Sahl André C, Rognlien Henning F, Andreassen Ole A, Melle Ingrid, Ueland Torill, Vaskinn Anja
Norwegian Centre for Mental Disorders Research, Oslo University Hospital, Oslo, Norway.
Department of Psychology, University of Oslo, Oslo, Norway.
Nord J Psychiatry. 2023 May;77(4):329-335. doi: 10.1080/08039488.2022.2106512. Epub 2022 Aug 2.
Social cognitive impairment is common in schizophrenia, but it is unclear if it is present in individuals with high IQ. This study compared theory of mind (ToM) in schizophrenia participants with low or high IQ to healthy controls.
One hundred and nineteen participants (71 healthy controls, 17 high IQ (IQ ≥115), and 31 low IQ (IQ ≤95) schizophrenia participants) were assessed with the Movie for the Assessment of Social Cognition, providing scores for total, cognitive, and affective ToM, along with overmentalizing, undermentalizing, and no-mentalizing errors. IQ was measured with Wechsler Abbreviated Scale of Intelligence; clinical symptoms with the Positive and Negative Syndrome Scale.
Healthy controls performed better than the low IQ schizophrenia group for all ToM scores, and better than the high IQ schizophrenia group for the total score and under- and no-mentalizing errors. The high IQ group made fewer overmentalizing errors and had better total and cognitive ToM than the low IQ group. Their number of overmentalizing errors was indistinguishable from healthy controls.
Global ToM impairment was present in the low IQ schizophrenia group. Overmentalizing was not present in the high IQ group and appears related to lower IQ. Intact higher-level reasoning may prevent the high IQ group from making overmentalizing errors, through self-monitoring or inhibition. We propose that high IQ patients are chiefly impaired in lower-level ToM, whereas low IQ patients also have impaired higher-level ToM. Conceivably, this specific impairment could help explain the lower functioning reported in persons with intact IQ.
社会认知障碍在精神分裂症中很常见，但尚不清楚高智商个体中是否存在该障碍。本研究比较了低智商或高智商精神分裂症患者与健康对照者的心理理论（ToM）。
119名参与者（71名健康对照者、17名高智商（智商≥115）和31名低智商（智商≤95）的精神分裂症患者）接受了社会认知评估影片测试，以获取整体、认知和情感ToM得分，以及过度心理化、心理化不足和无心理化错误得分。使用韦氏简式智力量表测量智商；使用阳性和阴性症状量表评估临床症状。
在所有ToM得分方面，健康对照者的表现均优于低智商精神分裂症组，在总分以及心理化不足和无心理化错误方面，健康对照者的表现优于高智商精神分裂症组。高智商组的过度心理化错误较少，整体和认知ToM表现优于低智商组。他们的过度心理化错误数量与健康对照者无差异。
低智商精神分裂症组存在整体ToM损害。高智商组不存在过度心理化现象，且似乎与较低智商有关。完整的高级推理可能通过自我监测或抑制作用，使高智商组避免出现过度心理化错误。我们提出，高智商患者主要在较低水平的ToM方面受损，而低智商患者在较高水平的ToM方面也受损。可以想象，这种特定损害有助于解释智商正常者功能较低的情况。
