Research Department of Cognitive Neuropsychiatry and Psychiatric Preventive Medicine, LWL University Hospital, Department of Psychiatry, Psychotherapy, and Preventive Medicine, Ruhr University Bochum, Germany.
Eur Psychiatry. 2012 Jul;27(5):358-64. doi: 10.1016/j.eurpsy.2010.10.002. Epub 2011 Feb 1.
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.
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.
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.
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.
尽管许多精神分裂症患者在心理状态归因能力方面存在障碍，但仍有相当数量的患者在心理状态归因任务中表现出正常或接近正常的水平。目前尚无研究分析在心理状态归因技能上存在一定程度保留的患者与心理化能力较差的患者之间的认知或行为差异。
为了研究“差”和“中等”心理化者的特征，58 名精神分裂症患者进行了心理状态归因任务、一般智力测试和两项执行功能测试。根据中位数分割程序定义“差”和“中等”心理化技能；患者组的中位数得分也在对照组的两个标准差内。此外，还对患者的社会行为技能和精神病理特征进行了评分。
在心理状态归因任务中表现正常或接近正常的患者的社会行为异常比心理化能力较差的患者（即使控制了智力）少，但在执行功能方面没有差异。中等心理状态表现者的紊乱和兴奋症状比差的表现者少。紊乱程度中介了心理状态归因对社会行为技能的影响。
具有（部分）保留心理化技能的精神分裂症患者在社交领域的行为问题比心理化能力较差的患者少。概念性紊乱中介了心理化技能对社会行为技能的预测，这表明紊乱患者可能需要特别关注社交认知技能训练。
