Theory of mind correlates with clinical insight but not cognitive insight in patients with schizophrenia

Zhang, Qi; Xu, Li; Parker, Giverny J.; Hong, Xiaohong; Wang, Yi; Lui, Simon S.Y.; Neumann, David L.; Cheung, Eric F.C.; Shum, David; Chan, Raymond C.K.

doi:10.1016/j.psychres.2016.01.044

Cited by 34 publications

(21 citation statements)

References 53 publications

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“…In a previous study by , SCZ patients showed significant impairment only in affective conditions but not cognitive conditions, and the authors suggested a dissociation of cognitive and affective components of ToM in SCZ. However, in the present study, our findings do not support this dissociation as SCZ patients showed impairment in both components, which is consistent with previous studies using the same task in first-episode and chronic SCZ patients (Ho et al, 2015;Zhang et al, 2016). Previous meta-analytic studies in MDD and BD patients have reported deficits in both cognitive (d = 0.49 for MDD; 0.68 for BD) and affective (d = 0.52 for MDD; 0.46 for BD)…”

Section: Tom Impairments Across Diagnostic Groupssupporting

confidence: 78%

Theory of mind impairment and its clinical correlates in patients with schizophrenia, major depressive disorder and bipolar disorder

Wang

Zou

et al. 2018

Schizophrenia Research

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Background: Although Theory of Mind (ToM) impairment has been observed in patients with a wide range of mental disorders, the similarity and uniqueness of these deficits across diagnostic groups has not been thoroughly investigated. Methods: We recruited 35 participants with schizophrenia (SCZ), 35 with bipolar disorder (BD), 35 with major depressive disorder (MDD), and 35 healthy controls in this study. All participants were matched in age, gender proportion and IQ estimates. The Yoni task, capturing both the cognitive and affective components of ToM at the first-and second-order level was administered. Repeated-measure ANOVA and MANOVA were conducted to compare the group differences in ToM performance. A network was then constructed with ToM performances, psychotic and depressive symptoms, and executive function as nodes exploring the clinical correlates of ToM. Results: Overall, ToM impairments were observed in all patient groups compared with healthy controls, with patients with SCZ performing worse than those with BD. In second-order conditions, patients with SCZ and MDD showed deficits in both cognitive and affective conditions, while patients with BD performed significantly poorer in cognitive conditions. Network analysis showed that second-order affective ToM performance was associated with psychotic and depressive symptoms as well as executive dysfunction, while second-order affective ToM performance and negative symptoms showed relatively high centrality in the network. Conclusions: Patients with SCZ, MDD and BD show different variety and severity of impairments in ToM sub-components. Impairment in higher-order affective ToM appears to be closely related to clinical symptoms in both psychotic and affective disorders.

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Section: Tom Impairments Across Diagnostic Groupssupporting

confidence: 78%

Theory of mind impairment and its clinical correlates in patients with schizophrenia, major depressive disorder and bipolar disorder

Wang

Zou

et al. 2018

Schizophrenia Research

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“…All participants were recruited from Chifeng Anding Hospital located in the Inner Mongolia autonomous region in China. The inclusion criteria were (1) ICD-10 diagnosis of schizophrenia; (2) clinical stability and absence of aggressive or hostile behaviour; (3) age 18 years or older; (4) ability to understand the survey instructions and willingness to provide written informed consent; and (5) sufficient cognitive capacity (a score of PANSS-G12 less than 4 [31]). The exclusion criteria were as follows: coexisting mental retardation, dementia, or other severe organic disorders, or drug or alcohol abuse.…”

Section: Subjectsmentioning

confidence: 99%

Mediation and moderation analyses: exploring the complex pathways between hope and quality of life among patients with schizophrenia

et al. 2020

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Background: The underlying mechanism between hope and quality of life is as yet unknown. We aim to examine the potential mediating effect of depression and resilience and the moderated effect of sex in this well-established association. Methods: Two hundred seven patients diagnosed with schizophrenia were administered a questionnaire battery that measured hope, depression, resilience and QOL. A multiple mediation model was used to examine the mediating effect of resilience and depression on the association between hope and QOL. A subgroup analysis was performed and a moderated mediation model was examined to find and test the moderated effect of sex on the mediation model. We used Mplus to perform moderation and mediation analyses so that the mediators and moderator could function together in the same model. Result: Sex was the moderator on the direct path between hope and QOL. The relationship between hope and QOL was mediated by resilience and depression in both sexes. When compared with female patients, the effect of hope on QOL was completely mediated by resilience and depression in males. In female patients, the model was partially mediated, and the direct effect of hope on QOL was significantly negatively correlated with the level of hope. Conclusion: We present a conceptual model containing the mediated effects of resilience and depression and the moderated effect of sex between hope and QOL, which we believe facilitates the understanding of these associations. This model should be useful in the formulation of strategies to improve QOL.

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“…Chan et al 48 found that global insight was linked to the ability to detect social faux pas. Zhang et al 64 found that people with schizophrenia classified as having high insight had better social cognitive abilities than those classified as having low insight, and that their social cognitive abilities were roughly equivalent to those of healthy controls.…”

Section: Social Cognition As a Root Of Poor Insightmentioning

confidence: 99%

“…One study reported that cognitive insight was related to theory of mind tasks 141 , although such a finding has not been replicated 11,64,140 . A meta-analysis has recently found a clinically significant but modest link between theory of mind and insight 142 .…”

Section: Social Cognition As a Root Of Poor Insightmentioning

confidence: 99%

Insight in schizophrenia spectrum disorders: relationship with behavior, mood and perceived quality of life, underlying causes and emerging treatments

et al. 2018

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Poor insight in schizophrenia is prevalent across cultures and phases of illness. In this review, we examine the recent research on the relationship of insight with behavior, mood and perceived quality of life, on its complex roots, and on the effects of existing and emerging treatments. This research indicates that poor insight predicts poorer treatment adherence and therapeutic alliance, higher symptom severity and more impaired community function, while good insight predicts a higher frequency of depression and demoralization, especially when coupled with stigma and social disadvantage. This research also suggests that poor insight may arise in response to biological, experiential, neuropsychological, social-cognitive, metacognitive and socio-political factors. Studies of the effects of existing and developing treatments indicate that they may influence insight. In the context of earlier research and historical models, these findings support an integrative model of poor insight. This model suggests that insight requires the integration of information about changes in internal states, external circumstances, others' perspectives and life trajectory as well as the multifaceted consequences and causes of each of those changes. One implication is that treatments should, beyond providing education, seek to assist persons with schizophrenia to integrate the broad range of complex and potentially deeply painful experiences which are associated with mental illness into their own personally meaningful, coherent and adaptive picture.

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Theory of mind correlates with clinical insight but not cognitive insight in patients with schizophrenia

Cited by 34 publications

References 53 publications

Theory of mind impairment and its clinical correlates in patients with schizophrenia, major depressive disorder and bipolar disorder

Theory of mind impairment and its clinical correlates in patients with schizophrenia, major depressive disorder and bipolar disorder

Mediation and moderation analyses: exploring the complex pathways between hope and quality of life among patients with schizophrenia

Insight in schizophrenia spectrum disorders: relationship with behavior, mood and perceived quality of life, underlying causes and emerging treatments

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