Hostname: page-component-cd9895bd7-dk4vv Total loading time: 0 Render date: 2024-12-26T13:10:45.593Z Has data issue: false hasContentIssue false
  • English
  • Français

Mental state attribution in schizophrenia: What distinguishes patients with “poor” from patients with “fair” mentalising skills?

Published online by Cambridge University Press:  15 April 2020

M. Brüne  and
D. Schaub
M. Brüne*
Affiliation:
Research Department of Cognitive Neuropsychiatry and Psychiatric Preventive Medicine, LWL University Hospital, Department of Psychiatry, Psychotherapy, and Preventive Medicine, Ruhr University Bochum, Alexandrinenstr. 1, 44791Bochum, Germany
D. Schaub
Affiliation:
Research Department of Cognitive Neuropsychiatry and Psychiatric Preventive Medicine, LWL University Hospital, Department of Psychiatry, Psychotherapy, and Preventive Medicine, Ruhr University Bochum, Alexandrinenstr. 1, 44791Bochum, Germany
*
*Corresponding author. E-mail address: [email protected] (M. Brüne).
Get access

Abstract

Purpose

Although many patients with schizophrenia are impaired in mental states attribution abilities, a significant number perform within normal or near-normal ranges in mental state attribution tasks. No studies have analysed cognitive or behavioural differences between patients with – to some extent – preserved mental state attribution skills and those with poor mentalising abilities.

Material and methods

To examine characteristics of “poor” and “fair” mentalisers, 58 patients with schizophrenia performed a mental state attribution task, a test of general intelligence, and two executive functioning tests. “Poor” and “fair” mentalising skills were defined according to a median-split procedure; the median score in the patient group was also within two standard deviations of the control group. In addition, patients’ social behavioural skills and psychopathological profiles were rated.

Results

Patients performing within normal or near normal ranges on the mental state attribution task had fewer social behavioural abnormalities than patients with poor mentalising abilities (even when controlled for intelligence), but did not differ in executive functioning. Fair mental state performers showed less disorganisation and excitement symptoms than poor performers. The degree of disorganisation mediated the influence of mental state attribution on social behavioural skills.

Conclusions

Schizophrenia patients with (partially) preserved mentalising skills have fewer behavioural problems in the social domain than patients with poor mentalising abilities. Conceptual disorganisation mediates the prediction of social behavioural skills through mentalising skills, suggesting that disorganised patients may require special attention regarding social-cognitive skills training.

Keywords

Mental state attributionMentalisingSocial behaviourDisorganisationSchizophrenia
Type
Original articles
Information
European Psychiatry , Volume 27 , Issue 5 , July 2012 , pp. 358 - 364
Copyright
Copyright © Elsevier Masson SAS 2012

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Abdel-Hamid, M., Lehmkämper, C., Sonntag, C., Juckel, G., Daum, I., Brüne, M.Theory of mind in schizophrenia: the role of clinical symptomatology and neurocognition in understanding other people's thoughts and intentions. Psychiatry Res. 2009; 165: 19–26.10.1016/j.psychres.2007.10.021CrossRefGoogle ScholarPubMed
Abu-Akel, A.Impaired theory of mind in schizophrenia. Pragm Cogn. 1999; 7: 247–282.CrossRefGoogle Scholar
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 4th ed., Text Revision. Washington DC: American Psychiatric Association; 2000.Google Scholar
Baron, R.M., Kenny, D.A.The moderator-mediator variable distinction in social psychological research: conceptual, strategic, and statistical considerations. J Pers Soc Psychol. 1986; 51: 1173–1182.10.1037/0022-3514.51.6.1173CrossRefGoogle ScholarPubMed
Baron-Cohen, S., Wheelwright, S., Hill, J., Raste, Y., Plumb, I.The “Reading the Mind in the Eyes” test revised version: a study with normal adults, and adults with Asperger Syndrome or high-functioning autism. J Child Psychol Psychiatry. 2001; 42: 241–251.CrossRefGoogle ScholarPubMed
Bora, E., Eryavuz, A., Kayahan, B., Sungu, G., Veznedaroglu, B.Social functioning, theory of mind and neurocognition in outpatients with schizophrenia; mental state decoding may be a better predictor of social functioning than mental state reasoning. Psychiatry Res. 2006; 145: 95–103.10.1016/j.psychres.2005.11.003CrossRefGoogle ScholarPubMed
Brekke, J.S., Hoe, M., Long, J., Green, M.F.How neurocognition and social cognition influence functional change during community-based psychosocial rehabilitation for individuals with schizophrenia. Schizophr Bull. 2007; 33: 1247–1256.10.1093/schbul/sbl072CrossRefGoogle ScholarPubMed
Brothers, L.The social brain: a project for integrating primate behavior and neurophysiology in a new domain. Conc Neurosci. 1990; 1: 27–51.Google Scholar
Brüne, M.Theory of mind” in schizophrenia: a review of the literature. Schizophr Bull. 2005; 31: 21–42.10.1093/schbul/sbi002CrossRefGoogle ScholarPubMed
Brüne, M., Abdel-Hamid, M., Lehmkämper, C., Sonntag, C.Mental state attribution, neurocognitive functioning, and psychopathology: what predicts poor social competence in schizophrenia best?. Schizophr Res. 2007; 92: 151–159.CrossRefGoogle ScholarPubMed
Brüne, M., Brüne-Cohrs, U.Theory of mind-evolution, ontogeny, brain mechanisms and psychopathology. Neurosci Biobehav Rev. 2006; 30: 437–455.CrossRefGoogle Scholar
Brüne M, Schaub D, Juckel G, Langdon R. Social skills and behavioral problems in schizophrenia: the role of mental state attribution, neurocognition and clinical symptomatology. Psych Res 2010 [Epub ahead of print].10.1016/j.psychres.2010.03.015CrossRefGoogle Scholar
Champagne-Lavau, M., Fossard, M., Martel, G., Chapdelaine, C., Blouin, G., Rodriguez, J.-P.et al.Do patients with schizophrenia attribute mental states in a referential comunication task?. Cogn Neuropsychiat. 2009; 14: 217–239.CrossRefGoogle Scholar
Corcoran, R., Cahill, C., Frith, C.D.The appreciation of visual jokes in people with schizophrenia. A study of ‘mentalizing’ ability. Schizophr Res. 1997; 24: 319–327.CrossRefGoogle ScholarPubMed
Corcoran, R., Mercer, G., Frith, C.D.Schizophrenia, symptomatology and social inference: investigating ‘theory of mind’ in people with schizophrenia. Schizophr Res. 1995; 17: 5–13.10.1016/0920-9964(95)00024-GCrossRefGoogle ScholarPubMed
Drury, V.M., Robinson, E.J., Birchwood, M.‘Theory of mind’ skills during an acute episode of psychosis and following recovery. Psychol Med. 1998; 28: 1101–1112.CrossRefGoogle ScholarPubMed
Dunbar, R.I.M.Psychology. Evolution of the social brain. Science. 2003; 302: 1160–1161.10.1126/science.1092116CrossRefGoogle ScholarPubMed
Dunbar, R.I.M.The social role of touch in humans and primates: behavioural function and neurobiological mechanisms. Neurosci Biobehav Rev. 2008; 34: 260–268.CrossRefGoogle ScholarPubMed
Frith, C.D.The cognitive Neuropsychology of Schizophrenia. Hove, UK: Lawrence Erlbaum Associates Ltd; 1992.Google Scholar
Frith, C.D.Schizophrenia and theory of mind. Psychol Med. 2004; 34: 385–389.CrossRefGoogle ScholarPubMed
Frith, C.D.Social cognition. Philos Trans R Soc Lond B Biol Sci. 2008; 363: 2033–2039.10.1098/rstb.2008.0005CrossRefGoogle ScholarPubMed
Harrington, L., Siegert, R., McClure, J.Theory of mind in schizophrenia: a critical review. Cogn Neuropsychiatry. 2005; 10: 249–286.CrossRefGoogle ScholarPubMed
Harrington, L., Langdon, R., Siegert, R.J., McClure, J.Schizophrenia, theory of mind, and persecutory delusions. Cogn Neuropsychiatry. 2005; 10: 87–104.CrossRefGoogle ScholarPubMed
Janssen, I., Krabbendam, L., Jolles, J., van Os, J.Alterations in theory of mind in patients with schizophrenia and non-psychotic relatives. Acta Psychiat Scand. 2003; 108: 110–117.CrossRefGoogle ScholarPubMed
Kay, S.R., Opler, L.A., Lindenmayer, J.P.The Positive and Negative Syndrome Scale (PANSS): rationale and standardisation. Br J Psychiatry. Suppl. 7 1989 59–67.CrossRefGoogle Scholar
Langdon, R., Michie, P.T., Ward, P.B., McConaghy, N., Catts, S., Coltheart, M.Defective self and/or other mentalising in schizophrenia: a cognitive neuropsychological approach. Cogn Neuropsychiatry. 1997; 2: 167–193.CrossRefGoogle ScholarPubMed
Lehrl, S., Triebig, G., Fischer, B.Multiple-choice vocabulary test MWT as a valid and short test to estimate premorbid intelligence. Acta Neurol Scand. 1995; 91: 335–345.CrossRefGoogle ScholarPubMed
Lysaker, P.H., Carcione, A., Dimaggio, G., Johannesen, J.K., Nicoló, G., Procacci, M.et al.Metacognition amidst narratives of self and illness in schizophrenia: associations with neurocognition, symptoms, insight and quality of life. Acta Psychiat Scand. 2005; 112: 64–71.CrossRefGoogle ScholarPubMed
Lysaker PH, Shea AM, Buck KD, Dimaggio G, Nicolò G, Procacci M, et al. Metacognition as a mediator of the effects of impairments in neurocognition on social function in schizophrenia spectrum disorders. Acta Psychiat Scand 2010; 10.1111/j.1600-0447.2010.01554x.CrossRefGoogle Scholar
Mazza, M., Costagliola, C., Di Michele, V., Magliani, V., Pollice, R., Ricci, A.et al.Deficit of social cognition in subjects with surgically treated frontal lobe lesions and in subjects affected by schizophrenia. Eur Arch Psychiatry Clin Neurosci. 2007; 257: 12–22.CrossRefGoogle ScholarPubMed
McCabe, R., Leudar, I., Antaki, C.Do people with schizophrenia display theory of mind deficits in clinical interactions?. Psychol Med. 2004; 34: 401–412.CrossRefGoogle ScholarPubMed
McGlade, N., Behan, C., Hayden, J., O’Donoghue, T., Peel, R., Haq, F.et al.Mental state decoding v. mental state reasoning as a mediator between cognitive and social function in psychosis. Br J Psychiatry. 2008; 193: 77–78.CrossRefGoogle ScholarPubMed
Mizrahi, R., Korostil, M., Starkstein, S.E., Zipursky, R.B., Kapur, R.The effect of antipsychotic treatment on Theory of Mind. Psychol Med. 2006; 37: 595–601.10.1017/S0033291706009342CrossRefGoogle ScholarPubMed
Nelson, H.E.A modified card sorting test sensitive to frontal lobe defects. Cortex. 1976; 12: 313–324.CrossRefGoogle ScholarPubMed
Pickup, G.J.Relationship between theory of mind and executive function in schizophrenia: a systematic review. Psychopathology. 2008; 41: 206–213.CrossRefGoogle ScholarPubMed
Pickup, G.J., Frith, C.D.Theory of mind impairments in schizophrenia: symptomatology, severity and specificity. Psychol Med. 2001; 31: 207–220.10.1017/S0033291701003385CrossRefGoogle ScholarPubMed
Pijnenborg, G.H.M., Withaar, F.K., Evans, J.J., van den Bosch, R.J., Timmerman, M.E., Brouwer, W.H.The predictive value of measures of social cognition for community functioning in schizophrenia: implications for neuropsychological assessment. J Int Neuropsychol Soc. 2009; 15: 239–247.CrossRefGoogle ScholarPubMed
Premack, D., Woodruff, G.Does the chimpanzee have a ‘theory of mind’?. Behav Brain Sci. 1978; 4: 515–526.CrossRefGoogle Scholar
Roncone, R., Falloon, I.R.H., Mazza, M., De Risio, A., Pollice, R., Necozione, S.et al.Is theory of mind in schizophrenia more strongly associated with clinical and social functioning than with neurocognitive deficits?. Psychopathology. 2002; 35: 280–288.CrossRefGoogle ScholarPubMed
Sarfati, Y., Hardy-Baylé, M.C.How do people with schizophrenia explain the behaviour of others? A study of theory of mind and its relationship to thought and speech disorganisation in schizophrenia. Psychol Med. 1999; 29: 613–620.CrossRefGoogle Scholar
Sarfati, Y., Hardy-Baylé, M.C., Besche, C., Widlöcher, D.Attribution of intentions to others in people with schizophrenia: a non-verbal exploration with comic strip. Schizophr Res. 1997; 25: 199–209.CrossRefGoogle Scholar
Sarfati, Y., Hardy-Baylé, M.C., Nadel, J., Chevalier, J.F., Widlöcher, D.Attribution of mental states to others in schizophrenic patients. Cogn Neuropsychiatry. 1997; 2: 1–17.CrossRefGoogle ScholarPubMed
Shamay-Tsoori, S.G., Shur, S., Barcai-Goodman, L., Medlovich, S., Harari, H., Levkovitz, Y.Dissociation of cognitive from affective components of theory of mind in schizophrenia. Psychiatry Res. 2007; 149: 11–23.10.1016/j.psychres.2005.10.018CrossRefGoogle Scholar
Simpson, J., Done, J., Vallée-Tourangeau, F.An unreasoned approach: a critique of research on reasoning and delusions. Cogn Neuropsychiatry. 1998; 3: 1–20.Google Scholar
Sprong, M., Schothorst, P., Vos, E., Hox, J., van Engeland, E.Theory of mind in schizophrenia. Br J Psychiatry. 2007; 191: 5–13.CrossRefGoogle Scholar
Van der Gaag, M., Hoffman, T., Remijsen, M., Hijman, R., de Haan, L., van Meijel, B.et al.The five-factor model of the Positive and Negative Syndrome Scale II: a ten-fold cross-validation of a revised model. Schizophr Res. 2006; 85: 280–287.CrossRefGoogle ScholarPubMed
Versmissen, D., Janssen, I., Myin-Germeys, I., Mengelers, R., Campo, J.A., van Os, J.et al.Evidence for a relationship between mentalising deficits and paranoia over the psychosis continuum. Schizophr Res. 2008; 99: 103–110.10.1016/j.schres.2007.09.024CrossRefGoogle ScholarPubMed
Walter, H., Ciaramidaro, A., Adenzato, M., Vasic, N., Ardito, R.B., Erk, S.et al.Dysfunction of the social brain in schizophrenia is modulated by intention type: an fMRI study. Soc Cogn Affect Neurosci. 2009; 4: 166–176.10.1093/scan/nsn047CrossRefGoogle ScholarPubMed
Wilson, B.A., Alderman, N., Burgess, P., Emslie, H., Evans, J.J.Behavioural Assessment of the Dysexecutive Syndrome (BADS). Bury St Edmunds: Thames Valley Test Company; 1996.Google Scholar
Woods, S.W.Chlorpromazine equivalent doses for the newer atypical antipsychotics. J Clin Psychiatry. 2003; 64: 663–667.CrossRefGoogle ScholarPubMed
Wykes, T., Sturt, E.The measurement of social behaviour in psychiatric patients: an assessment of the reliability and validity of the SBS schedule. Br J Psychiatry. 1986; 148: 1–11.CrossRefGoogle ScholarPubMed
Submit a response

Comments

No Comments have been published for this article.