Exploring spontaneous mentalization in schizophrenia: An eyetracking study

Abstract

Individuals with schizophrenia have been shown to be impaired in their ability to attribute intentions to others. However, the mentalizing tasks usually used impose large demands on explicit reasoning, thus leaving the large domain of implicit social cognition largely unexplored in schizophrenia. Yet, Frith has suggested that social cognitive deficits in schizophrenia were characterized by dissociation between an impaired explicit mentalization and a spared implicit mentalization [1]. Another question that remains open is whether schizophrenic patients’ difficulties in those tasks can be characterized as hypo- [2] or as hyper mentalization deficits [3]. In order to test these two questions, mentalization was tested in individuals with schizophrenia (n = 29) and in control subjects (n = 29) with the Frith-Happé paradigm [4], while eye movements were recorded. Explicit mentalizing was measured from participants’ verbal descriptions and was contrasted with implicit mentalization measured through eyetracking. As a group, schizophrenia cases made less accurate and intentional descriptions of the intentional animations whereas no differences where found for the random animations. These differences were not explained by lower verbal or performance IQ or impaired executive function measured by cognitive contextual control. However, eyetracking results revealed that individuals with and without schizophrenia showed a similar modulation of eye movements in response to the different condition of Frith-Happé animations. To conclude, participants with schizophrenia showed an explicit deficit in mentalization in the direction of a hypomentalization, whereas their implicit mentalization was preserved, thus suggesting dissociation between explicit and implicit attribution of intentions in schizophrenia.

Disclosure of interest

The authors declare that they have no conflicts of interest concerning this article.