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Theory of mind deficits for processing counterfactual information in persons with chronic schizophrenia

Published online by Cambridge University Press:  12 August 2008

R. S. Kern ,
M. F. Green ,
A. P. Fiske ,
K. S. Kee ,
J. Lee ,
M. J. Sergi ,
W. P. Horan ,
K. L. Subotnik ,
C. A. Sugar  and
K. H. Nuechterlein
R. S. Kern*
Affiliation:
Department of Psychiatry and Biobehavioral Sciences, Geffen School of Medicine at UCLA, Los Angeles, CA, USA Department of Veterans Affairs VISN 22 Mental Illness Research, Education, and Clinical Center, Los Angeles, CA, USA
M. F. Green
Affiliation:
Department of Psychiatry and Biobehavioral Sciences, Geffen School of Medicine at UCLA, Los Angeles, CA, USA Department of Veterans Affairs VISN 22 Mental Illness Research, Education, and Clinical Center, Los Angeles, CA, USA
A. P. Fiske
Affiliation:
Department of Anthropology; Center for Culture, Brain, and Development; and Center for Behavior, Evolution, and Culture, University of California, Los Angeles, CA, USA
K. S. Kee
Affiliation:
Department of Psychiatry and Biobehavioral Sciences, Geffen School of Medicine at UCLA, Los Angeles, CA, USA Department of Veterans Affairs VISN 22 Mental Illness Research, Education, and Clinical Center, Los Angeles, CA, USA California State University, Channel Islands, CA, USA
J. Lee
Affiliation:
Department of Psychiatry and Biobehavioral Sciences, Geffen School of Medicine at UCLA, Los Angeles, CA, USA Department of Veterans Affairs VISN 22 Mental Illness Research, Education, and Clinical Center, Los Angeles, CA, USA
M. J. Sergi
Affiliation:
Department of Psychiatry and Biobehavioral Sciences, Geffen School of Medicine at UCLA, Los Angeles, CA, USA Department of Veterans Affairs VISN 22 Mental Illness Research, Education, and Clinical Center, Los Angeles, CA, USA California State University, Northridge, CA, USA
W. P. Horan
Affiliation:
Department of Psychiatry and Biobehavioral Sciences, Geffen School of Medicine at UCLA, Los Angeles, CA, USA Department of Veterans Affairs VISN 22 Mental Illness Research, Education, and Clinical Center, Los Angeles, CA, USA
K. L. Subotnik
Affiliation:
Department of Psychiatry and Biobehavioral Sciences, Geffen School of Medicine at UCLA, Los Angeles, CA, USA
C. A. Sugar
Affiliation:
Department of Biostatistics, UCLA School of Public Health, Los Angeles, CA, USA
K. H. Nuechterlein
Affiliation:
Department of Psychiatry and Biobehavioral Sciences, Geffen School of Medicine at UCLA, Los Angeles, CA, USA Department of Psychology, University of California, Los Angeles, CA, USA
*
*Address for correspondence: R. S. Kern, Ph.D., VA Greater Los Angeles Healthcare System (MIRECC 210 A), Building 210, Room 116, 11301 Wilshire Blvd, Los Angeles, CA 90073, USA. (Email: rkern@ucla.edu)
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Abstract

Background

Interpersonal communication problems are common among persons with schizophrenia and may be linked, in part, to deficits in theory of mind (ToM), the ability to accurately perceive the attitudes, beliefs and intentions of others. Particular difficulties might be expected in the processing of counterfactual information such as sarcasm or lies.

Method

The present study included 50 schizophrenia or schizo-affective out-patients and 44 demographically comparable healthy adults who were administered Part III of The Awareness of Social Inference Test (TASIT; a measure assessing comprehension of sarcasm versus lies) as well as measures of positive and negative symptoms and community functioning.

Results

TASIT data were analyzed using a 2 (group: patients versus healthy adults)×2 (condition: sarcasm versus lie) repeated-measures ANOVA. The results show significant effects for group, condition, and the group×condition interaction. Compared to controls, patients performed significantly worse on sarcasm but not lie scenes. Within-group contrasts showed that patients performed significantly worse on sarcasm versus lie scenes; controls performed comparably on both. In patients, performance on TASIT showed a significant correlation with positive, but not negative, symptoms. The group and interaction effects remained significant when rerun with a subset of patients with low-level positive symptoms. The findings for a relationship between TASIT performance and community functioning were essentially negative.

Conclusions

The findings replicate a prior demonstration of difficulty in the comprehension of sarcasm using a different test, but are not consistent with previous studies showing global ToM deficits in schizophrenia.

Keywords

Counterfactual informationdeceptionsarcasmschizophreniatheory of mind
Type
Original Articles
Information
Psychological Medicine , Volume 39 , Issue 4 , April 2009 , pp. 645 - 654
Copyright
Copyright © 2008 Cambridge University Press

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