego Portales, Santiago, Chile, National Scientific and Technical Research Council (CONICET), Buenos Aires, Argentina, Parc Sanitari Joan de Deu-SSM, CIBERSAM, Universitat de Barcelona, Sant Boi, Barcelona, Spain, Escuela de Psicología, Facultad de Ciencias Sociales, Pontificia Universidad Católica de Chile, Santiago, Chile, Laboratorio de Neurociencia Cognitiva, Departamento de Psiquiatría, Facultad de Medicina, y Centro Interdisciplinario de Neurociencia, Pontificia Universidad Católica de Chile, Santiago, Chile, Programa de Doctorado en Psicología, Departamento de Psicología, Facultad de Ciencias Sociales, Universidad de Chile, Santiago, Chile, Departamento de Física, FCEN, UBA and IFIBA, Conicet, Pabellón 1, Ciudad Universitaria, 1428 Buenos Aires, Argentina, Universidad Torcuato Di Tella, Alte. Juan Saenz Valiente 1010, Buenos Aires C1428BIJ, Argentina, and MRC Cognition and Brain Sciences Unit, Cambridge, UK
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Sullivan S, Herzig D, Mohr C, Lewis G, Corcoran R, Drake R, Evans J. Theory of mind and social functioning in first episode psychosis. Cogn Neuropsychiatry 2013; 18:219-42. [PMID: 22803807 DOI: 10.1080/13546805.2012.698239] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
INTRODUCTION There is evidence of associations between social functioning and theory of mind performance and between social functioning and negative symptoms in chronic psychosis. This study investigates these associations in those with first episode psychosis who are unaffected by factors related to long-term mental illness. Our first hypothesis states that there is an association between theory of mind and social functioning. The second hypothesis states that there is no association between symptoms of psychosis and social functioning. METHODS Fifty-two individuals with first episode psychosis were assessed for social functioning, theory of mind ability (using the Hinting test with verbal stimuli and the Visual Cartoon test with pictorial stimuli), and symptoms of psychosis. Multivariable logistic regression was used to examine associations. RESULTS Social functioning and theory of mind were associated when measured by the Hinting test (OR 1.70, 95% CI 1.08, 2.66), but not with the Visual Cartoon test (ToM jokes OR 0.61, 95% CI 0.15, 2.53). There was no association between social functioning and symptoms (psychotic symptoms; OR 0.95, 95% CI 0.81, 1.12; selected negative symptoms; OR 1.33, 95% CI 0.78, 2.25). CONCLUSIONS 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.
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Affiliation(s)
- Sarah Sullivan
- Academic Unit of Psychiatry, School of Experimental Psychology, University of Bristol, Bristol, UK.
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Bora E, Pantelis C. Theory of mind impairments in first-episode psychosis, individuals at ultra-high risk for psychosis and in first-degree relatives of schizophrenia: systematic review and meta-analysis. Schizophr Res 2013; 144:31-6. [PMID: 23347949 DOI: 10.1016/j.schres.2012.12.013] [Citation(s) in RCA: 233] [Impact Index Per Article: 21.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2012] [Accepted: 12/26/2012] [Indexed: 10/27/2022]
Abstract
Theory of mind (ToM) deficit is a well-established feature of schizophrenia and has been suggested as a vulnerability marker of this disorder. However, as most of this evidence is based on studies in chronic patients, it is less clear whether ToM is impaired prior to or following the onset of a first-episode and whether it is evident in unaffected relatives of patients. In this meta-analysis, ToM performance of 3005 individuals with first-episode psychosis (FEP), individuals at ultra-high risk for psychosis (UHR) and unaffected relatives were compared with 1351 healthy controls. ToM was substantially impaired in first-episode psychosis (Cohen d=1.0) and this deficit was comparable to findings in chronic patients. ToM was also impaired in unaffected relatives (d=0.37) and UHR subjects (d=0.45) and performances of these groups were intermediate between FES and healthy controls. Severity of ToM deficits in unaffected relatives and UHR subjects was similar to other cognitive deficits observed in these groups. Longitudinal studies of clinical and genetic high-risk subjects are necessary to investigate the trajectory of development of ToM deficits in schizophrenia.
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Affiliation(s)
- Emre Bora
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, The University of Melbourne and Melbourne Health, VIC, Australia.
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Bechi M, Spangaro M, Bosia M, Zanoletti A, Fresi F, Buonocore M, Cocchi F, Guglielmino C, Smeraldi E, Cavallaro R. Theory of Mind intervention for outpatients with schizophrenia. Neuropsychol Rehabil 2013; 23:383-400. [PMID: 23379271 DOI: 10.1080/09602011.2012.762751] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Social disability is one of the critical areas known to be a predictor of daily functioning in schizophrenia. Recent studies showed that impairments in Theory of Mind (ToM) contribute to real-world social functioning and are more strongly associated with community outcomes than other neuropsychological domains of cognition. Several experiments revealed an improving potential of social cognition targeted training, particularly through introduction of verbalisation and explicit manipulation of information about others' mental states. Based on these data, we evaluated longitudinally, with a controlled trial, the feasibility and efficacy of ToM training and the possible influences of daily functioning and IQ on the enhancement of ToM abilities. Thirty outpatients with schizophrenia were recruited and randomly allocated to two groups: ToM Intervention (ToMI), based on verbalisation of selected comic strips representing ToM scenarios, or active control group (ACG). Results showed a significant improvement of ToM abilities among subjects allocated to ToMI compared to ACG, confirming the hypothesis of the enhancing potential of training methods targeting ToM functions. Moreover, we observed no influences of neuropsychological and functional variables on ToM improvement. Development of future studies should take into account possible effects of ToM training on functional outcome, according to the strong associations between ToM abilities and real-world social functioning.
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Affiliation(s)
- Margherita Bechi
- San Raffaele Scientific Institute, Department of Clinical Neurosciences, Universitary Scientific Institute Hospital, Milan, Italy.
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Fett AKJ, Maat A. Social cognitive impairments and psychotic symptoms: what is the nature of their association? Schizophr Bull 2013; 39:77-85. [PMID: 21697150 PMCID: PMC3523914 DOI: 10.1093/schbul/sbr058] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Social cognitive deficits are associated with psychotic symptoms, but the nature of this association remains unknown. This study uses a genetically sensitive cross-trait cross-sibling design to investigate the nature of the overlap between both phenotypes. A sample of 1032 patients, 1017 of their healthy siblings, and 579 control subjects were recruited within the Dutch Genetic Risk and Outcome in Psychosis (GROUP) study. Participants completed a battery of cognitive tests, including 2 social cognitive tests on theory of mind (ToM) and emotion recognition. Within siblings, symptoms were assessed with the Structured Interview for Schizotypy--Revised. The Positive and Negative Syndrome Scale was used to assess patients' symptoms. Within patients, social cognitive performance was consistently and significantly associated with disorganized and, to a lesser degree, with negative symptoms. Associations with positive symptoms were significant, but smaller. Suggestive of a shared etiology, both social cognitive factors showed significant familial clustering. The associations between patients' ToM and subclinical symptoms in siblings were nonsignificant, suggesting that their overlap within patients is due to individual rather than shared familial factors. Indicative of a shared etiology, familial covariation was present between patients' emotion recognition ability and disorganized and, albeit to a lesser degree, positive but not negative subclinical symptoms in siblings.
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Affiliation(s)
- Anne-Kathrin J. Fett
- Department of Psychiatry and Neuropsychology, School of Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands,Department of Psychology and Education, VU University of Amsterdam, Amsterdam, The Netherlands,Department of Psychosis Studies, Institute of Psychiatry, King’s College London, London, UK
| | - Arija Maat
- Department of Psychiatry, Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, Utrecht, The Netherlands
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Billeke P, Aboitiz F. Social cognition in schizophrenia: from social stimuli processing to social engagement. Front Psychiatry 2013; 4:4. [PMID: 23444313 PMCID: PMC3580762 DOI: 10.3389/fpsyt.2013.00004] [Citation(s) in RCA: 69] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2012] [Accepted: 02/06/2013] [Indexed: 11/13/2022] Open
Abstract
Social cognition consists of several skills which allow us to interact with other humans. These skills include social stimuli processing, drawing inferences about others' mental states, and engaging in social interactions. In recent years, there has been growing evidence of social cognitive impairments in patients with schizophrenia. Apparently, these impairments are separable from general neurocognitive impairments, such as attention, memory, and executive functioning. Moreover, social cognition seems to be a main determinant of functional outcome and could be used as a guide to elaborate new pharmacological and psychological treatments. However, most of these studies focus on individual mechanisms and observational perspectives; only few of them study schizophrenic patients during interactive situations. We first review evidences of social cognitive impairments both in social stimuli processing and in mental state attribution. We focus on the relationship between these functions and both general cognitive impairments and functional outcome. We next review recent game theory approaches to the study of how social engagement occurs in schizophrenic patients. The advantage of using game theory is that game-oriented tasks can assess social decision making in an interactive everyday situation model. Finally, we review proposed theoretical models used to explain social alterations and their underlying biological mechanisms. Based on interactive studies, we propose a framework which takes into account the dynamic nature of social processes. Thus, understanding social skills as a result of dynamical systems could facilitate the development of both basic research and clinical applications oriented to psychiatric populations.
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Affiliation(s)
- Pablo Billeke
- Centro Interdisciplinario de Neurociencia, Pontificia Universidad Católica de Chile Santiago, Chile ; Departamento de Psiquiatría, Escuela de Medicina, Pontificia Universidad Católica de Chile Santiago, Chile
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Bechi M, Riccaboni R, Ali S, Fresi F, Buonocore M, Bosia M, Cocchi F, Smeraldi E, Cavallaro R. Theory of mind and emotion processing training for patients with schizophrenia: preliminary findings. Psychiatry Res 2012; 198:371-7. [PMID: 22425473 DOI: 10.1016/j.psychres.2012.02.004] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2011] [Revised: 02/02/2012] [Accepted: 02/06/2012] [Indexed: 02/07/2023]
Abstract
Impairments in social cognition are critical predictors of social functioning in patients with schizophrenia. Emotion processing (EP) and theory of mind (ToM) are hypothesized to influence real-world behavior more directly than basic cognition and represent important targets of intervention. The use of video scenes depicting human interactions could constitute an appropriate tool to enhance understanding of the characters' behavior and stimulate inferences on mental states. The aim of our pilot study was to evaluate longitudinally, with a controlled trial, the feasibility and the efficacy of a single-paradigm emotion recognition and ToM training designed for outpatients affected by schizophrenia, with the goal to create an ecological treatment, overcoming artificial laboratory biases, by the use of specific videotaped material. Fifty-two outpatients were randomly assigned to an EP and ToM video-based training (n=27) or to a standard social cognitive rehabilitation treatment (n=24). They were assessed before and after 12 weeks of intervention and compared to a time-matched control group (n=24). Our results show a statistically significant improvement in ToM abilities, confirming the hypothesis of the enhancing potential of social cognitive interventions, but no changes with respect to EP; despite the need for a deeper examination, these data support further development of this treatment approach.
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Affiliation(s)
- Margherita Bechi
- Department of Clinical Neurosciences, San Raffaele Universitary Scientific Institute Hospital, Vita-Salute San Raffaele University, Milano, Italy.
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Maat A, Fett AK, Derks E. Social cognition and quality of life in schizophrenia. Schizophr Res 2012; 137:212-8. [PMID: 22406280 DOI: 10.1016/j.schres.2012.02.017] [Citation(s) in RCA: 91] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2011] [Revised: 01/31/2012] [Accepted: 02/14/2012] [Indexed: 12/14/2022]
Abstract
Schizophrenia is associated with poor quality of life (QOL). Whereas the effects of neurocognitive deficits and psychopathology on QOL of schizophrenia patients have recently been elucidated, little is known about social cognitive deficits in this regard. This study investigated the influence of social cognition on QOL in schizophrenia. A sample of 1032 patients, 1011 of their siblings, and 552 healthy controls was recruited from the Dutch Genetic Risk and Outcome in Psychosis (GROUP) study. Participants completed a battery of cognitive tests, including social cognitive tests on theory of mind and emotion perception. To assess QOL the World Health Organization QOL Assessment-BREF (WHOQOL-BREF) was used. Schizophrenia symptoms were assessed with the Positive and Negative Syndrome Scale (PANSS). Social cognitive performance was significantly worse in patients compared to siblings and healthy controls. Patients had the poorest QOL, while QOL in healthy controls was better than in siblings. Theory of mind but not emotion perception or neurocognition was associated with QOL in patients, whereas neurocognition was the only significant predictor of QOL in siblings and healthy controls. There was a significant interaction between theory of mind and symptom severity with respect to QOL. Our study indicates that social cognition is associated with QOL in schizophrenia. Theory of mind rather than emotion perception is associated with QOL, and this association is moderated by schizophrenia symptoms. In particular, patients with relatively unimpaired theory of mind and more severe schizophrenia symptoms have poor QOL and could therefore benefit from therapeutic intervention.
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Affiliation(s)
- Arija Maat
- Department of Psychiatry, Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, Utrecht, The Netherlands
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Pentaraki AD, Stefanis NC, Stahl D, Theleritis C, Toulopoulou T, Roukas D, Kaliora SC, Chatzimanolis I, Smyrnis N, Russell T, Kravariti E, Murray RM. Theory of Mind as a potential trait marker of schizophrenia: a family study. Cogn Neuropsychiatry 2012; 17:64-89. [PMID: 22216944 DOI: 10.1080/13546805.2011.568289] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
INTRODUCTION Although there is some evidence that Theory of Mind (ToM) deficits may be trait markers of schizophrenia it is not clear yet if ToM deficits are primary deficits, that is, to be independent of deficits in general intellectual abilities and executive function. The aim was to examine if ToM deficits may be trait markers of the illness and the effect of cognitive inhibition, general intellectual abilities and depression on ToM abilities of patients with schizophrenia and their unaffected parents. METHODS We assessed ToM abilities (first-order and second-order ToM stories, The Revised Eyes Test), cognitive inhibition (Stroop Task), general intellectual ability (Standard Progressive Matrices Test Plus) in patients with schizophrenia (N=21) and their unaffected fathers (N=21) and mothers (N=21) in comparison with healthy control families (healthy control males, N=21, healthy control fathers, N=21, healthy control mothers, N=21) RESULTS Patients showed deficits in first-order ToM tasks but some of these deficits were mediated by general intellectual abilities. Impairments in cognitive inhibition mediated only patients' performance in The Revised Eyes Test. Patients showed deficits in second-order ToM stories independently of deficits in general intellectual abilities and cognitive inhibition. Unaffected parents did not show deficits in first-order ToM tasks, whereas they showed deficits in second-order ToM stories. However, the deficits that unaffected parents showed in second-order ToM stories were mediated by their deficits in general intellectual abilities, and there was an effect of remitted depression on the unaffected mothers' performance. CONCLUSIONS The results suggest that intact neurocognitive and general intellectual abilities are necessary in order patients and their unaffected parents to pass successfully ToM tasks. Patients and their unaffected parents show ToM deficits but these deficits are not similar. Patients show ToM deficits but these deficits seem to be a component of the pathophysiology of the illness (e.g., deficits in executive function, general intellectual abilities).
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Affiliation(s)
- A D Pentaraki
- Division of Psychological Medicine, Institute of Psychiatry, King's College London, London, UK.
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Montag C, Neuhaus K, Lehmann A, Krüger K, Dziobek I, Heekeren HR, Heinz A, Gallinat J. Subtle deficits of cognitive theory of mind in unaffected first-degree relatives of schizophrenia patients. Eur Arch Psychiatry Clin Neurosci 2012; 262:217-26. [PMID: 21892777 DOI: 10.1007/s00406-011-0250-2] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2010] [Accepted: 08/12/2011] [Indexed: 10/17/2022]
Abstract
Alterations of theory of mind (ToM) and empathy were implicated in the formation of psychotic experiences, and deficits in psychosocial functioning of schizophrenia patients. Inspired by concepts of neurocognitive endophenotypes, the existence of a distinct, potentially neurobiologically based social-cognitive vulnerability marker for schizophrenia is a matter of ongoing debate. The fact that previous research on social-cognitive deficits in individuals at risk yielded contradictory results may partly be due to an insufficient differentiation between qualitative aspects of ToM. Thirty-four unaffected first-degree relatives of schizophrenia patients (21 parents, 8 siblings, 5 children; f/m: 30/4; mean age: 48.1 ± 12.7 years) and 34 controls subjects (f/m: 25/9; mean age: 45.9 ± 10.9 years) completed the 'Movie for the Assessment of Social Cognition'-a video-based ToM test-and an empathy questionnaire (Interpersonal Reactivity Index, IRI). Outcome parameters comprised (1) 'cognitive' versus 'emotional' ToM, (2) error counts representing 'undermentalizing' versus 'overmentalizing', (3) empathic abilities and (4) non-social neurocognition. MANCOVA showed impairments in cognitive but not emotional ToM in the relatives' group, when age, gender and neurocognition were controlled for. Relatives showed elevated error counts for 'undermentalizing' but not for 'overmentalizing'. No alterations were detected in self-rated dimensions of empathy. Of all measures of ToM and empathy, only the IRI subscale 'fantasy' was associated with measures of psychotic risk, i.e. a history of subclinical delusional ideation. The present study confirmed subtle deficits in cognitive, but not emotional ToM in first-degree relatives of schizophrenia patients, which were not explained by global cognitive deficits. Findings corroborate the assumption of distinct social-cognitive abilities as an intermediate phenotype for schizophrenia.
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Affiliation(s)
- Christiane Montag
- Department of Psychiatry and Psychotherapy, Charité University Medicine Berlin, Campus Mitte, Germany
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Metacognitive and social cognition deficits in patients with significant psychiatric and medical adversity: a comparison between participants with schizophrenia and a sample of participants who are HIV-positive. J Nerv Ment Dis 2012; 200:147-52. [PMID: 22297309 PMCID: PMC4431998 DOI: 10.1097/nmd.0b013e3182439533] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Research exploring metacognition and social cognition in schizophrenia has tended to use control groups experiencing relatively little adversity. Therefore, it remains unclear whether the deficits found among persons with schizophrenia are merely the result of greater life adversity. To explore this issue, we assessed metacognition and social cognition among 40 participants with schizophrenia and 25 adults with HIV. We chose to explore this phenomenon in people with HIV given the literature suggesting that this group experiences significant adversity. Measures of metacognition and social cognition included the Metacognition Assessment Scale (MAS), the Hinting test, and the Bell-Lysaker Emotion Recognition Test (BLERT). After controlling for education, years since diagnosis, and memory, the schizophrenia group performed more poorly on the MAS and the Hinting test. No differences were found on the BLERT. The results are consistent with the possibility that schizophrenia is linked to decrements in metacognition and some forms of social cognition.
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de Achával D, Villarreal MF, Costanzo EY, Douer J, Castro MN, Mora MC, Nemeroff CB, Chu E, Bär KJ, Guinjoan SM. Decreased activity in right-hemisphere structures involved in social cognition in siblings discordant for schizophrenia. Schizophr Res 2012; 134:171-9. [PMID: 22137736 DOI: 10.1016/j.schres.2011.11.010] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2011] [Revised: 11/08/2011] [Accepted: 11/09/2011] [Indexed: 10/14/2022]
Abstract
BACKGROUND Social cognitive deficits contribute to functional disability in schizophrenia. Social cognitive tasks in healthy persons consistently evoke activation of medial prefrontal cortex, inferior frontal gyrus, temporoparietal gyrus, and posterior cingulate cortex/precuneus. We tested the hypothesis that patients with schizophrenia and their unaffected siblings share dysfunction of the same neural networks. METHODS Neural activation during emotion processing (EP), theory of mind (ToM), and control tasks was measured using functional magnetic resonance imaging (fMRI) in 14 patients with schizophrenia, 14 nonpsychotic siblings of patients with schizophrenia, and 14 matched healthy subjects. RESULTS Compared with healthy controls, patients with schizophrenia showed reduced activation of right hemisphere structures involved in EP and ToM including inferior frontal gyrus, middle frontal gyrus, and right temporoparietal junction. These deficits were shared, in part, by unaffected siblings. The latter group demonstrated deficits in bilateral precuneus activation during ToM, not present in patients. CONCLUSIONS Schizophrenia appears to be associated with a deficit in activation of right hemisphere components of a ToM network. Such deficits are shared in part by those at high genetic risk but unaffected by schizophrenia.
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Affiliation(s)
- Delfina de Achával
- Sections of Cognitive Neurology and Psychiatry, Fundación para la Lucha contra las Enfermedades Neurológicas de la Infancia (FLENI), Argentina
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Meijer J, Simons CJP, Quee PJ, Verweij K. Cognitive alterations in patients with non-affective psychotic disorder and their unaffected siblings and parents. Acta Psychiatr Scand 2012; 125:66-76. [PMID: 22013907 DOI: 10.1111/j.1600-0447.2011.01777.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVE The purpose of this study was to examine a range of cognitive measures as candidate phenotypic liability markers for psychosis in a uniquely large sample of patients with psychosis, their unaffected relatives and control subjects. METHOD Patients with non-affective psychosis (n = 1093), their unaffected siblings (n = 1044), parents (n = 911), and controls (n = 587) completed a comprehensive cognitive test battery. Cognitive functioning was compared using tests of verbal learning and memory, attention/vigilance, working memory, processing speed, reasoning and problem solving, acquired knowledge, and social cognition. Age- and gender-adjusted z-scores were compared between groups using mixed-model analyses of covariance. Clinically relevant impairment (-1 and -2 SD from control mean) was compared between subject groups. RESULTS Patients performed significantly worse than controls in all cognitive domains (z-range -0.26 to -1.34). Siblings and parents showed alterations for immediate verbal learning, processing speed, reasoning and problem solving, acquired knowledge, and working memory (z-range -0.22 to -0.98). Parents showed additional alterations for social cognition. Prevalence of clinically relevant impairment in relatives ranged from 50% (-1 SD criterion) to 10% (-2 SD criterion). CONCLUSION Cognitive functioning is a candidate intermediate phenotype given significant small to large alterations in patients and intermediate alterations in first-degree relatives.
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Affiliation(s)
- J Meijer
- Department of Psychiatry, Academic Medical Centre University of Amsterdam, The Netherlands
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Chan KKS, Chen EYH. Theory of mind and paranoia in schizophrenia: a game theoretical investigation framework. Cogn Neuropsychiatry 2011; 16:505-29. [PMID: 21563010 DOI: 10.1080/13546805.2011.561576] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
INTRODUCTION. Ample evidence already shows that theory of mind (ToM) is impaired in people with schizophrenia. Our aim was to critically review this literature. METHOD. We completed a selected review of the research literature on ToM in schizophrenia. RESULTS. Gaps in ToM research were identified. A specific relationship between impaired ToM and paranoid delusions, although intuitively reasonable from a theoretical basis, has only been demonstrated in a few studies. Psychometric properties of ToM tasks employed in these studies may be a confounding factor in drawing conclusions about the relationship. Because most ToM measures have focused on the third-person perspective, participants are not actively interacting. The tasks fail to capture the cognitive demands faced by individuals in real-life situations, and, in effect, are not a direct measure of ToM. CONCLUSIONS. Potential research areas are discussed. Since game theoretical paradigms require the direct involvement of the first person and situate the participant's interpersonal reasoning within an interactive context, they provide more ecologically valid experimental platforms than conventional questionnaire measures to assess ToM in schizophrenia research.
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Barragan M, Laurens KR, Navarro JB, Obiols JE. 'Theory of Mind', psychotic-like experiences and psychometric schizotypy in adolescents from the general population. Psychiatry Res 2011; 186:225-31. [PMID: 20728945 DOI: 10.1016/j.psychres.2010.07.051] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/21/2009] [Revised: 05/13/2010] [Accepted: 07/29/2010] [Indexed: 10/19/2022]
Abstract
This study examined 'Theory of Mind' (ToM) functioning, its association with psychometric schizotypy and with self-reported psychotic-like experiences (PLEs) and depressive symptoms, in a community sample of adolescents. Seventy-two adolescents (mean age 14.51years) from Barcelona, Spain, completed questionnaires assessing PLEs, depressive symptoms, and schizotypy. A verbal ToM task and a vocabulary test were administered. The effect of symptomatology, vocabulary ability, age, and gender on task performance was explored. Neither total score on schizotypy nor PLEs were associated with ToM performance. A significant effect of vocabulary on adolescent's performance of both ToM and control stories was found. ToM showed significant negative associations with positive schizotypy, and with one cluster of positive PLEs: first-rank experiences. Positive significant associations between ToM and persecutory delusions and the impulsive aspects of schizotypy were found. Depressive symptoms did not affect ToM performance. Positive schizotypal traits and first-rank symptoms are associated with ToM deficits in adolescents. Results support the trait-(versus state-) dependent notion of ToM impairments in schizophrenia. ToM may be a developmental impairment associated with positive schizotypy and PLEs.
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Affiliation(s)
- Marcela Barragan
- Department of Clinical and Health Psychology, Universidad Autónoma de Barcelona, Spain.
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