Hostname: page-component-cd9895bd7-fscjk Total loading time: 0 Render date: 2024-12-24T18:42:06.221Z Has data issue: false hasContentIssue false

The Impact of Impaired “Theory of Mind” on Social Interactions in Schizophrenia

Published online by Cambridge University Press:  28 March 2011

Mary H. Kosmidis*
Affiliation:
Lab of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece
Maria Giannakou
Affiliation:
Lab of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece
Giorgos Garyfallos
Affiliation:
2nd Department of Psychiatry, Aristotle University of Thessaloniki, Thessaloniki, Greece
Grigoris Kiosseoglou
Affiliation:
Lab of Cognitive Neuroscience, School of Psychology, Aristotle University of Thessaloniki, Thessaloniki, Greece
Vassilis P. Bozikas
Affiliation:
1st Department of Psychiatry, Aristotle University of Thessaloniki, Thessaloniki, Greece
*
Correspondence and reprint requests to: Mary H. Kosmidis, School of Psychology, Aristotle University of Thessaloniki, GR 54124 Thessaloniki, Greece. E-mail: [email protected]

Abstract

Given the importance of social dysfunction in schizophrenia, many studies have explored how social cognition, and, particularly, Theory of Mind (ToM) may affect patients’ social interactions. In the present study, we investigated the impact of ToM deficits on social interactions, taking into account overall neuropsychological functioning as well as clinical and demographic characteristics. We assessed 28 patients with schizophrenia and 30 healthy participants on a series of tasks including tests of ToM, neuropsychological tests focused on functions potentially relevant to ToM and role plays as an indicator of social interactions. Patients performed more poorly than healthy controls across most ToM and some of the neuropsychological tests. Correlations and hierarchical regression analyses indicated the impact of some, but not all, facets of ToM on patients’ social interactions, over and above neuropsychological functioning, positive and negative symptom ratings, duration of illness and demographic characteristics. These findings suggest that remediation of ToM deficits in patients with schizophrenia may help to improve their social interactions. (JINS, 2011, 17, 511–521)

Type
Research Articles
Copyright
Copyright © The International Neuropsychological Society 2011

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

Addington, J., Addington, D. (2000). Neuropsychological and social functioning in schizophrenia: A 2.5 year follow-up study. Schizophrenia Research, 44, 4756.CrossRefGoogle ScholarPubMed
American Psychiatric Association. (1994). DSM-IV: Diagnostic and statistical manual of mental disorders (4th ed.). Washington, DC: American Psychiatric Association.Google Scholar
Armitage, S.G. (1946). An analysis of certain psychological tests used for the evaluation of brain injury. Psychological Monographs, 60, 148.CrossRefGoogle Scholar
, M.B., Zanello, A., Varnier, M., Koellner, V., Merlo, M.C.G. (2008). Deficits in neurocognition, theory of mind and social functioning in patients with schizophrenic disorders. Are they related? Journal of Nervous and Mental Disease, 196, 153156.CrossRefGoogle ScholarPubMed
Bell, M., Tsang, H.W.H., Greig, T.C., Bryson, G.J. (2009). Neurocognition, social cognition, perceived social discomfort, and vocational outcomes in schizophrenia. Schizophrenia Bulletin, 35, 738747.CrossRefGoogle ScholarPubMed
Bellack, A.S., Morrison, R.L., Wixted, J.T., Mueser, K.T. (1990). An analysis of social competence in schizophrenia. British Journal of Psychiatry, 156, 809818.CrossRefGoogle ScholarPubMed
Bellack, A.S., Mueser, K.T., Douglas, M., Bennett, M. (1981). Social problem solving assessment battery. Philadelphia, PA: Medical College of PA/EPPI, Department of Psychiatry.Google Scholar
Bora, E., Eryavuz, A., Kayahan, B., Sungu, G., Veznedaroglu, B. (2006). 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 Research, 145, 95103.CrossRefGoogle ScholarPubMed
Bozikas, V.P., Kosmidis, M.H., Kafantari, A., Gamvrula, K., Vasiliadou, E., Petrikis, P., Karavatos, A. (2006). Community dysfunction in schizophrenia: Rate-limiting factors. Progress in Neuro-Psychopharmacology and Biological Psychiatry, 30, 463470.CrossRefGoogle ScholarPubMed
Bozikas, V.P., Kosmidis, M.H., Kiosseoglou, G., Karavatos, A. (2006). Neuropsychological profile of cognitively impaired patients with schizophrenia. Comprehensive Psychiatry, 47, 136143.CrossRefGoogle ScholarPubMed
Brüne, M. (2005). Emotion recognition, theory of mind and social behavior in schizophrenia. Psychiatry Research, 133, 135147.CrossRefGoogle ScholarPubMed
Brüne, M., Abdel-Hamid, M., Lehmkämper, C., Sonntag, C. (2007). Mental state attribution, neuropsychological functioning, and psychopathology: What predicts poor social competence in schizophrenia best? Schizophrenia Research, 92, 151159.CrossRefGoogle ScholarPubMed
Brüne, M., Brüne-Cohrs, U. (2006). Theory of mind – evolution, ontogeny, brain mechanisms and psychopathology. Neuroscience and Biobehavioral Reviews, 30, 437455.CrossRefGoogle ScholarPubMed
Brunet, E., Sarfati, Y., Hardy-Bayle, M.C., Decety, J. (2003). Abnormalities of brain function during a nonverbal theory of mind task in schizophrenia. Neuropsychologia, 41, 15741582.CrossRefGoogle ScholarPubMed
Chouinard, G., Ross-Chouinard, A., Annable, L., Jones, B.D. (1980). Extrapyramidal rating scale. Canadian Journal of Neurological Sciences, 7, 233.Google Scholar
Corcoran, R., Mercer, G., Frith, C.D. (1995). Schizophrenia, symptomatology and social inference: Investigating theory of mind in schizophrenia. Schizophrenia Research, 17, 513.CrossRefGoogle ScholarPubMed
Dickinson, D., Coursey, R.D. (2002). Independence and overlap among neuropsychological correlates of community functioning in schizophrenia. Schizophrenia Research, 56, 161170.CrossRefGoogle Scholar
Donahoe, C.P., Carter, M.J., Bloem, W.D., Hirsch, G.L., Laasi, N., Wallace, C.J. (1990). Assessment of interpersonal problem solving skills. Psychiatry, 53, 329339.CrossRefGoogle ScholarPubMed
Drury, V.M., Birchwood, M., Robinson, M. (1998). Theory of mind skills during an acute episode of psychosis and following recovery. Psychological Medicine, 28, 11011112.CrossRefGoogle ScholarPubMed
Dworkin, R.H., Cornblatt, B.A., Friedmann, R., Kaplansky, L.M., Lewis, J.A., Rinaldi, A., Erlenmeyer-Kimling, L. (1993). Childhood precursors of affective versus social deficits in adolescents at risk for schizophrenia. Schizophrenia Bulletin, 19, 563577.CrossRefGoogle Scholar
Frith, C.D. (1992). The cognitive neuropsychology of schizophrenia. Hove, UK: Psychology Press.Google Scholar
Frith, C.D., Corcoran, R. (1996). Exploring theory of mind in people with schizophrenia. Psychological Medicine, 26, 521530.CrossRefGoogle ScholarPubMed
Green, M.F. (1996). What are the functional consequences of neuropsychological deficits in schizophrenia? American Journal of Psychiatry, 153, 321330.Google ScholarPubMed
Greig, T.S., Bryson, G.J., Bell, M.D. (2004). Theory of mind performance in schizophrenia: Diagnostic, symptom, and neuropsychological correlates. Journal of Nervous and Mental Disease, 192, 1218.CrossRefGoogle ScholarPubMed
Harrington, L., Langton, R.M., Siegert, R.J., McClure, J. (2005). Schizophrenia, theory of mind and persecutory delusions. Cognitive Neuropsychiatry, 10, 87104.CrossRefGoogle ScholarPubMed
Heaton, R.K., Gur, R.C., Mandal, M.K., Salloum, J.B., Gur, R.E., Scheider, F. (1993). Wisconsin Card Sorting Test: Revised and Expanded. Odessa, FL: Psychological Assessment Resources.Google Scholar
Janssen, I., Krabbendam, L., Jolles, J., van Os, J. (2003). Alterations in theory of mind in patients with schizophrenia and nonpsychotic relatives. Acta Psychiatrica Scandinavica, 108, 110117.CrossRefGoogle Scholar
Kay, S.R., Fiszbein, A., Opler, L.A. (1987). The Positive and Negative Syndrome Scale (PANSS) for Schizophrenia. Schizophrenia Bulletin, 13, 261276.CrossRefGoogle ScholarPubMed
Langdon, R., Coltheart, M., Ward, P.B., Catts, S.V. (2001). Mentalizing, executive planning and disengagement in schizophrenia. Cognitive Neuropsychiatry, 6, 81108.CrossRefGoogle Scholar
Langdon, R., Coltheart, M., Ward, P.B., Catts, S.V. (2002). Disturbed communication in schizophrenia: The role of poor pragmatics and poor mind-reading. Psychological Medicine, 32, 12731284.CrossRefGoogle ScholarPubMed
Leslie, A.M. (1987). Pretence and representation: The origins of ‘theory of mind’. Psychological Review, 94, 412426.CrossRefGoogle Scholar
Lykouras, E., Botsis, A., Oulis, P. (1994). The Positive and Negative Syndrome Scale (PANSS) (in Greek). Athens: Tsiveriotis Ed.Google Scholar
Mazza, M., De Risio, A., Tozzini, C., Roncone, R., Casacchia, M. (2003). Machiavellianism and theory of mind in people affected by schizophrenia. Brain and Cognition, 51, 262269.CrossRefGoogle ScholarPubMed
Mueser, K.T., Doonan, R., Penn, D.L., Blanchard, J.J., Bellack, A.S., Nishith, P., DeLeon, J. (1996). Emotion perception and social competence in chronic schizophrenia. Journal of Abnormal Psychology, 105, 271275.CrossRefGoogle ScholarPubMed
Patterson, T.L., Moscona, S., McKibbin, C.L., Davidson, K., Jeste, D.V. (2001). Social skills performance assessment among older patients with schizophrenia. Schizophrenia Research, 48, 351360.CrossRefGoogle ScholarPubMed
Penn, D.L., Mueser, K.T., Doonan, R., Nishith, P. (1995). Relations between social skills and ward behavior in chronic schizophrenia. Schizophrenia Research, 16, 225232.CrossRefGoogle ScholarPubMed
Penn, D.L., Mueser, K.T., Spaulding, W.D., Hope, D.A., Reed, D. (1995). Information processing and social competence in chronic schizophrenia. Schizophrenia Bulletin, 21, 269281.CrossRefGoogle ScholarPubMed
Pijnenborg, G.H.M., Withaar, F.K., Evans, J.J., van den Bosch, R.J., Timmerman, M.E., Brouwer, W.H. (2009). The predictive value of measures of social cognition for community functioning in schizophrenia: Implications for neuropsychological assessment. Journal of the International Neuropsychological Society, 15, 239247.CrossRefGoogle ScholarPubMed
Pinkham, A.E., Penn, D.L. (2006). Neuropsychological and social cognitive predictors of interpersonal skill in schizophrenia. Psychiatry Research, 143, 167178.CrossRefGoogle ScholarPubMed
Pollice, R., Roncone, R., Falloon, R.H., Mazza, M., DeRisio, A., Necozione, S., Casacchia, M. (2002). Is theory of mind in schizophrenia more strongly associated with clinical and social functioning than with neuropsychological deficits? Psychopathology, 35, 280288.Google Scholar
Sarfati, Y., Hardy-Bayle, M.C. (1999). How do people with schizophrenia explain the behavior of others? A study of mind and its relationship to thought and speech disorganization in schizophrenia. Psychological Medicine, 29, 613620.CrossRefGoogle ScholarPubMed
Sayers, M.D., Bellack, A.S., Wade, J.H., Bennett, M.E., Fong, P. (1995). An empirical method for assessing social problem solving in schizophrenia. Behavior Modification, 19, 267289.CrossRefGoogle ScholarPubMed
Schenkel, L.S., Spaulding, W.D., Silverstein, S.M. (2005). Poor premorbid social functioning and theory of mind deficit in schizophrenia: Evidence of reduced context processing? Journal of Psychiatry Research, 39, 499508.CrossRefGoogle ScholarPubMed
Shamay-Tsoory, S.G., Shur, S., Harari, H., Levkovitz, Y. (2007). Neuropsychological basis of impaired empathy in schizophrenia. Neuropsychology, 21, 431438.CrossRefGoogle Scholar
Sheehan, D.V., Lecrubier, Y., Sheeman, K.H., Amorim, P., Javans, J., Weiller, E., Dunbar, G.C. (1998). The Mini-Neuropsychiatric Interview (M.I.N.I.): The development and validation of a structured diagnostic psychiatric interview for DSM-IV and ICD-10. Journal of Clinical Psychiatry, 59, 2233.Google Scholar
Stroop, J.R. (1935). Studies of interference in series verbal reactions. Journal of Experimental Psychology, 18, 643662.CrossRefGoogle Scholar
Vlahou, C.H., Kosmidis, M.H. (2002). The Greek Trail Making Test: Preliminary normative data for clinical and research use. Psychology: Journal of Hellenic Psychological Society (in Greek), 9, 336352.Google Scholar
Wechsler, D. (1997). Manual for the Wechsler Adult Intelligence Scale-Third Edition. San Antonio, TX: Psychological Corporation.Google Scholar
Zafiri, M., Kosmidis, M.H. (2008). Effects of demographic characteristics on the “Stroop conflict”. Psychology: Journal of Hellenic Psychological Society, Special Issue: Psychometric assessment: Applications to neuropsychology and education (in Greek), 15, 319341.Google Scholar