Studying Social Cognition in Patients with Schizophrenia and Patients with Frontotemporal Dementia: Theory of Mind and the Perception of Sarcasm

Abstract

We investigated social cognition and theory of mind in patients with schizophrenia and in patients with frontotemporal dementia in order to elucidate the cognitive mechanisms involved in the breakdown of these skills in psychiatric and neurological patients. Our tasks included videotaped scenarios of social interactions depicting sincere, sarcastic and paradoxical remarks, as well as lies. We found impaired performance of the schizophrenia group on all theory of mind conditions despite their intact understanding of sincere statements. In contrast, the FTD group performed poorly only when they had to rely on paralinguistic cues indicating sarcasm or lies, and not on paradoxical remarks or sarcasm when given additional verbal cues. Our findings suggest that, while current deficits in social and interpersonal functioning in patients with FTD may reflect a decrement in previously acquired skills, similar deficits in patients with schizophrenia may reflect an altogether inadequately learned process.

Language, executive function and social cognition in the diagnosis of frontotemporal dementia syndromes

“…Dozens of case studies and between group comparisons have provided empirical support for the clinically described social cognitive deficits in bvFTD including impaired ability to process facial emotions (Cavallo et al, 2011; Gleichgerrcht et al, 2002; Miller et al, 2012; Torralva et al, 2009), detect socially inappropriate speech (Gleichgerrcht et al, 2010; C. Gregory et al, 2002; Torralva et al, 2009), adopt the perspective of another person (Adenzato et al, 2010; Eslinger et al, 2011; C. Gregory et al, 2002; Lough et al, 2001; Lough & Hodges, 2002), solve social dilemmas (Eslinger et al, 2007), perceive sarcasm (Kosmidis et al, 2008), or react to fearful or sad stimuli (Sturm et al, 2006; Werner et al, 2007). …”

Social cognition in neurodegenerative disorders: a systematic review

“…Studies have also shown that bv-FTD patients have difficulties in identifying social concepts, judging the appropriate plan of action in social dilemmas, recognising sarcasm and differentiating minor social transgressions from serious moral violations 52 53 57 59–62. Imaging studies have suggested that poor moral judgement and socio-pathic behaviour in bv-FTD may be linked to involvement of the MFC and right temporal lobe, regions believed to play a critical role in social cognition 2 61 63 64…”

What dementia reveals about proverb interpretation and its neuroanatomical correlates

“…Zahn et al (2009) examined context-dependent knowledge of social concepts in patients with frontal-temporal lobar degeneration, finding that they are particularly impaired on such tasks. Nonliteral language interpretation has also been studied with respect to interpretation of sarcasm (as opposed to proverb interpretation) in bvFTD patients (Kipps, Nestor, Acosta-Cabronero, Arnold, & Hodges, 2009;Kosmidis et al, 2008;Rankin et al, 2009), wherein bvFTD patients were observed to have significantly more trouble comprehending sarcasm, compared to healthy controls and AD patients, and, this was attributed to frontal lobe dysfunction.…”