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High-functioning autism patients share similar but more severe impairments in verbal theory of mind than schizophrenia patients

Published online by Cambridge University Press:  18 September 2017

L. N. W. Tin ,
S. S. Y. Lui ,
K. K. Y. Ho ,
K. S. Y. Hung ,
Y. Wang ,
H. K. H. Yeung ,
T. Y. Wong ,
S. M. Lam ,
R. C. K. Chan  and
E. F. C. Cheung
L. N. W. Tin
Affiliation:
Castle Peak Hospital, Hong Kong Special Administrative Region, China
S. S. Y. Lui*
Affiliation:
Castle Peak Hospital, Hong Kong Special Administrative Region, China Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
K. K. Y. Ho
Affiliation:
Castle Peak Hospital, Hong Kong Special Administrative Region, China
K. S. Y. Hung
Affiliation:
Castle Peak Hospital, Hong Kong Special Administrative Region, China
Y. Wang
Affiliation:
Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China
H. K. H. Yeung
Affiliation:
Castle Peak Hospital, Hong Kong Special Administrative Region, China
T. Y. Wong
Affiliation:
Castle Peak Hospital, Hong Kong Special Administrative Region, China RWTH Aachen University, Aachen, Germany
S. M. Lam
Affiliation:
Castle Peak Hospital, Hong Kong Special Administrative Region, China
R. C. K. Chan
Affiliation:
Neuropsychology and Applied Cognitive Neuroscience Laboratory, CAS Key Laboratory of Mental Health, Institute of Psychology, Chinese Academy of Sciences, Beijing, China Department of Psychology, University of Chinese Academy of Sciences, Beijing, China
E. F. C. Cheung
Affiliation:
Castle Peak Hospital, Hong Kong Special Administrative Region, China
*
Author for correspondence: Simon S Y Lui, E-mail: [email protected]
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Abstract

Background

Evidence suggests that autism and schizophrenia share similarities in genetic, neuropsychological and behavioural aspects. Although both disorders are associated with theory of mind (ToM) impairments, a few studies have directly compared ToM between autism patients and schizophrenia patients. This study aimed to investigate to what extent high-functioning autism patients and schizophrenia patients share and differ in ToM performance.

Methods

Thirty high-functioning autism patients, 30 schizophrenia patients and 30 healthy individuals were recruited. Participants were matched in age, gender and estimated intelligence quotient. The verbal-based Faux Pas Task and the visual-based Yoni Task were utilised to examine first- and higher-order, affective and cognitive ToM. The task/item difficulty of two paradigms was examined using mixed model analyses of variance (ANOVAs). Multiple ANOVAs and mixed model ANOVAs were used to examine group differences in ToM.

Results

The Faux Pas Task was more difficult than the Yoni Task. High-functioning autism patients showed more severely impaired verbal-based ToM in the Faux Pas Task, but shared similar visual-based ToM impairments in the Yoni Task with schizophrenia patients.

Conclusions

The findings that individuals with high-functioning autism shared similar but more severe impairments in verbal ToM than individuals with schizophrenia support the autism–schizophrenia continuum. The finding that verbal-based but not visual-based ToM was more impaired in high-functioning autism patients than schizophrenia patients could be attributable to the varied task/item difficulty between the two paradigms.

Keywords

High-functioning autismmentalisingschizophreniatheory of mind
Type
Original Articles
Information
Psychological Medicine , Volume 48 , Issue 8 , June 2018 , pp. 1264 - 1273
Copyright
Copyright © Cambridge University Press 2017 

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References

American Psychiatric Association (2000) Diagnostic and Statistical Manual of Mental Disorders: DSM-IV-TR. Washington, DC: American Psychiatric Association.Google Scholar
American Psychiatric Association (2013) Diagnostic and Statistical Manual of Mental Disorders, 5th edn. Washington, DC: American Psychiatric Association.Google Scholar
Annett, M (1970) A classification of hand preference by association analysis. British Journal of Psychology 61, 303–321.Google Scholar
Baron-Cohen, S (1995) Mindblindness: An Essay on Autism and ‘Theory of Mind’. Cambridge, Mass.: MIT Press.Google Scholar
Baron-Cohen, S (2001) Theory of mind in normal development and autism. Prisme 34, 174–183.Google Scholar
Bastiaansen, JA, Meffert, H, Hein, S, Huizinga, P, Ketelaars, C, Pijnenborg, M, Bartels, A, Minderaa, R, Keysers, C, de Bildt, A (2011) Diagnosing autism spectrum disorders in adults: the use of Autism Diagnostic Observation Schedule (ADOS) module 4. Journal of Autism and Developmental Disorders 41, 1256–1266.Google Scholar
Bora, E, Yucel, M, Pantelis, C (2009) Theory of mind impairment in schizophrenia: meta-analysis. Schizophrenia Research 109, 1–9.CrossRefGoogle ScholarPubMed
Bowler, DM (1992) ‘Theory of mind’ in Asperger's syndrome. Journal of Child Psychology and Psychiatry 33, 877–893.Google Scholar
Blakemore, SJ (2008) The social brain in adolescence. Nature Reviews Neuroscience 9, 267–277.Google Scholar
Bliksted, V, Ubukata, S, Koelkebeck, K (2016) Discriminating autism spectrum disorders from schizophrenia by investigation of mental state attribution on an on-line mentalizing task: a review and meta-analysis. Schizophrenia Research 171, 16–26.Google Scholar
Burnett, S, Sebastian, C, Cohen Kadosh, K, Blakemore, SJ (2011) The social brain in adolescence: evidence from functional magnetic resonance imaging and behavioural studies. Neuroscience and Biobehavioral Reviews 35, 1654–1664.Google Scholar
Chan, RC, Chen, EY, Law, CW (2006) Specific executive dysfunction in patients with first-episode medication-naïve schizophrenia. Schizophrenia Research 82, 51–64.Google Scholar
Chapman, LJ, Chapman, JP (1973) Problems in the measurement of cognitive deficit. Psychological Bulletin 79, 380–385.Google Scholar
Cheung, C, Yu, K, Fung, G, Leung, M, Wong, C, Li, Q, Sham, P, Chua, S, McAlonan, G (2010) Autistic disorders and schizophrenia: related or remote? An anatomical likelihood estimation. PLoS ONE 5, e12233.Google Scholar
Chung, YS, Barch, D, Strube, M (2014) A meta-analysis of mentalizing impairments in adults with schizophrenia and autism spectrum disorder. Schizophrenia Bulletin 40, 602–616.CrossRefGoogle ScholarPubMed
Couture, SM, Penn, DL, Losh, M, Adolphs, R, Hurley, R, Piven, J (2010) Comparison of social cognitive functioning in schizophrenia and high functioning autism: more convergence than divergence. Psychological Medicine 40, 569–579.Google Scholar
Craig, JS, Hatton, C, Craig, FB, Bentall, RP (2004) Persecutory beliefs, attributions and theory of mind: comparison of patients with paranoid delusions, Asperger's syndrome and healthy controls. Schizophrenia Research 69, 29–33.Google Scholar
Daniels, JL, Forssen, U, Hultman, CM, Cnattingius, S, Savitz, DA, Feychting, M, Sparen, P (2008) Parental psychiatric disorders associated with autism spectrum disorders in the offspring. Paediatrics 121, 1357–1362.Google Scholar
Evans, JJ, Chua, SE, McKenna, PJ, Wilson, BA (1997) Assessment of the dysexecutive syndrome in schizophrenia. Psychological Medicine 27, 635–646.Google Scholar
First, MB, Spitzer, RL, Gibbon, M, Williams, JBW (1996) Structured Clinical Interview for DSM-IV (SCID-I) (User's Guide and Interview) Research Version. New York: Biometrics Research Institute, New York State Psychiatric Institute.Google Scholar
Frith, CD (1992) The cognitive neuropsychology of schizophrenia. Hillsdale, NJ: Lawrence Erlbaum Associates Ltd.Google Scholar
Gardner, DM, Murphy, AL, O'Donnell, H, Centorrino, F, Baldessarini, RJ (2010) International consensus study of antipsychotic dosing. American Journal of Psychiatry 167, 686–693.Google Scholar
Gong, YX (1992) Manual of Wechsler Adult Intelligence Scale-Chinese Version. Changsha: Chinese Map Press.Google Scholar
Ho, KKY, Lui, SSY, Hung, KSY, Wang, Y, Li, Z, Cheung, EFC, Chan, RCK (2015) Theory of mind impairments in patients with first-episode schizophrenia and their unaffected siblings. Schizophrenia Research 166, 1–8.Google Scholar
Hynes, CA, Baird, AA, Grafton, ST (2006) Differential role of the orbital frontal lobe in emotional versus cognitive perspective-taking. Neuropsychologia 44, 374–383.CrossRefGoogle ScholarPubMed
Kay, SR, Fiszbein, A, Opler, L (1987) The positive and negative syndrome scale for schizophrenia. Schizophrenia Bulletin 13, 261–276.Google Scholar
King, BH, Lord, C (2011) Is schizophrenia on the autism spectrum? Brain Research 1380, 34–41.Google Scholar
Kolvin, I (1971) Studies in the childhood psychoses. I. Diagnostic criteria and classification. British Journal of Psychiatry 118, 381–384.Google Scholar
Kolvin, I, Ounsted, C, Humphrey, M, McNay, A (1971) Studies in the childhood psychoses. II. The phenomenology of childhood psychoses. British Journal of Psychiatry 118, 385–395.CrossRefGoogle ScholarPubMed
Lai, CL, Lau, Z, Lui, SY, Lok, E, Tam, V, Chan, Q, Cheng, KM, Lam, SM, Cheung, EFC (2016) Meta-analysis of neurocognitive measures of functioning of children and adolescents with high-functioning autism spectrum disorders. Autism Research 10, 911–939.Google Scholar
Larsson, HJ, Eaton, WW, Madsen, KM, Vestergaard, M, Olesen, AV, Agerbo, E, Schendel, D, Thorsen, P, Mortensen, PB (2005) Risk factors for autism: perinatal factors, parental psychiatric history, and socioeconomic status. American Journal of Epidemiology 161, 916–925.Google Scholar
Lugnegård, T, Unenge Hallerbäck, M, Hjärthag, F, Gillberg, C (2013) Social cognition impairments in Asperger syndrome and schizophrenia. Schizophrenia Research 143, 277–284.CrossRefGoogle ScholarPubMed
Marx, J (2007) Behavioral genetics. Evidence linking DISC1 gene to mental illness builds. Science 318, 1062–1063.CrossRefGoogle ScholarPubMed
Murphy, D (2006) Theory of mind in Asperger's syndrome, schizophrenia and personality disordered forensic patients. Cognitive Neuropsychiatry 11, 99–111.Google Scholar
Norman, RM, Malla, AK (2001) Duration of untreated psychosis: a critical examination of the concept and its importance. Psychological Medicine 31, 381–400.CrossRefGoogle ScholarPubMed
Ozguven, HD, Oner, O, Baskak, B, Oktem, F, Olmez, S, Munir, K (2010) Theory of mind in schizophrenia and Asperger's syndrome: relationship with negative symptoms. Bulletin of Clinical Psychopharmacology 20, 5–13.Google Scholar
Pickup, GJ, Frith, CD (2001) Theory of mind impairments in schizophrenia: symptomatology, severity and specificity. Psychological Medicine 31, 207–220.Google Scholar
Pilowsky, T, Yirmiya, N, Arbelle, S, Mozes, T (2000) Theory of mind abilities of children with schizophrenia, children with autism, and normally developing children. Schizophrenia Research 42, 145–155.Google Scholar
Poletti, M, Enrici, I, Adenzato, M (2012) Cognitive and affective theory of mind in neurodegenerative diseases: neuropsychological, neuroanatomical and neurochemical levels. Neuroscience and Biobehavioral Reviews 36, 2147–2164.Google Scholar
Sasson, NJ, Pinkham, AE, Carpenter, KLH, Belger, A (2011) The benefit of directly comparing autism and schizophrenia for revealing mechanisms of social cognitive impairment. Journal of Neurodevelopmental Disorders 3, 87–100.Google Scholar
Sebastian, CL, Fontaine, NMG, Bird, G, Blakemore, SJ, De brito, SA, Mccrory, EJP, Viding, E (2012) Neural processing associated with cognitive and affective theory of mind in adolescents and adults. Social Cognitive and Affective Neuroscience 7, 53–63.Google Scholar
Shamay-Tsoory, SG (2008) Recognition of ‘fortune of others’ emotions in asperger syndrome and high functioning autism. Journal of Autism and Developmental Disorders 38, 1451–1461.Google Scholar
Shamay-Tsoory, SG, Aharon-Peretz, J, Levkovitz, Y (2007b) The neuroanatomical basis of affective mentalizing in schizophrenia: comparison of patients with schizophrenia and patients with localized prefrontal lesions. Schizophrenia Research 90, 274–283.Google Scholar
Shamay-Tsoory, SG, Aharon-Peretz, J, Perry, D (2009) Two systems for empathy: a double dissociation between emotional and cognitive empathy in inferior frontal gyrus versus ventromedial prefrontal lesions. Brain 132, 617–627.Google Scholar
Shamay-Tsoory, SG, Shur, S, Barcai-Goodman, L, Medlovich, S, Harari, H, Levkovitz, Y (2007a) Dissociation of cognitive from affective components of theory of mind in schizophrenia. Psychiatry Research 149, 11–23.Google Scholar
Sheitman, BB, Kraus, JE, Bodfish, JW, Carmel, H (2004) Are the negative symptoms of schizophrenia consistent with an autistic spectrum illness? Schizophrenia Research 69, 119–120.Google Scholar
Stone, VE, Baron-Cohen, S, Knight, RT (1998) Frontal lobe contributions to theory of mind. Journal of Cognitive Neuroscience 10, 640–656.Google Scholar
Viñas-Jornet, M, Esteba-Castillo, S, Gabau, E, Ribas-Vidal, N, Baena, N, San, J, Ruiz, A, Coll, MD, Novell, R, Guitart, M (2014) A common cognitive, psychiatric, and dysmorphic phenotype in carriers of NRXN1 deletion. Molecular Genetics and Genomic Medicine 2, 512–521.Google Scholar
Volkmar, F, Siegel, M, Woodbury-Smith, M, King, B, McCracken, J, State, M, American Academy of Child and Adolescent Psychiatry Committee on Quality Issues (CQI) (2014) Practice parameter for the assessment and treatment of children and adolescents with autism spectrum disorder. Journal of the American Academy of Child and Adolescent Psychiatry 53, 237–257.Google Scholar
Volkmar, FR, Cohen, DJ (1991) Comorbid association of autism and schizophrenia. American Journal of Psychiatry 148, 1705–1707.Google Scholar
Völlm, BA, Taylor, AN, Richardson, P, Corcoran, R, Stirling, J, McKie, S, Deakin, JF, Elliott, R (2006) Neuronal correlates of theory of mind and empathy: a functional magnetic resonance imaging study in a nonverbal task. NeuroImage 29, 90–98.Google Scholar
Zhu, CY, Lee, TMC, Li, XS, Jing, SC, Wang, YG, Wang, K (2007) Impairments of social cues recognition and social functioning in Chinese people with schizophrenia. Psychiatry and Clinical Neurosciences 61, 149–158.Google Scholar