Is Theory of Mind in Schizophrenia More Strongly Associated with Clinical and Social Functioning than with Neurocognitive Deficits?

Abstract

This paper examines the correlations between ‘Theory of Mind’ (ToM) and neurocognitive performance, together with clinical and social functioning, in out-patients with schizophrenic disorders. It was hypothesised that, since the ability to make inferences about the environment and about other peoples’ mental states is a key ingredient of social competence, the assessment of ToM would correlate more strongly with current social functioning than with more traditional neurocognitive measures. ‘Independent raters’ assessed Theory of Mind, neurocognitive and clinical variables as well as community functioning in 44 subjects with schizophrenia. The neuropsychological measures were more closely associated with community functioning than with psychiatric symptoms. These associations remained evident when the effects of intelligence were controlled. Patients with a higher level of competence in making social inferences had better overall community functioning than those who showed less ability in this aspect of social cognition. In a regression model, the capacity to comprehend other people’s mental states (ToM-2) was among the best predictors of global social functioning, together with recent onset of illness, good verbal fluency and low levels of negative and positive symptoms. These results are consistent with other recent findings. ToM measures of social cognition may be a useful addition to neuropsychological assessment when developing programmes for reducing clinical impairments and improving the community functioning of subjects with schizophrenic disorders. Further studies are needed to verify the value of these measures as predictors of the successful application of specific psychosocial rehabilitation strategies.

Does employment promote the process of recovery from schizophrenia? A review of the existing evidence

“…A growing body of literature has shown, consistently, that schizophrenia patients compared to healthy people present social cognitive and neurocognitive impairments which are relatively stable and persistent, suggesting that this is a trait-dependent rather than state-dependant aspect of the disorder [9][10][11]. Social cognitive deficits have been widely described as modifying patients' behavior when interacting with other people (theory of mind (ToM) deficits) [11][12][13][14] and in recognizing emotions [15][16][17] and other social information cues [9,18]. Therefore, social cognitive deficits are believed to be important predictors of functional outcome in schizophrenia [19,20].…”

Assessing Perspective Taking in Schizophrenia Using Relational Frame Theory

“…For instance, people with schizophrenia poorly understand irony and metaphors because they often require inferring the intention of the speaker (Langdon, Davies, & Coltheart, 2002;Mo, Su, Chan, & Liu, 2008). More generally, impairments in mental states attribution are linked to a deficit in social functioning, which constitutes one of the most dramatic features of this illness (Bora, Eryavuz, Kayahan, Sungu, & Veznedaroglu, 2006;Brüne, 2005bBrüne, , 2006Roncone et al, 2002;Schenkel, Spaulding, & Silverstein, 2005). according to Hyronemus, Penn, Corrigan, and Martin (1998), inaccurate social perception persists during remission phases and causes failures in social integration, which, in turn, contribute to the reemergence of psychotic symptoms.…”

Factors leading to bad social outcome in subjects with psychosis

“…Quest'ultima abilita si riferisce alia capacita tipicamente umana con cui gli individui attribuiscono un senso alia loro esistenza e interpretano il comportamento proprio e degli altri (Arcuri & Castelli, 2000). Diversi modelli di analisi della cognizione sociale, applicati a pazienti con disturbi mentali, hanno descritto i meccanismi di apprendimento, di pensiero e di memoria connessi con tale dominio con risultati stimolanti e suggestivi (Roncone et al, 2002;Pinkham et al, 2003). Vedi tabella I per una definizione evolutiva.…”