Department of Psychiatry, University of Muenster, School of Medicine, Albert-Schweitzer-Strasse 11, 48149 Muenster, Germany.
Schizophr Res. 2010 Jun;119(1-3):115-23. doi: 10.1016/j.schres.2009.12.015. Epub 2010 Jan 8.
There is substantial evidence for Theory of Mind (ToM) deficits in patients with schizophrenia. Many psychotic symptoms may best be understood in light of an impaired capacity to infer one's own and other persons' mental states and to relate those to executing behavior. The aim of our study was to investigate ToM abilities in first-episode schizophrenia patients and to analyze them in relation to neuropsychological and psychopathological functioning.
A modified Moving Shapes paradigm was used to assess ToM abilities in 23 first-episode patients with schizophrenia and 23 matched healthy controls. Participants had to describe animated triangles which moved (1) randomly, (2) goal-directed, or (3) in complex, socially interactive ways (ToM video sequences). Neuropsychological functioning, psychopathology, autistic and alexithymic features as well as empathetic abilities were correlated with ToM performance.
Compared to healthy controls, first-episode schizophrenia patients gave more incorrect descriptions and used less ToM-related vocabulary when responding to socially complex ToM video sequences. No group differences were revealed for videos with random movements. ToM abilities correlated significantly with positive symptoms, reasoning, verbal memory performance and verbal IQ, but not with empathetic abilities or autistic and alexithymic features. When controlling for reasoning, verbal memory performance and verbal IQ, the correctness of video descriptions was still significantly worse in schizophrenia patients.
The results of our study in first-episode schizophrenia patients underline recent findings on ToM deficits in the early course of schizophrenia. Only a moderate influence of neurocognitive deficits on ToM performance was observed. Impairment in ToM abilities seems to be predominantly independent of clinical state, alexithymia and empathy.
大量证据表明精神分裂症患者存在心理理论（Theory of Mind，ToM）缺陷。许多精神病症状可以通过推断自己和他人的心理状态以及将这些状态与执行行为联系起来的能力受损来更好地理解。我们的研究旨在调查首发精神分裂症患者的 ToM 能力，并分析其与神经认知和精神病理学功能的关系。
使用改良的移动形状范式评估 23 名首发精神分裂症患者和 23 名匹配的健康对照组的 ToM 能力。参与者必须描述移动的动画三角形（1）随机移动、（2）有目标导向移动或（3）以复杂的社交互动方式移动（ToM 视频序列）。将神经认知功能、精神病理学、自闭症和述情障碍特征以及同理心能力与 ToM 表现相关联。
与健康对照组相比，首发精神分裂症患者在回应社交复杂 ToM 视频序列时，给出的错误描述更多，使用的 ToM 相关词汇更少。对于随机运动的视频，两组之间没有差异。ToM 能力与阳性症状、推理、言语记忆表现和言语智商显著相关，但与同理心能力或自闭症和述情障碍特征无关。当控制推理、言语记忆表现和言语智商时，精神分裂症患者的视频描述正确性仍然明显较差。
我们对首发精神分裂症患者的研究结果强调了精神分裂症早期 ToM 缺陷的最新发现。仅观察到神经认知缺陷对 ToM 表现的中等影响。ToM 能力的损害似乎主要与临床状态、述情障碍和同理心无关。
