Institute of Allied Health Sciences, College of Medicine, National Cheng Kung University, Tainan 701401, Taiwan.
Department of Occupational Therapy, Shu-Zen Junior College of Medicine and Management, Kaohsiung 821004, Taiwan.
Int J Environ Res Public Health. 2021 Jul 4;18(13):7172. doi: 10.3390/ijerph18137172.
Adults with schizophrenia usually have impairments in theory of mind (ToM), which subsequently cause them problems in social interaction. Therefore, it is important for healthcare providers to assess their ToM using adequate measures. This systematic review evaluated current ToM measures (or ToM tasks) for adults with schizophrenia and summarized their specific characteristics, including the concept and construct, administration, and psychometric properties. From a review of 117 articles, 13 types of ToM tasks were identified, and the findings from these articles were qualitatively synthesized. The results showed that ToM tasks are diverse in their presentation modalities, answer modes, strategies of controlling cognitive confounders, and scoring. Most tasks employ cognitive and affective dimensions and target a specific, single ToM concept. The present systematic review found that psychometric evidence supporting the ToM tasks, such as internal consistency, test-retest reliability, unidimensionality, and convergent, criterion, and ecological validities, is insufficient. Based on the results, we propose several principles for selecting appropriate ToM tasks in practice, e.g., selecting a task with multiple ToM concepts, or an exclusive ToM construct containing the cognitive and affective dimensions. Moreover, future studies are needed to provide more psychometric evidence on each type of ToM task applied in people with schizophrenia.
成年人精神分裂症患者通常存在心理理论（ToM）缺陷，这会导致他们在社交互动中出现问题。因此，医疗保健提供者使用适当的措施评估他们的 ToM 非常重要。本系统评价评估了针对精神分裂症成年患者的当前 ToM 测量方法（或 ToM 任务），并总结了它们的具体特征，包括概念和结构、实施和心理计量学特性。通过对 117 篇文章的回顾，确定了 13 种 ToM 任务，并对这些文章的结果进行了定性综合。结果表明，ToM 任务在呈现方式、回答方式、认知混淆控制策略和评分方面存在多样性。大多数任务采用认知和情感维度，针对特定的、单一的 ToM 概念。本系统评价发现，支持 ToM 任务的心理计量学证据，如内部一致性、重测信度、单维性、收敛性、标准和生态有效性不足。基于这些结果，我们提出了在实践中选择适当的 ToM 任务的几个原则，例如选择具有多个 ToM 概念的任务，或包含认知和情感维度的独特 ToM 结构。此外，需要进一步研究提供每种类型的 ToM 任务在精神分裂症患者中的心理计量学证据。
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