Theory of mind in the early course of schizophrenia: stability, symptom and neurocognitive correlates, and relationship with functioning

Ventura, Joseph; Ered, Arielle; Gretchen‐Doorly, Denise; Subotnik, Kenneth L.; Horan, William P.; Hellemann, Gerhard; Nuechterlein, Keith H.

doi:10.1017/s0033291714003171

Cited by 71 publications

(76 citation statements)

References 49 publications

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“…Social cognitive impairments persevere from the onset of illness across the course of schizophrenia. 51 They are negatively associated with employment and independent living, 52,53 and social cognition is more strongly predictive of real-world functioning than neurocognitive performance. 54 Thus, the large effects in this domain are encouraging, suggesting that the cognitive benefits of exercise may generalize to improve psychosocial and occupational outcomes for people with schizophrenia.…”

Section: Discussionmentioning

confidence: 99%

Aerobic Exercise Improves Cognitive Functioning in People With Schizophrenia: A Systematic Review and Meta-Analysis

Firth

Stubbs

Rosenbaum

et al. 2016

SCHBUL

283

300

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Cognitive deficits are pervasive among people with schizophrenia and treatment options are limited. There has been an increased interest in the neurocognitive benefits of exercise, but a comprehensive evaluation of studies to date is lacking. We therefore conducted a meta-analysis of all controlled trials investigating the cognitive outcomes of exercise interventions in schizophrenia. Studies were identified from a systematic search across major electronic databases from inception to April 2016. Meta-analyses were used to calculate pooled effect sizes (Hedges g) and 95% CIs. We identified 10 eligible trials with cognitive outcome data for 385 patients with schizophrenia. Exercise significantly improved global cognition (g = 0.33, 95% CI = 0.13–0.53, P = .001) with no statistical heterogeneity (I2 = 0%). The effect size in the 7 studies which were randomized controlled trials was g = 0.43 (P < .001). Meta-regression analyses indicated that greater amounts of exercise are associated with larger improvements in global cognition (β = .005, P = .065). Interventions which were supervised by physical activity professionals were also more effective (g = 0.47, P < .001). Exercise significantly improved the cognitive domains of working memory (g = 0.39, P = .024, N = 7, n = 282), social cognition (g = 0.71, P = .002, N = 3, n = 81), and attention/vigilance (g = 0.66, P = .005, N = 3, n = 104). Effects on processing speed, verbal memory, visual memory and reasoning and problem solving were not significant. This meta-analysis provides evidence that exercise can improve cognitive functioning among people with schizophrenia, particularly from interventions using higher dosages of exercise. Given the challenges in improving cognition, and the wider health benefits of exercise, a greater focus on providing supervised exercise to people with schizophrenia is needed.

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Section: Discussionmentioning

confidence: 99%

Aerobic Exercise Improves Cognitive Functioning in People With Schizophrenia: A Systematic Review and Meta-Analysis

Firth

Stubbs

Rosenbaum

et al. 2016

SCHBUL

283

300

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show abstract

“…Based on prior research suggesting that social status may be associated with neural activity in the main DMN hubs (Muscatell et al, 2012), we included parental SES as a covariate in both models. To account for the association between neurocognitive and social deficits observed in schizophrenia (Fett et al, 2011; Ventura et al, 2015), we also included mean global neurocognition as a covariate in both models. Finally, we included gender and age as covariates in both models given research that shows gender and age-related resting-state connectivity differences (Damoiseaux et al, 2008; Satterthwaite et al, 2014; Tian, Wang, Yan, & He, 2011).…”

Section: Methodsmentioning

confidence: 99%

Default mode functional connectivity is associated with social functioning in schizophrenia.

Fox¹,

Abram²,

Reilly³

et al. 2017

Journal of Abnormal Psychology

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Individuals with schizophrenia display notable deficits in social functioning. Research indicates that neural connectivity within the default mode network (DMN) is related to social cognition and social functioning in healthy and clinical populations. However, the association between DMN connectivity, social cognition, and social functioning has not been studied in schizophrenia. For the present study, we used resting-state neuroimaging data to evaluate connectivity between the main DMN hubs (i.e., the medial prefrontal cortex (mPFC) and the posterior cingulate cortex-anterior precuneus (PPC)) in individuals with schizophrenia (n=28) and controls (n=32). We also examined whether DMN connectivity was associated with social functioning via social attainment (measured by the Specific Levels of Functioning Scale) and social competence (measured by the Social Skills Performance Assessment), and if social cognition mediates the association between DMN connectivity and these measures of social functioning. Results revealed that DMN connectivity did not differ between individuals with schizophrenia and controls. However, connectivity between the mPFC and PCC hubs was significantly associated with social competence and social attainment in individuals with schizophrenia but not in controls as reflected by a significant group-by-connectivity interaction. Social cognition did not mediate the association between social functioning and DMN connectivity in individuals with schizophrenia. Our findings suggest that fronto-parietal DMN connectivity in particular may be differentially associated with social functioning in schizophrenia and controls. As a result, DMN connectivity may be used as a neuroimaging marker to monitor treatment response or as a potential target for interventions that aim to enhance social functioning in schizophrenia.

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“…'s () and Ventura et al . 's () findings, any such impairment, if found, is expected to be indexed by fewer appropriate social facts, after accounting for any group difference (if found) for counts of basic facts, and less usage of, at least, goal‐driven actions/intentions terms. We had no specific predictions about the usage of the other mental‐state terms; as perception and emotion are less complex to represent, patients might spontaneously generate as many perception and emotion terms as controls, perhaps even more (including negative emotional terms), which would be consistent with Russell et al .…”

Section: Introductionmentioning

confidence: 95%

“…More recently, Ventura et al . () used the same stimuli and instructions as Horan et al . and reported a similar deficit of spontaneous mentalizing in recent‐onset schizophrenia patients that persisted at 6‐month follow‐up.…”

Section: Introductionmentioning

confidence: 99%

Impairments of spontaneous and deliberative mentalizing co‐occur, yet dissociate, in schizophrenia

Langdon

Flynn

Connaughton

et al. 2017

British J Clinic Psychol

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Findings People with schizophrenia were less likely than controls to spontaneously attribute causal mental states when viewing dynamic signals of emotionally driven and goal-driven behaviours. These impairments were even more pronounced when participants were instructed to think of the stimuli as people, suggesting that perceiving others in social roles does not prompt people with schizophrenia to anthropomorphize about others as agents motivated by their own inner worlds. Impairments of spontaneous mentalizing were found to co-occur independently with explicit mentalizing deficits in schizophrenia, consistent with the claim that humans can access two distinct systems for understanding others' minds. Findings suggest that interventions to improve conscious deliberative mentalizing in schizophrenia may not be enough; we also need to target implicit mentalizing processes. Limitations The patient sample was chronic and only mildly symptomatic. As such, findings cannot be generalized to other stages and phases of the illness. All patients were also medicated, allowing for the possibility that automatic responses to socially salient stimuli may have been pharmacologically attenuated. Future research may examine whether unmedicated young people at ultra-high risk of psychosis show a similar profile of mentalizing impairment. Future work may also examine whether impairments of deliberative and spontaneous mentalizing associate differentially with social functioning and different cognitive domains in schizophrenia.

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Theory of mind in the early course of schizophrenia: stability, symptom and neurocognitive correlates, and relationship with functioning

Cited by 71 publications

References 49 publications

Aerobic Exercise Improves Cognitive Functioning in People With Schizophrenia: A Systematic Review and Meta-Analysis

Aerobic Exercise Improves Cognitive Functioning in People With Schizophrenia: A Systematic Review and Meta-Analysis

Default mode functional connectivity is associated with social functioning in schizophrenia.

Impairments of spontaneous and deliberative mentalizing co‐occur, yet dissociate, in schizophrenia

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