Making sense of theory of mind and paranoia: The psychometric properties and reasoning requirements of a false belief sequencing task

Abstract

INTRODUCTION. This study used Item-Response Theory (IRT) to model the psychometric properties of a false belief picture sequencing task. Consistent with the mental time travel hypothesis of paranoia, we anticipated that performance on this deductive theory of mind (ToM) task would not be associated with the presence of persecutory delusions but would be related to other clinical, cognitive, and demographic factors. METHOD. A large (N=237) and diverse clinical and nonclinical sample differing in levels of depression and paranoid ideation performed 2 ToM tasks: the false belief sequencing task and a ToM stories task that was used to assess the validity of the false belief sequencing task as a measure of ToM. RESULTS. A unidimensional IRT model was found to fit the data well. Latent ToM ability as measured by the false belief sequencing task was negatively related with age and positively with IQ. In contrast to the ToM stories measure, there was no association between clinical diagnosis or symptoms and false belief picture sequencing after controlling for age and IQ. CONCLUSIONS. In line with mental time travel hypothesis of paranoia (Corcoran, 2010 ), performance on this deductive nonverbal ToM task is not related to the presence of paranoid symptoms. This measure is best suited for assessing ToM functioning where participants' performance falls just short of the average latent ToM ability. Furthermore, it is sensitive to the effects of increasing age and decreasing IQ.

Dissociation of understanding from applying others’ false beliefs in remitted schizophrenia: evidence from a computerized referential communication task

“…Our results are consistent with a previous study [25,36], which indicated that patients with schizophrenia had difficulties in taking others’ perspective. The findings are also consistent with previous studies using false belief picture-sequencing tasks [37-39]. Patients with schizophrenia performed poorly on this type of task that required the ability to apply others’ false beliefs.…”

The metabolic basis of psychosis in bipolar disorder: A positron emission tomography study

“…Specifically, for the Theory of Mind, it has been reported that alterations in these abilities and psychotic features are deeply intertwined. This is because psychotic and paranoid patients present an altered salience and therefore utilize contextual information inappropriately, inducing incorrect social inferences and quantitatively “over‐generating” hypotheses or “over‐attributing” significance . Therefore, it seems plausible that brain structures involved in Theory of Mind, including the fusiform gyrus might overlap with areas associated with psychotic disorders, including BD .…”

Combined social cognitive and neurocognitive rehabilitation strategies in schizophrenia: neuropsychological and psychopathological influences on Theory of Mind improvement

“…As reported by Frith's notion, ToM impairments in schizophrenia are intrinsically diverse and dependent on symptomatology (Frith & Corcoran, 1996; Mazza et al 2001; Pickup & Frith, 2001; Stewart et al 2008; Corcoran et al 2011) and paranoia appears of particular relevance. It has thus been hypothesized that paranoid patients possess basic capabilities to represent mental states; however, they utilize contextual information inappropriately, inducing incorrect social inferences and quantitatively ‘over-generating’ hypotheses or ‘over-attributing’ significance and intents to events, persons and inanimate objects.…”