Elaboration of a rehabilitation method based on a pathogenetic hypothesis of “theory of mind” impairment in schizophrenia

Abstract

"Theory of mind" skills have repeatedly been shown to be impaired in schizophrenic patients. The purpose of this paper is to develop a therapeutic intervention targeting schizophrenic patients' abilities to attribute mental states to others. This preliminary study tried to test the hypothesis that this kind of intervention should improve patients' communication abilities; we also wondered if this would have a positive impact on their more general psychopathology. Eight chronic schizophrenic patients were asked to analyse video scenes (showing interactions between two or more persons), with particular attention being paid to the characters' mental states. Their clinical assessments (general clinical symptoms, communication, and the ability to attribute intentions to others, rated before and after two training sessions, over a one-week period) were compared with those of a control group of six chronic schizophrenic patients. The results support our hypothesis of a possible improvement of patients' communication disorders and an improvement of their abilities to attribute intentions to others. The more general psychopathology ratings, however, remained unchanged. Although these results need further development and confirmation, they suggest a possible promising approach for psychosocial rehabilitation therapies based on "theory of mind" skills.

Social cognition and interaction training for patients with stable schizophrenia in Chinese community settings

“…"Targeted" social cognitive interventions focus on a single ability, such as emotion perception or theory of mind (Penn and Combs, 2000;Frommann et al, 2003;Silver et al, 2004;Wolwer et al, 2005;Kayser et al, 2006;Russell et al, 2006;Mazza et al, 2010). However, the benefits of "targeted" interventions may be limited as social cognition is a multi-dimensional construct, including emotion processing, social perception and knowledge, theory of mind, and attributional bias (e.g., Green et al, 2008;Penn et al, 2008).…”

Affective empathy in schizophrenia: a meta-analysis

“…Additional literature further indicates impairments in self-reported cognitive empathy (e.g., see Corbera et al, 2013;Fischer-Shofty et al, 2013;Michaels et al, 2014;Shamay-Tsoory et al, 2007;Singh et al, 2015;Sparks et al, 2010). Some interventions have been designed to foster cognitive empathy in people diagnosed with schizophrenia, such as Metacognitive Reflection and Insight Therapy (Lysaker et al, 2007;Lysaker et al, 2010;Van Donkersgoed et al, 2014) and training to enhance understanding of thoughts, behavioral motivations and emotions in video tasks that are often used to assess aspects of cognitive empathy (Kayser et al, 2006).…”

Metacognitive and social cognition training (MSCT) in schizophrenia: A preliminary efficacy study

“…Most of these treatment programs were designed to directly address deficits in social cognition (e.g., emotion recognition, theory of mind) using remediation methods, while debiasing approaches are rarely employed when the primary focus is social cognitive processes (e.g., Hogarty et al, 2004;Roncone et al, 2004;Silver et al, 2004;Wolwer et al, 2005;Choi and Kwon, 2006;Kayser et al, 2006;Russell et al, 2006;Marsh et al, 2010;Mazza et al, 2010). However, deficits and biases affecting social cognition occur together in schizophrenia, and thus potentiate each other.…”