Department of Psychiatry, National Institute of Mental Health and Neuro Sciences (NIMHANS), Bangalore, India.
Aust N Z J Psychiatry. 2014 Mar;48(3):249-58. doi: 10.1177/0004867413500350. Epub 2013 Aug 8.
Schizophrenia patients experience impairments across various functional roles. Emotional unresponsiveness and an inability to foster intimacy and display affection may lead to impairments in parenting. A comprehensive cognitive understanding of parenting abilities in schizophrenia has the potential to guide newer treatment strategies. As part of a larger study on functional ability in schizophrenia patients, we attempted a cognitive deconstruction of their parenting ability.
Sixty-nine of the 170 patients who participated in a study on social cognition in remitted schizophrenia were parents (mean age of their children: 11.8 ± 6.2 years). They underwent comprehensive assessments for neurocognition, social cognition (theory of mind, emotion processing, social perception and attributional bias), motivation and insight. A rater blind to their cognitive status assessed their social functioning using the Groningen Social Disabilities Schedule. We examined the association of their functional ability (active involvement and affective relationship) in the parental role with their cognitive performance as well as with their level of insight and motivation.
Deficits in first- and second-order theory of mind (t = 2.57, p = 0.01; t = 3.2, p = 0.002, respectively), speed of processing (t = 2.37, p = 0.02), cognitive flexibility (t = 2.26, p = 0.02) and motivation (t = 2.64, p = 0.01) had significant association with parental role dysfunction. On logistic regression, second-order theory of mind emerged as a specific predictor of parental role, even after controlling for overall functioning scores sans parental role.
Second-order theory of mind deficits are specifically associated with parental role dysfunction of patients with schizophrenia. Novel treatment strategies targeting theory of mind may improve parenting abilities in individuals with schizophrenia.
精神分裂症患者在各种功能角色中都存在障碍。情感反应迟钝，无法培养亲密关系和表达情感，可能导致育儿能力受损。对精神分裂症患者育儿能力的全面认知有助于指导新的治疗策略。作为精神分裂症患者功能能力的更大研究的一部分，我们尝试对他们的育儿能力进行认知解构。
在一项缓解期精神分裂症患者社会认知的研究中，170 名患者中有 69 名是父母（他们孩子的平均年龄为 11.8 ± 6.2 岁）。他们接受了神经认知、社会认知（心理理论、情绪处理、社会感知和归因偏见）、动机和洞察力的全面评估。一位对他们认知状况不知情的评估者使用格罗宁根社会残疾量表评估他们的社会功能。我们研究了他们在父母角色中的功能能力（积极参与和情感关系）与他们的认知表现以及他们的洞察力和动机水平之间的关系。
在第一级和第二级心理理论（t=2.57，p=0.01；t=3.2，p=0.002）、加工速度（t=2.37，p=0.02）、认知灵活性（t=2.26，p=0.02）和动机（t=2.64，p=0.01）方面存在缺陷与父母角色功能障碍有显著关联。在逻辑回归中，即使在不考虑父母角色的整体功能评分的情况下，第二级心理理论也成为父母角色的特定预测指标。
第二级心理理论缺陷与精神分裂症患者的父母角色功能障碍有特定关联。针对心理理论的新型治疗策略可能会提高精神分裂症患者的育儿能力。
